Thursday, December 13, 2012

Health and Human Services or Health and Hedge-fund Services? When it comes to Medicaid dental mills, it’s the latter.

December 11, 2012
On Tuesday, December 11, 2012, The Today Show aired an investigative report about the on going troubles at the Small Smiles Dental Centers. Interviews included one with Health and Human Services (HHS) officials in charge of overseeing the compliance of the notoriously troubled clinics.

If you’ve not seen the report, please take time to do that here.

The segment included an interview with a HHS-OIG Branch spokesperson. However, if not for the HHS-OIG seal displayed one would presume it came out of the the PR department at CSHM headquarters.

NBS News Senior Investigative Correspondent, Lisa Myers asks HHS-OIG spokesperson, “They’ve had 4 bites at the apple, when is enough, enough?”  

HHS-OIG responded with this check list:HHS

1. “Dentists have been fired” – Well, dentists are fired there every day!! They are fired every day because they don’t meet the production numbers set by the corporate office. Their turn over had been setting at 48% since the beginning!

What about the Chief Dental Officer – Steven Adair, DDS?  He actually got a promotion. Dr. Adair is the author of the news letter for CSHM in which he suggests instead of the papoose board, try the “superman cape” method.

What is the Superman Cape Technique? Here, read this!

Compliance officers? – Yes, a few. They have burned through 3 in 2.5 years. CSHM will not hesitate to been throw one under the bus, blaming them for falsified reports to the OIG.

2. “Clinics have been closed” – Yes, they have filed bankruptcy! The started closing clinics in early 2011! HHS only forced 1 clinic in actually close – Manassas Virginia.

3. “This is not the same company” – True, it simply filed for bankruptcy, reorganized with some of the same investors in the background, and changed it’s name, replaced the CEO and President. But that was in 2011!

3. “The Independent Monitor is telling us that Quality of Care is consistently improving” – The same independent monitor in place for 3 years! The one CSHM pays. The one whose head dental investigator is buddies with the company’s Chief Dental Officer. So exactly when did that “improvement” begin? June of 2012? Certainly not in April 2012? The new people in charge actually  stepped in October 2011. It just wasn’t on paper with the bankruptcy court until June 2012.

The company has been in the news, how many times since 2007?

Each and every time it’s the same story: children abused; babies being strapped down in papoose boards; no anesthesia; mouths full of crowns; sealants; infection and  dentists paid based on a percentage of billing! It was this way in 2007, it’s this way today.

Under the Corporate Integrity Agreement, CSHM self-reports it’s bad behavior. Time and time again they have failed to report several breaches of the agreement. One in particular was the $200K x-ray fraud committed, at the very Denver clinic in this piece, by a long time dentist and office manager. Why was the fraud committed? Because the dentist could make more since his salary was cut from a base amount to a percentage of billing, that’s why.

Self-reporting fails! Dentists won’t even self report the influence non-dentist corporate executives have on their treatment of patients.   

In fact CSHM so much wiped their butts with that Corporate Integrity Agreement, they started paying dentists a % of the amount they billed Medicaid, 3 months after signing it, which was in direct violation of the agreement!

4. “They were fined” – Yes, $24 MILLION DOLLARS, 3 long years ago! That wasn’t enough to change their behavior, was it? I wonder what amount  HHS-OIG thinks would deter the child abuse and fraud?

In 2010, HHS-OIG, agreed to the “payment plan” for that $24 million dollar fine.  As I’ve pointed out before, it’s in their best interest to keep the torture chambers open, and sing their praises in order to collect. All the while, putting their head in the sand that CSHM is stealing 3 times that a year from the taxpayers and abusing children in the process! It’s MADNESS! Screw the $24 Million they owe, and close the doors!


HHS-OIG says if the doors were closed, “it would leave 500,00 children without dental care” –  So is HHS’s excuse to allow the potential for over 1 million to be absurdly abused a year! This company alone sees over 1 million patients a year. - 1,082,460 patients in 2010.

Kool Smiles, Small Smiles step-cousin - is just as bad if not worse, they have been doing this since 2006 and HHS has done nothing to even slow them down. Kool Smiles saw 1,150, 440 patients in Texas ALONE in 2011!!

The letter from the new CEO – David Wilson - says they have hired 50 new dentists. Well, $hit, they hire 50 new dentist a month with a turnover of 48%! Geez!

ceoletterYou might also note in the piece David Wilson’s name is blurred out and he refused comment. I don’t think his name was even mentioned. It’s obvious he’s not so “proud” of how well the company is doing!

In the investigation it said in Ohio 6 of 7 records reveal unnecessary baby root canals – that is 86%! That isn’t the scary part. What is scary is only 7 charts were checked.

These clinics see nearly 100 patients a day! In 2010 the Ohio clinics treated 105,000 patients! If 85% receive unnecessary work, that it 89,250 children whose teeth were drilled and filled or capped unnecessarily. Even giving them a break and saying it’s only 50% is astronomical! And a sporadic inspection looked at 7 charts! OMG! 

It appears to me if the government agencies designed to protect the people are in bed with, or at least having a sleazy affair, with the bad guys. They have enough evidence to put every one of these people under the jail. Yet they continue to let them have access to our children – Child abuse with the government’s permission, protection and seal of approval. This is unacceptable!

CSHM is still refusing to admit they “own” the dental centers as well, as I see they stated the “affiliated” centers. What a crock! As evident by the cover-up of the true owners of these clinics — maybe HHS is no longer Health and Human Services but rather Health and Hedge-fund Services.

So who are the good guys? Well, it appears it’s left up to the public, parents, and trial lawyers - maybe a few billion dollars in malpractice settlements will deter this behavior. Hopefully Senators Grassley and Bacus will lock the doors on these criminal enterprises! We can only cross our fingers and pray.

I challenge anyone overseeing this debacle to take their children or grandchildren to one of these places and drop them off for some treatment. Let me know how it goes! If you refuse let them treat your child or grandchild, why is it ok with you to let this company treat ours?

The Administrative and Civil Remedies Branch (ACRB), falls under HHS – Health and Human Services>Office of the Secretary>Office of Inspector General>Office of Counsel to the Inspector General>Administrative and Civil Remedies Branch> Bureaucracy at it’s best I presume!