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Sunday, January 31, 2010

Class Action Filed Against FORBA Small Smiles

.... or as it's put in Cause number

3:10-cv-00172-JGC
IN THE U.S. DISTRICT COURT
FOR THE NORTHERN DISTRICT OF OHIO
WESTERN DIVISION
Defendants:

FORBA HOLDINGS,
LLC; FORBA SERVICES, INC.;
SMALL SMILES HOLDING
COMPANY, LLC; SMALL
SMILES OF TOLEDO
LLC; JOHN/JANE DOES 1
THROUGH 75 (Identities and
addresses unknown)
Defendants.

A class action suit was filed January 25, 2010.

Here are a few excerpts of the Complaint:

1. This case arises out of Defendants’ nationwide conspiracy to perform medically
unnecessary dental procedures and use unnecessary or excessive nitrous oxide sedation and physical restraints upon children at their pediatric dental clinics located in at least 23 states, in order to defraud their parents/guardians and third party payors, and obtain additional compensation.


2. Through this action, Plaintiff and others similarly situated seek recovery for damages
stemming from said conspiracy and fraud, including, but not limited to, medical expenses, pain
and suffering, severe emotional distress, trauma and psychological injuries.

....Plaintiff further proposes the following subclass:
Any child and/or the parent/guardian of any child who resided in the State of Ohio and received medically unnecessary or excessive treatment, x-rays, sedation and/or restraints at any of Defendant’s Ohio clinics.



....As to this subclass, Plaintiff asserts Ohio state law claims, including, but not limited to,
claims for fraud, Ohio RICO, assault and battery, intentional and/or negligent infliction of
emotional distress, violations of Ohio’s Consumer Sales Practices Act, loss of consortium and
punitive damages.


...There are common questions of law and fact in the action that relate to and affect the rights of each Class member, and include, but are not limited to:
a. Whether Defendants issued and enforced through their nationwide clinics
guidelines, policies, procedures, practices and “billing production goals” that
were specifically designed to defraud their minor patients’ unsuspecting
parents/guardians and third party payors by performing medically unnecessary
and painful dental procedures and/or x-rays upon the children, including, but not
necessarily limited to, pulpotomies (baby root canals), extractions, filings,
crowns, and improperly, unnecessarily or excessively using nitrous oxide sedation,
physical restraints and/or behavior management techniques on the children during
surgery in order to obtain additional compensation.



For example, upon information and belief, during their training in Pueblo, Colorado,
employees of the nationwide clinics, including, but not limited to, employees of Defendant Small
Smiles of Toledo, LLC, were taught Defendants’ policy called, “conversion.” “Conversion” was
a term used by Defendants to describe their attempt to convert their routine care Medicaid eligible patients to patients receiving medically unnecessary procedures beyond routine checkups
and cleanings. Specifically, employees were taught that it was Defendants’ policy to
“convert” all child patients requiring simple cleanings and check-ups into child patients requiring
extensive and more expensive additional procedures, such as pulpotomies, the dental process of
removing pulp from the pulp chambers of the teeth, and the implant of steel crowns.
Defendants’ employees were taught and in fact performed pulpotomies, and then placed steel
crowns over the teeth instead of installing simple fillings, which is the usual procedure, in order
to obtain additional and more expensive grounds to bill the patients’ parent/guardians and third
party payors.

You can read the Complaint in it's entirety here: Class Action Against FORBA /Small Smiles

Wednesday, January 27, 2010

New Mexico Join 22 Other States in $24 Million Settlement

New Mexico Attorney General Gary King announced today:

New Mexico joins 22 other states and the federal government to settle allegations against FORBA Holdings, LLC., a dental management company that provides management services to Small Smiles dental clinics nationwide. Under the agreement,FORBA agrees to pay the participating states and the United States $24 million, plus interest, to resolve allegations that it caused bills to be submitted to these states’ Medicaid programs for medically unnecessary dental services performed on children insured by Medicaid. Medicaid is funded jointly by the federal and state governments.

New Mexico will receive $361,970.88 under the settlement, which is less than the amount the SIC (State Investment Counsel)invested in Small Smiles. That investment was made under the New Mexico Private Equity Investment Program, a venture capital initiative designed for New Mexico start-ups. As we revealed, though, Small Smiles was not a New Mexico company, but is owned by an Arabian investment bank. As the result of our reporting, the SIC removed Small Smiles from its list of New Mexico companies receiving equity investments, but has not recouped its investment.

Read complete story here.

Small Smiles Dentist's Still Abusive After $24 Million Settlement

A grandmother made this comment on a blog post this morning and thought it deserved being posted right up front. According to her this happened Mon. January 25, 2010. I advised her to contact HHS and report it. Personally I wouldn't waste my time with FORBA's hotline. If you call it, it's likely they will just have a heads up to cover up. You would think after the national attention Small Smiles got AGAIN last week, the dentists and assistants would have gotten the word to do better, guess not.

I have never had a problem with the billing situtation. But what about the nurses and Dentist that fill like they can get away with abuse toward our childern. I'm a grandmother raising 4 granddaughters all go to Small Smiles until today. My 10 year old has asthma they know this and also knows she is scared of Dentist and Doctor from treatment on her asthma. They have always been pretty good about calming her down and making her fill safe. But when a Dentist goes in and belittles her because she is crying and scared and another (the Dentist Assitant) grabbes her arms and shakes her back and forth and all 3 of them laugh at her afterwards. She then makes a comment "You will probably get me fired". My granddaughter tells the Dentist she needed her inhaler because she was having a hard time breathing, instead of getting her inhaler the Dentist tells her "I think your doing this just to get attention". Then she says " Let's all stare at her and give her the attention and see if she will stop crying". I ask again who is protecting our children behind closed doors at Small Smiles. I went up and talk to some supervisor and she pretty much said my granddaughter was lying.

Thursday, January 21, 2010

FORBA Forced To Change? Doubtful !

Reported by: Jane Flasch
Email: jflasch@13wham.com

1/21/2010

Rochester, N.Y. / Washington D.C. -- After 13WHAM News raised questions about the use of restraining devices and unnecessary root canals on children, the parent company of Small Smiles promised changes.

In a two-page statement, FORBA Dental Management CEO Michael Lindley detailed the changes including a reversal of a policy to never allow parents into the same room with their children while their teeth are being pulled or drilled. That was December 2007. Yet 13WHAM News has received a dozen e-mails from parents who say as recent as last month those policies were not in place.

Nadine Dukes says her 10-year-old daughter’s calls for “mom” were ignored. "She was screaming. I heard it, but I didn't know who it was. They never got me,” says Nadine. When she next saw her daughter Kitana six of her teeth were gone -- pulled out.

Fast forward three years. Small Smiles will pay a $24 million settlement to the US government, promising changes once again so its clinics won't be forced to close.

read more...


After a report by 9News in Denver reporter, Deborah Sherman and subsequent state investigation, of the Small Smiles clinics owned by the DeRose family, laws in Colorado were changed and took effect in 2005.

Strict guidelines were put in place to limit the number of root canals that could be done on a child in one office visit and when it's appropriate to use the dreadful papoose board. Yet here we are in 2010 and we find the Small Smiles Clinics and other clinics owned by Forba Holding, LLC are still mistreating, over-treating, and down right abusing children for profit.

Michael Lindley, Alfred Smith, Rodney Caywood of the Nashville, Tennessee area, Jack Draughon, William C. Miller, Jr. and Charles H. Ogburn of Atlanta, GA, Bowen Diehl of Dallas Tx and Charles Griffith of Englewood, Colorado should be tarred, feathered and ran out of town on a rail, after they write that $24 million dollar check to taxpayers. These people are listed as the 'Managers' of FORBA Holding, LLC 618 Church Street, Suite 520, Nashville, Tennessee.

Texas, Nebraska, Ohio, Colorado, Kansas and Kentucky Portions of 24 Million Dollar Settlement

Oklahoma to get $700,000 as it's part of the $24 million dollar settlement.

State to get $70K in case
Oklahoma will get $700,000 as part of an agreement with FORBA Holdings LLC to settle a Medicaid billing dispute. Oklahoma has joined 22 states in the deal with the dental management company. The states and federal government alleged FORBA billed state Medicaid programs for medically unnecessary dental services on children insured by Medicaid. Under the agreement, FORBA will pay the states and federal government $24 million, plus interest, and enter into a five-year corporate integrity agreement with the Department of Health and Human Services’ Office of the Inspector General. FORBA provided management services to Small Smiles dental clinics nationally, including three in Oklahoma.

JULIE BISBEE,



Nebraska to get $270,000.

Attorney General Jon Bruning announced today that Nebraska has joined twenty-two other states and the federal government to settle allegations against FORBA Holdings, LLC., a dental management company that provided management services to Small Smiles dental clinics nationwide.

Under the agreement, FORBA agreed to pay $24 million, plus interest, to resolve allegations that it billed state Medicaid programs for medically unnecessary dental services performed on children. Medicaid is funded jointly by the federal and state governments.

“Taking advantage of taxpayers is bad enough,” Bruning said. “But to do so by performing unneeded dental work on children will not be tolerated.”

Nebraska alleged that FORBA, which operates dental clinics under the name of “Small Smiles,” submitted claims for a wide range of dental services provided to low-income children that were either medically unnecessary or performed in a manner that failed to meet professionally-recognized standards of care.

Nebraska’s portion of the recovery is more than $270,000. In addition, FORBA has agreed to expanded oversight from the federal Department of Health and Human Services.

A team representing the National Association of Medicaid Fraud Control Units (NAMFCU) participated in the investigation and conducted settlement negotiations with FORBA on behalf of the settling states. Team members included representatives from Ohio and South Carolina. Nebraska Assistant Attorney General Mark Collins is the president of NAMFCU.

Courtesy: Nebraska Attorney General's Office


Texas gets $546,000 from FORBA settlement


Kansas to get $1.2 million.

My question here is, why are they in Kansas in the first place. Isn't corporate dental practices illegal in Kansas. Oh, wait, I forgot the story they tell...they don't own it. It's own by, ....well last person to be named as owner was Dr. Mohammad Akbar. Funny thing though, FORBA says it's 'firing' dentists over this. How can they fire dentists in clinics they just 'manage'? If I were to do the bookkeeping for a company that got into deep doo doo, I doubt I would have the power to fire the workers at the company.



Ohio will receive $2.3 million of the $24 million dollars. FORBA/Small Smiles settlement.

Ohio is taking a $2.3 million chunk of a $24 million multi-state settlement with a chain of pediatric dental clinics accused of making Medicaid foot the bill for unnecessary procedures.

Attorney General Richard Cordray on Wednesday said Ohio along with 22 other states and federal officials have struck a settlement with Nashville, Tenn.-based FORBA Holdings LLC, which runs the 23-state Small Smiles chain. In Ohio, the company has pediatric clinics in several cities, including locally in Roselawn and Colerain Township.




Kentucky gets $124,000 of the $24 million dollars.

Kentucky is one of 23 states that reached a $24 million settlement with a chain of pediatric dental clinics accused of billing Medicaid for unnecessary procedures.

Under the terms of the settlement, Kentucky will receive about $124,000 from Nashville, Tenn.-based FORBA Holdings LLC, the parent company of Small Smiles dental clinics. Of that settlement, about $44,000 will go to reimburse Kentucky’s Medicaid program, according to a news release.

In Louisville, Small Smiles has a clinic at 3438 Taylor Blvd. (Home of Dr. Melenie R. Abrams, DDS).

According to the release, some of the procedures billed to Medicaid included extractions, root canals, fillings and crowns. The company, which serves children in low-income families, also allegedly used improper techniques to restrain children.

Through the settlement, FORBA has signed an agreement to change policies at its clinics and establish procedures to detect and ultimately avoid performing unnecessary dental work.

FORBA said in a statement that the agreement “encourages us to continue to focus on vital, high-quality dental care for children in America’s low-income communities and allows us to build on the improvements implemented since the company was acquired in September 2006.”

The $24 million settlement is set to be paid out over a five-year period.



Colorado gets $1.2 million

Colorado is to receive $1.2 million as its share of a $24 million multistate settlement of a series of whistle-blower lawsuits against dental-management company

FORBA Holdings LLC, parent of the Small Smiles chain of pediatric dental clinics, state Attorney General John Suthers announced.

Nashville-based FORBA — which focuses on serving low-income children eligible for state-paid dental care benefits — had been accused in the suits of making Medicaid foot the bill for unnecessary procedures.

The 23-state settlement resulted from lawsuits filed in Maryland, Virginia and South Carolina.

The suits alleged FORBA submitted claims for reimbursement “for a wide range of dental services that were either medically unnecessary or performed in a manner that failed to meet professionally recognized standards of care,” Suthers’ office said in a statement.

As part of the settlement, FORBA signed an agreement to change policies at its clinics and establish procedures to detect and ultimately avoid performing unnecessary dental work.

In a statement Wednesday, FORBA said the agreement “encourages us to continue to focus on vital, high-quality dental care for children in America’s low-income communities, and allows us to build on the improvements implemented since the company was acquired in September 2006.”

FORBA was acquired in 2006 by Arcapita Bank, a Bahrain-based investment firm with an Atlanta-based U.S. unit,

The $24 million settlement is set to be paid out over a five-year period to states where FORBA has clinics.

In Colorado, FORBA operates Small Smiles outlets in Denver, Aurora, Thornton, Greeley, Colorado Springs and Pueblo, according to its website.











New York will get $1.1 million as it's share of the settlement. Steve Flamisch reports below.

Wednesday, January 20, 2010

The Announcement, $24 Mil. Settlement


All I can say, is WOO HOO!

After two plus years and hundreds of hours compiling info and haphazardly posting the bits of what I found here, as well as the great work by several reporters across the US, whose reports you find on this site. Justice has finally come.

After being sued in Federal Court by FORBA for libel, trade secrets and something else (been so long I forgot) (as one put it "I took a bullet for the cause.") Justice has finally come.

After staying strong, a few sleepless nights, and a lot of legal research, (felt like I could pass the bar exam before it was over) but I hung in there and wore them down to drop the suit. Justice has finally come.

Anything we've gone through to get this story told can NOT compare to the mental, physical and emotional abuse hundreds of thousands of children have suffered at the hands of these dentists and FORBA Holding, LLC and it's execs over the years, at least since 2003 and probably further back. My hope was the place would be shut down completely. That they would never get their hands on another child and not receive another penny of our tax dollars. I'm not sure what it's going to take to make that happen. Mike DeRose and Tish Ballance in the North Carolina offices were fined $10 mil two years ago, and Tish is right back at it, in Wayneboro, NC. (Carolina West Dental) and still living high.
FOR IMMEDIATE RELEASE
Wednesday, January 20, 2010
National Dental Management Company Pays $24 Million to Resolve Fraud Allegations
Medically Unnecessary Dental Services Allegedly Performed on Children

WASHINGTON - The United States today announced that it has settled False Claims Act allegations against FORBA Holdings LLC, a dental management company that provides business management and administrative services to 69 clinics nationwide known as "Small Smiles Centers." Under the agreement, FORBA will pay the United States and participating states $24 million, plus interest, to resolve allegations that it caused bills to be submitted to state Medicaid programs for medically unnecessary dental services performed on children insured by Medicaid, which is funded jointly by the federal and state governments. FORBA has further agreed to put in place various remedial measures designed to prevent similar unlawful conduct from occurring in the future. The government’s investigation of individual dentists is ongoing, and FORBA is cooperating with that investigation by providing information about dentists who may have violated professional standards.

The United States alleged that FORBA was liable for causing the submission of claims for reimbursement for a wide range of dental services provided to low-income children that were either medically unnecessary or performed in a manner that failed to meet professionally-recognized standards of care. These services included performing pulpotomies (baby root canals), placing crowns, administering anesthesia (including nitrous oxide), performing extractions, and providing fillings and/or sealants.

"We have zero tolerance for those who break the law to exploit needy children," said Tony West, Assistant Attorney General for the Civil Division of the Department of Justice. "Illegal conduct like this endangers a child’s well-being, distorts the judgments of health care professionals, and puts corporate profits ahead of patient safety."

Assistant Attorney General West praised the collaborative efforts of the federal and state agencies that made this result possible. The Justice Department’s Civil Division and the U.S. Attorneys’ Offices for the District of Maryland, the Western District of Virginia, the District of South Carolina, and the District of Colorado handled these cases. The Civil Division led the nationwide investigation, which was conducted by the Office of Inspector General for the Department of Health and Human Services, the Federal Bureau of Investigation, and the National Association of Medicaid Fraud Control Units.

To resolve the allegations against it, FORBA will pay $24 million, plus interest. The federal share of the civil settlement is $14,285,645, and the states’ Medicaid share is $9,714,355.25. In addition, as part of the settlement, FORBA has agreed to enter into an expansive five-year Corporate Integrity Agreement with the Office of Inspector General of the Department of Health and Human Services. The agreement provides for procedures and reviews to be put in place to avoid and promptly detect conduct similar to that which gave rise to this matter. Specifically, FORBA must engage external reviewers to monitor its quality of care and reimbursement processes. In addition, the chief dental officer must develop and implement policies and procedures to ensure that the Small Smiles clinics provide services consistent with professionally recognized standards of care. FORBA has also agreed to cooperate in the government’s continuing investigation of individual dentists.

"We will not tolerate Medicaid providers who prey on vulnerable children and seek unjust enrichment at taxpayers’ expense," said Daniel R. Levinson, Inspector General of the U.S. Department of Health and Human Services. "This settlement reaffirms our commitment to protect the health and well-being of Medicaid beneficiaries and to ensure the integrity of this essential health care program."

"Health care providers must be held accountable when they mistreat patients and overcharge insurers," said Rod J. Rosenstein, U.S. Attorney for the District of Maryland. "We are committed to using our affirmative civil enforcement authority to protect patients from inadequate care and protect governmental health coverage programs from fraudulent charges."

The government’s investigation was initiated by three lawsuits filed under the qui tam, or whistleblower, provisions of the False Claims Act, which permit private citizens to sue on behalf of the United States and share in any recovery. These actions are pending in the U.S. District Courts for the District of Maryland, the Western District of Virginia, and the District of South Carolina. As part of today’s resolution, the three whistleblowers will receive payments totaling more than $2.4 million from the federal share of the settlement.

"In this case, FORBA put greed and profits before the well-being of children," said Timothy J. Heaphy, U.S. Attorney for the Western District of Virginia. "It endangered the health and safety of innocent children and defrauded the taxpayer of millions of dollars. Today’s settlement addresses these egregious acts and sends a clear message that Medicaid fraud will be expeditiously addressed by this Department."

This settlement with FORBA is part of the government’s emphasis on combating health care fraud. One of the most powerful tools in that effort is the False Claims Act, which the Department of Justice has used to recover approximately $2.2 billion since January 2009 in cases involving fraud against federal health care programs. The Justice Department’s total recoveries in False Claims Act cases since January 2009 have topped $3 billion.

The settlement is to be paid over a 5 year period.


Here is FORBA's response. Never seen such a short statement in my life!!

“This comprehensive resolution encourages us to continue to focus on vital,
high-quality dental care for children in America’s low-income communities,
and allows us to build on the improvements implemented since the company
was acquired in September 2006. We look forward to fulfilling our
commitment to the dental health of underserved children for years to come.”


Nothing but empty words.

Tuesday, January 12, 2010

Small Smiles Dental Sexual Harrassment Suit Filed in 2006

I found this the other day and thought it was worth keeping in the Archives for later use.  Wasn't it the NM clinics where they were playing "wheel barrow", "69" and "chicken fight".  I bet if the plaintiff had these videos back when she sued, things might have turned out differently.  One of the videos is below, the others are here:

Employees at play 1
Employees at play 2

One last comment, someone was waaaaayyy off when they referred to Dan DeRose as a Dr! 

Suit targets alleged sexual harassment, discrimination
Sent on 26-09-2006.
The clinic, which caters to poor children, is one of many offices operated by Colorado-based FORBA. The company's attorney described the plaintiffs as four disgruntled former employees.
``We have conducted one thorough investigation of all of those exact allegations, as set forth in the letter from their attorney, and (found them to be) absolutely unsubstantiated,'' Joe Bower said. He said FORBA interviewed more than 20 employees at the St. Michael's Drive office, but no patients.
The attorney spoke on behalf of Drs. Patrick McQuitty and Melvin Takaki, who continue to work at the Santa Fe office; dental assistant Josh Neil, who now works at Small Smiles in Albuquerque; and Dr. Daniel DeRose, who works in the company's Colorado office.
_One dentist using physical force to stop patients from crying, on one occasion causing one child to gag.
_Dentists touching workers in one sexual manner, such as cupping one breast underneath one plaintiff's bra.
_Dentists groping themselves and making lewd sexual comments about workers and patients.
_One dentist engaging in sex on the job with consensual workers and maligning those who refused his advances.
Instruments were not properly sterilized between patients, the lawsuit says, and unqualified workers were allowed to write prescriptions and operate the X-ray machine.
``Absolutely, 100-percent untrue,'' Bower said. ``It's one general fabrication. Unbelievable.''
The women were fired out of retaliation and have suffered financially, the lawsuit says. Bower, however, said two were fired for allegedly violating attendance policies. He said the others resigned voluntarily.