Wednesday, June 22, 2011

Straight Smiles - Another illegal dental clinic owned and operated by Church Street Health Management opens in Worcester, MA


I hope the folks at “Straight Smiles” are paying real close attention to the Medicaid Orthodontics scams being exposed in Texas, since I’m sure that is exactly what this is as well, if not worse.

[honestly I can hardly even say “straight smiles” since I immediately think of “straight face” and how they keep one I’ll never know]

In the article below the “Lead Orthodontist” said about the patient she was examining:

“ Zulanihs had a loose tooth and small signs of a posterior cross bite. Although she was not ready for braces, interceptive treatment would widen the upper arch of her palette”

(her licenses say she is a “general dentist, searching the Dentaquest site for MA Orthodontists, there is only 2 in a 30 mile radius, and she is NOT one of them)

[she means a palatal expander as seen here and here ] hyraxmodelRPE

“If this wasn’t found or not acted upon, it could result in trauma as well as recession of her lower anterior teeth.” 

[trauma!  really? well dang good thing the child got in there in time to prevent such a trauma]

It really means we found something, ever so tiny and insignificant but I think I found something so we can bill the taxpayers of Massachusetts.

Is it legal?  Well, of course not.  However I asked a dear friend, a dentist, living in Massachusetts about having to be a “real” orthodontist and advertising as a “specialty” when you are NOT a specialist?  Here is their reply:

As for the ortho question, you are going to just love my unclear and muddled answer! In the wacky state of Massachusetts, general dentists can do ortho, provided that they can "perform to the same standards" as specialists. (If that truly is the case, then why would any Orthodontist spend the extra 2-3 years in residency?)
In medicine, that is almost like your ear/nose/throat guy deciding he'll take a swing at open heart surgery.
The regulations, as far as I'm aware mostly have prohibitions against advertising to the public as a specialist. This pretty much falls in line with the ADA position. Hope this helps.




This press release was made announcing the Straight Smiles in Worecester, MA.
Telegram and Gazette

By James Niedzinsk
June 6, 2011
WORCESTER —  When 8-year-old Zulanihs Huertas walked into Straight Smiles, she said she wasn’t scared and she thought the clinic “was pretty cool.”  After her dental scan, she picked out a toy folding fan for herself and one for her sister.

Zulanihs was among the children and their parents who attended the opening this week of Straight Smiles, an orthodontics clinic at 388 Park Ave. that serves those on the MassHealth health care plan. The clinic specializes in care of children’s teeth and is an offshoot of Small Smiles, a dental clinic for children in the Worcester area.

Free dental screenings were provided during the Straight Smiles grand opening.
“We focus our care on children who are uninsured and come from low-income families. We accept patients who do not have insurance as well as those who are on MassHealth,” said Dr. Angeline Y. Chan, (Chan-Kosie) lead orthodontist at Straight Smiles.

Lower-income and uninsured children often don’t get access to the care they need, said Dr. Chan. But the number of dentists and orthodontists in the Massachusetts Dental Society who accept patients who are uninsured or on MassHealth has risen in recent years. As of May, the MDS had 1,305 dentists accepting patients with MassHealth. Last year, the MDS had 1,254 members participating in MassHealth
Within the Worcester district, 141 members, or 42 percent, accept patients with MassHealth, according to Scott G. Davis, chief communications officer of the Massachusetts Dental Society. “We’ve been able to nearly double the number of MassHealth dental providers statewide over the past few years as a result of the MDS’ active recruitment efforts,” said Mr. Davis.

MassHealth, which provides health insurance to more than 1 million people in Massachusetts, is a necessity, according to state Sen. Harriette L. Chandler, D-Worcester. Many low-income or uninsured children rely on the program for oral care, she said.

“If we don’t provide oral health for a child at an early age, all kinds of problems can begin. The mouth is the window to the rest of the body,” Ms. Chandler said.
According to Dr. Chan, Zulanihs had a loose tooth and small signs of a posterior cross bite. Although she was not ready for braces, interceptive treatment would widen the upper arch of her palette, said Dr. Chan.

“If this wasn’t found or not acted upon, it could result in trauma as well as recession of her lower anterior teeth,” she said.  Some procedures performed at Straight Smiles include being fitted for braces as well as treating impacted teeth. Dr. Chan said the clinic would not be able to treat cases of a cleft lip or cleft palate because of their complicated nature.

Dr. Kevin M. Reilly, senior vice president of operations at Straight Smiles, said Straight Smiles was created because of space problems at Small Smiles, which was serving about 80 children a day. Straight Smiles handles the orthodontic-based work that was once done at Small Smiles.
Contact James Niedzinski by email at

[where are they getting those 80 children a day?]

DentaQuest, LLC a/k/a Doral is the subcontractor for the Dental Services of Massachusetts, Inc. 

Straight Smiles
388 Park Ave
Worcester, MA  10602

Massachusetts Corporation Search:
Straight Smiles of Worcester, PLLC
ID number 001050080
Organized 04-04-2011
388 Park Avenue
Worcester, MA
Name and business address of each manager: left blank
Name and business address of the person in addition to the manager who is authorized documents to be filed with the Corporations Division: Linda S. Zoeller, 618 Church Street, Nashville, Tennessee
Name and address of the person authorized to execute, acknowledge, deliver and record any  recordable instrument: Linda Zoeller, 618 Church Street, Nashville, Tennessee.

View the Certificate of Organization Here

In two places in the above document it says this place will deliver General Dentistry and the person’s “rendering” that service are Mareen George, DMD and Yogita Kanorwalla, DDS.

”List of the members/mangers who will render a professional services
in the Commonwealth and has attached the applicable regulating board that each member or manager who will render the services in the Commonwealth is duly licensed :”
[Call and try to get an appointment with “orthodontist” Mareen Geroge. (508) 798-6565]

Mareen George, DMD  290 Park Aveune, Worchester, MA 01609
Yogita Kanorwalla, DMD 378 Cooley Street, Five Town Plaza, Springfield, MA  01128

Business Address  Linda S. Zoeller 618 Church Street, Suite 520, Nashville, Tennessee 37219

Dental License Search Results:

Mareen George # DN20315
Shrewsbury, MA  01545-5034
Issue date: 07-14-2005
Facility Permit #DN2031550D  Issued May 30, 2008
Worcester, MA 01609-1805
Nitrous Oxide Permit DN2031520C (they have the number at the site transposed as 3051520C)

Yogita S. Kanorwalla # DN20652
Springfield, MA  01128
Issue date: 09-16-2002
Facility Permit DN20652550D  issued May 30, 2008
Nitrous Oxide Permit DN2065220C

Angeline Chan – Kosie #DN21406
Issue date: June 29, 2005
Somerville, MA  02144

Douglas Hart MacGilpin #DN1855071
Lawrence, MA  01843
Issue date 03-17-2009

Wendy E. Sharpe #DN14308
Springfield, MA  01104 1311
Issue date – 08-20-1979
She was on Probation from April 2009 to April 2010

So far there are only two dentists that have nitrous and facility permits!  Neither actually work at the facility. 

Orthodontic Service Codes range from D8000 to D8999

MassHealth Dental Reimbursement Rates
Pre-orthodontic treatment visits D8660 $31 a pop for children, only $22 for adults. The “Interceptive” orthodontic treatment Dr. Chan  mentions falls under the reimbursement I.C. which means:

”The Division will list these codes and apply individual consideration until appropriate rates can be developed. individual consideration (I.C.) reimbursement”

D8070 = $I.C.
D8080 = $1,143
D8090 = $ I.C.
In fact, most Orthodontic treatment falls under I.C. in MassHealth program on it’s January 2009 fee schedule. (the EPSDT is the chidlren’s fee schedule and Allowable Fee column is the adult fee schedule, it says so right here, about the middle of the page.

Medicaid Reimbursement for Rapid  Palatal Expanders  (RPE)
 MassHealth Dental Program Regulations are 130 CMR 450.105 and 420.000 which describe dental benefits, services limitations and member eligibility. 

New YorkInterceptive Orthodontic Treatment, page 27 Only Orthodontists are reimbursed for codes D8050, D8060 or removable appliance therapy D8210
The reimbursement rate is “BR” meaning the value is to be determined “by report”. So bill at your usual and customary amount and send us the info, and we’ll let you know.
Codes D8070, D8080 and D8090 are once in a lifetime treatments and may be billed with appliance has been placed and active treatment has initiated:

D8070 = $986.00
D8080 = $986.00
D8090 = $986.00
Pre-orthodontic treatment visits D8660 reimburse at $29.00 a pop

Related Information:

MassHealth – Office of Health and Human Services (EOHHS)

History of Medicaid Dental Care in Massachusetts:

1998- bipartisan Special Legislative Commission on Oral Health reported high risk population and compared ways to increase dental services for at-risk children.

2000-Commission released “The Oral Health Crisis in Massachusetts”  Core issue was that MassHelath dentists were withdrawing from the program due to low reimbursement.  And at the same time, the at-risk population was increasing.

2002 – Budget cuts eliminated adult Medicaid dental services.  The Oral Health advocacy Task Force was established..

2005- Court case filed by Health Care for All against Massachusetts saying the state was not meeting its federal statutory obligations under “Early and Periodic Screening, Diagnosis and Treatment.”  The court ordered the state to implement caseload capacity to allow MassHealth dentists to limit the number of MassHealth participants served by each practice.  The court also ordered MassHealth dental reimbursement rates for those under 21 years of age, be increased by $13,074,000.00 ($13.74 million) for fiscal year 2007 which began July 1, 2006.

Reimbursement rates for adult services covered about 1/2 the cost of care.  The Massachusetts Dental Society had a “Call to Action” and pledged at least 65% of their members would begin taking Medicaid patients by 2013.

2006 – Adult benefits were reinstated, expanding services to 540,000 adults.

2008- Catalyst Institute (Now DentaQuest Institute) reported massive cavities among school aged children across Massachusetts.  According to their estimates more than 1/4 of kindergartner in the state had cavities. 

[Wait just a minute, the very company, DentaQuest, that manages and profits from MassHealth Dental Program, was the same company who reported the need for more treatment, higher reimbursement rates, and scared the lawmakers with possible inflated statistics to further their cause.  WTF!]