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Tuesday, October 30, 2012

Factoids from the Texas House Hearing on Public Health October 15 2012

Statement to committee by TSBDE Executive Director,Glenn Parker

Total number of dentists accepting Medicaid

  • 4687 in August 2007
  • 7399 in August 2012
    Increase of 57%

    Total number of Orthodontists accepting Medicaid

  • 142 in August 2007
  • 368 in August 2012
  • 226% increase in providers


    Civil Orthodontia "Whistleblower" Lawsuits

  • 20 cases involving 400+ potential dentist defendants
  • 8 convictions so far
  • 2 plea agreements so far
  • 4 indicted currently 
  • 9 awaiting the Grand Jury
  • Credible Allegations of Fraud (CAF) Payment Holds

    • 89 for non-orthodontic services
    • 26 Orthodontic services

    Criminal Medicaid Fraud Cases

  • 153 total criminal cases (dentists, support staff,private equity investors)
  • 45 are orthodontia related
             30 % orthodontic are fraud cases
  • 27 orthodontic provider investigation completed
  • $229,000,000 of probable fraud
  • 93% is the average of cases where patients did not qualify for braces. Ranging from 39% to 100% of records checked so far.
  • $154,000,000 in general dentistry of probable fraud
  • 55% is the average of overutilization - billing fraud; overtreatment. Ranging from 25% by some providers to 99% by other providers.
  • Office of Inspector General & TMHP
  • August 2008 audit of TMHP revealed problems
  • 2011 was follow-up on 2008 audit
  • 12 investigation in 2011
  • 108 so far in 2012

  • Time needed to complete an investigation
  • 4 years in 2011
  • 8 weeks by end of 2012
  • How do the new DMO's (MCNA & DentaQuest) in Texas negotiate to enroll providers?
  • Individual dentists - if the own their own clinic
  • Management, i.e. NCDR, LLC and CSHM - in the case of group practices.
  • TSBDE cases turned over to district attorneys
  • 200 in 10 years - of individuals practicing dentistry without a license
  • 3rd degree felony
  • 5 convicted and jail time
  • if acted upon, most have plea agreements and board is not notified
  • Curbing illegal corporate practice of dentistry and patient shopping
  • DentaQuest -  Cease and Desist Letters
  • Texas State Board Dental Examiners (TSBDE) -
  • Forward to AG's office for investigation
  • Could but have not sent Cease and Desist Letters.
  • Look if someone is working for a non-dentist owner and take action against that dentist
  • Non-dentist may not influence or attempt to influnce a dentist in treatment, doing so is practicing dentistry without a license.
  • i.e. Doug Brown - Kool Smiles
  • i.e. David Wilson - Small Smiles
  • i.e. Stephen Thorne - Pacific Dental
  • i.e. Michael Dell – Affordable Dental
  • Have had cases where dentist being investigating said he or she was influenced by a Office Manager or other employee of a DSO.
  • 5 dentists reported such in last 2 years
  • Took action against the dentist
  • # of Dental Practices or Dental Management Organizations
  • Unknown by TSBDE
  • Acronyms for illegal operating dental management companies

  • DSO – Dental Service Organization

  • DMSO – Dental Management Service Organizations

  • NDOE – Non Dentist own entities

  • Indicator of fraud
  • Billboards offering Free Braces
  • OIG re: Jail Time:

    There will be, and there are, and it’s a parade of horrors. We don’t see the end of the parade but we are going to make sure that every body that participated in the parade gets to be evaluated to see if we can criminally prosecute them. We’re going to make sure that if there’s an ability to recover under the Texas Medicaid Fraud Prevention Act we will pursue that.

    We are coordinating with the Office of Inspector General through our task force, if we find that the quickest way to get resolution and recover the money from them is to go through the Office of the Inspector General processes, through SOA, we will do that. So we are trying to attempt to anything and everything to facilitate the quickest resolution and get the state of Texas money that has been stolen from it, back.

    It’s the “quickest resolution” that gives me pause.

    Monday, October 29, 2012

    Could they survive without Medicaid?

    I’m talking about the private equity firms.

    Just for the heck of it, let’s say, one of these dental mills were cut from the Medicaid program in Texas.

    Let’s say they have 35-40 clinics and gross about $70 million dollars a year.

    Taking the fact they are operating illegally out of the equation.

    Without a scam like Aspen, rename their clinics, turn them into private pay-adults and children- and still survive?

    Is DentalSmart designed to attract foreign investors?

    There is a chain of clinics in South Carolina, called DentalSmart. It appears they are set up to attract foreign investors through, what is called an EB-5 Immigrant Investor program. (see bottom of post) I say this because it has entities set up described as EB5 Investment companies. Of course I could always be wrong.

    Dental Smart Logo
    DentalSmart
    2020 Savannah Highway
    Charleston, SC 29407
    P. 1-843-735-6727

    http://dentalsmartus.com/index.php

    Trademark Registered May 12, 2011 by National Dental Centers of America, Inc.

    National Dental Centers of America, Inc is a Delaware Corporation

    South Carolina filings -
    National Dental Centers of America, Inc
    Brian Schleifer
    17 Lockwood Dr. TE 401
    Charleston, SC 29401
    Filed 10-26-2010

    DentalSmart EB5 Investment V, LLC
    Registered Agent:
    EB5 Investment Managers, LLC
    301 Augusta Street
    Greenville, SC 29601
    Filed 9-6-2012

    Sunday, October 28, 2012

    Judge Sally Montgomery and Richard J. Malouf birds of a feather? Neither seem to care too much about the law.

    sallymontgomeryJudge Sally Montgomery, ranked one of Texas’s worst judges in 2006, still sucks.

    Below is a story that should scare the hell out of every American. A Texas judge doesn’t care about the laws, she says exactly that. Sally is trying to silence free speech and especially whistleblowers.

    It is an undisputable fact that if people like Byron Harris, Candace Evans, Jim Moriarty, myself and others weren’t talking about this scandal in dentistry and dental clinics like Malouf’s All Smiles clinics, where do you think we would be right now?

    Would anyone be paying attention in Austin?

    Just last week, at a hearing on Public Health Texas Rep. Lois Kolkhorst, said, ‘thank goodness for the Bill of Rights, because that’s really what brought it to a head.’

    But for Harris and WFAA’s reporting there would be no joint task force in Texas and taxpayers would still be bleeding millions of dollars by the day.

    Would anyone be paying attention in Washington?

    In March, at a hearing in DC, it was recognized that it took a reporter in Texas to uncover the massive orthodontic fraud.

    Would anyone be paying attention to the child abuse happening behind closed doors in these dental offices. That answer is NO!

    Evidently, Judge Sally Montgomery of Dallas County Court, is not too fond of our “Bill of Rights.” She doesn’t care too much about Texas’s Citizens Participation Act either, a law passed unanimously in 2011.

    It’s clear time has come to put Sally Montgomery out to pasture, and elect someone else to Dallas County Court No. 3.

     

     

     

    Case against Candy Evans, Laura Wilson and WFAA gets nuttier thanks to power-hungry judge

     

    culturemap dallas

    By Teresa Gubbins

    10.26.12 | 10:03 am

    The lawsuit filed against real estate reporter and CultureMap contributor Candy Evans, Channel 8 WFAA and Laura Wilson by Strait Lane residents Richard and Leanne Malouf has moved into mediation, a process that begins on Friday.

    Malouf, a dentist who's been accused of Medicare fraud, and his wife, Leanne, filed a lawsuit October 16 alleging that Evans et al trespassed on their property; invaded their privacy; and defamed, libeled and slandered them after publishing photos of the Maloufs' backyard with its ongoing construction of a massive waterpark.

    "The parties have agreed to mediate the case, and we'll begin that process [Friday]," says Larry Friedman, who is representing Evans.

    ​The Maloufs filed a lawsuit October 16 alleging that Evans, Laura Wilson and WFAA trespassed on their property; invaded their privacy; and defamed, libeled and slandered them.

    On October 19, Judge Sally Montgomery of Dallas County Court at Law No. 3 issued a temporary restraining order for two weeks, forbidding anyone from stepping onto the Maloufs' property. That put the case on hold and gave the parties an opportunity to mediate a solution rather than going back to court.

    Friday, October 26, 2012

    Texas DentaQuest–3 and 4 surface restoration reimbursement–Up. General anesthesia and IV sedation reimbursement–Up

    Texas Stakeholders Meeting – October 26, 2012

    Fee Changes by DentaQuest:

    3 and 4 surface fillings are up, some more than double. For instance 4 surface amalgam's up from $60.02 to $125, 4 surface composites $75.06 to $135 – effective September 1, 2012.

    Being the cynic I am, is this to make up the difference if it is finally decided stainless steel crowns have to be pre-approved?

    Is to help keep the fraudsters stay out of hot water and still in the dough? Stainless steel crowns are $153, now 4 four surface amalgams just slightly less, where before they were dang near $100 less.

    The sedation fees disturb me a slight bit. Of course none of it would disturb me if not for the lack of regard of children’s health and wellbeing these days.

    Effective October 1, 2012 -

    D9220 – General Anesthesia was $85.75 now, $125 first 30 min.
    D9920 – GA each additional 15 min, was $30.63, now, $35.00

    D9230 – Nitrous Oxide – NO CHANGE

    D9241 – IV-Sedation was $119.44, now up slightly to $125 for the first 30 minutes.
    D9242 – IV – Sedation was $28.44, now up slightly to $35 for each addition 15 min.

    D9248 – Non- IV Sedation was $183.75, huge drop to $125.00.

    fee schedule change

     

     

     

     

     

     

     

     

     

     

    fee schedule change 2

    Why was Waller, Lansden, Dortch, and Davis represented at the Texas House Public Health Committee meeting October 15, 2012?

    The law firm of Waller Lansden was selected to serve as legal counsel to the Texas Health Services Authority (THSA), whose objective is coordination the implementation of strategic and operational plans for the health information exchanges (HIEs) that will provide access to electronic medical records throughout the State of Texas. (which is a whole other can of worms I’m leaving for someone else!)

    On October 15, 2012,  Elizabeth Rogers of Waller Lansden testified before Texas House Public Heath Committee meeting in which she basically threw the Texas Dental Board under the bus for not doing it’s job. I agree whole heartedly with her assessment. (yes, I know, whether I agree with her or not is inconsequential) According to the roster, she was there representing the Texas Coalition of Dental Support Organizations

    Anyway, here is Rogers’ testimony. Pull up a seat and listen. Then let’s talk.
    (This was immediately after Diane Earle of Kool Smiles gave her testimony.)

    Here is the handout given to the committee by Waller

    Here’s what:

    Waller Lansden serves as legal counsel to Dr Richard Malouf, of All Smiles Dental, in his initial plea deal w/ state Attorney General Abbott.

    Waller Lansden also serves as legal counsel to Church Street Health Management (CSHM) (d/b/a Small Smiles Dental, Wild Smiles, etc.), and has been involved with the company from its acquisition by private equity investors. 2007 Waller Street News

    I’m wondering how Waller’s, clients like Richard Malouf – All Smiles and CSHM-Small Smiles feels about what she had to say.

    Currently Small Smiles is owned by Garrison Investment. Not sure if Waller spends a lot of time on CSHM? Well, here’s a time sheet. If you look closely you will see where they are actually the ones handling some serious compliance issues at one of the Ohio clinics.

    Why is this a problem? Small Smiles gave birth to Kool Smiles. Two dentists from Small Smiles, along with a paramedic (sounds like the beginning of a bad joke) joined with FFL Partners to start Kool Smiles and NCDR, LLC.

    I don’t know this to be 100% fact - but I’m pretty darn sure, Kool Smiles is one of the clinics on CAF – Hold in Texas. (Credible Allegations of Fraud) Meaning, they are not getting their money, hence Diane Earle sent to “fall on the sword”. Earle goes to Texas, swears her testimony is the truth, and 4 days later is having a production meeting in Atlanta at NCDR headquarters!! These execs at Kool Smiles and spineless cowards and have yet to lay themselves on the alter for sacrifice. But they will sure send out the stupid folks – Earle and Buckey for example. (sorry, got off on a KS rant there for a minute)

    Another troubling aspect - Waller Lansden professes it is the counsel to the DSO’s here in this ad:

    Waller Lansden Ad to Be Dental Management companies Top Firm

    Besides all of the above, Waller Lansden are also members of the DGPA,  the group propagating the illegal operation of the dental management companies. Most of it’s members, founders, and officers belong to the dental management companies backed by private equity. I being a member of the “club” most likely to land in legal trouble, it’s a great idea. But… be part of the governing body involved in these matter is a whole other situation.

    If Texas is working hard to close the doors on the hen house, don’t lock it down with the wolves’ operatives inside, unless they are double agents, of course.

    Other written testimony from the hearing

    HHSC-Chris Traylor and Doug Wilson Presentation

    TSBDE-Glenn Parker Written Testimony

    TDA-Dr. Richard Black Testimony

    Kool Smiles-Dr. Diane Earle Testimony

    Waller-Supplemental Handout

    TAGD-Dr. Joey Cazares Testimony

    South Texas Dental-Dr. Greg Lerner Written Testimony

    Thursday, October 25, 2012

    Dental Management companies on the list of newly registered lobby efforts of Liberty Partners Group, LLC

    Politico published a list of “new” lobbying registrations.

    Look who is on the list. (list is at the bottom of the page)

    Liberty Partners Group LLC: Affordable Care Inc.

    Liberty Partners Group LLC: Aspen Dental

    Liberty Partners Group LLC: Dental Group Practice Association

    Liberty Partners Group LLC: Dental One Partners Inc.

    Liberty Partners Group LLC: Great Expressions Dental Centers

    Liberty Partners Group LLC: Hall, Render, Killian, Heath, & Lyman

    Liberty Partners Group LLC: Heartland Dental Care

    Liberty Partners Group LLC: Smile Brands

    Liberty Partners Group LLC: Western Dental Services

     

    Andrew L. Woods – Liberty Partners Group

    You just can’t make sense out of nonsense.

    Kool Smiles senior district manger tries to explain dental service organization to Texas lawmakers. Hope this wasn’t under oath. Ooops, it was. See Witness Affirmation Form

    Pop the corn and watch a train wreck.

    Diane Earle, DDS’s testimony October 15, 2012:

    Here is the “raw” clip of Earle’s testimony

    Didn’t the tones in their voices say, “Bless her hearts” ?

    Final Bids in for Heartland Dental

    Update Thursday October 25, 2012:

    Effingham Daily News:

    October 25, 2012

    Heartland Dental Care for sale

    Bill Grimes Effingham Daily News

    EFFINGHAM — While international news services are reporting that Heartland Dental Care is for sale in a potential 10-figure deal, a Heartland executive said Wednesday that no deal would affect the local presence of the dental practice management giant.

        “We want the people of Effingham to know that we are committed to Effingham,” said Chad Thompson, the company’s vice president of administration.
     
      Thompson declined to comment on the potential deal, but international news service Reuters reported earlier this week that private equity firms KKR & Co., Apax Partners and Madison Dearborn Partners have bid for Heartland Dental. Reuters said the sale price could reach $1.3 billion.

     

    Saturday, October 20, 2012

    Representative Lois Kolkhorst tips hat to those reporting on the dental Medicaid fraud in Texas

    Dedicated to all those who are not deterred from speaking out

    During a Texas Public Health committee meeting on October 15, 2012, committee Chair Rep. Lois Kolkhorst, tipped her hat to the public, for speaking out about the massive amount of dental Medicaid fraud taking place in Texas.

    “…This wasn’t a huge issue on this committee or others would have maybe been a little more privy to it—it took a lot of news reporting for us to really, and thank goodness for the Bill of Rights, because that’s really what brought it to a head, “ s

    “…I want to tip my hat to Channel 8 and WFAA in Dallas, certainly the Texas Tribune has given this a lot of coverage…”

    Without the public and company insiders speaking out, without Mr. Harris at WFAA, listening, Representative Kolkhorst and the Public Health committee would still be in the dark.. And I suspect the Texas Inspector General and Attorney General’s office would still be turning a blind eye to the red flags they found in 2008.

    However, since Richard Malouf -  under fraud investigation himself - filed a SLAPP lawsuit last week against WFAA TV; investigative reporter, Byron Harris; Mary C. Jones and his neighbor, Laura Wilson, I’m guessing he’s not as appreciative of the “reporting” and our “Bill of Rights.” 

    Note, Rep. Kolkhorst said it took a “lot of news reporting” to get their attention. So don’t quit; keep blowing those whistles and beating your drums. Don’t be intimidated by even the sleaziest of those who may try to twist the truth.

    On a side note: I don’t live in Texas and I don’t have a clue who Lois Kolkhorst is. But I would vote for her over the two loons we have running for President based on the October 15, 2012 hearing alone.

    Go Lois!

    Who owns Aspen Dental? Leonard Green & Partners (LGP) Private Equity

    Leonard Green & Partners are the true owners of Aspen Dental Centers. They own or are heavily invested in several popular brands. (see below)

    The one that concerns me is U.S. Renal Care - a renal disease management company.

    Now that we see how they operate Aspen Dental,  I shutter to think how this company maintains it’s production numbers or how they keep costs down at U.S. Renal Care. Might be worth someone looking into. 

    Aspen Dental Class Action Complaint

    LGP Collage

     

     

     

     

     

    Other Leonard Green & Partners Investments:  

    Aspen Dental

    Neiman Marcus

    BJ's Wholesale Club

    Petco

    The Container Store, Inc

    Rite Aid

    David's Bridal

    Savers

    DelTaco

    Sport Authority

    Equinox Fitness

    TireRack.com

    J. Crew

    Tourneau

    Jo-Ann Fabrics

    Whole Foods

    NCDR, LLC’s clinics - Kool Smiles Dental - pitch to Texas House of Representatives

    On Monday October 15, 2012, Dr. Diane Coopwood Earle, DDS, Senior Regional Dental Director of Kool Smiles Dental centers gave a 4 page statement, and subsequent testimony before the Texas House of Representatives committee on Public Health.
    Summary of her statement:
    - She’s been a licensed dentist in Texas for 30 years.
    - Kool Smiles has 38 offices in Texas.They employee 85 dentists in 38 offices in Texas (only 34 show up in 2011 data).
    - All 38 Kool Smiles are owned by dentists.(Liar, Liar, Pants on Fire!)
    - All clinical and patient treatment decisions are made by the treating dentist
    - NCDR, LLC handles non-clinical administrative, critical business support and purchasing. (more lies including the fact, only licensed medical professionals are legally able to purchase many medical supplies)
    - DSO’s are “innovative” business models. (Bernie Madoff too was “innovative”)
    - As a dentist, DSO’s help her do what she “does best – providing high quality dental care to my patients and spending more time with them.” (she billed Texas for performing 833 procedures on 643 patients in 2011, that’s about 12 patients a week.)
    - Non-clinical leaders DO NOT interfere with clinical decisions of the dentists
    - She has “NEVER been told by a corporation or corporate entity how to treat our patients.” (I bet that statement comes back to bite her in the ass)
    - “Without that necessary separation between delivery of professional quality dental care and administrative support, the model would not work.” (this will be another bite on the back side, I bet)

    Friday, October 19, 2012

    Thursday, October 18, 2012

    Class Action Filed Against Aspen Dental–They operate illegally.

    Aspen Dental Class Action Complaint 3:12-CV-1565

    Brian S. Cohen, Esq. 

    COHEN LAW GROUP, P.C.
    2 Greenwich Office Park - Suite 300
    Greenwich, CT 06831
    Phone: 203-485-7525
    Fax: 203-485-7526

    10 East 40th Street - 46th Floor
    New York, NY 10016
    Phone: 212-967-2879

    Fax: 646-349-2567
    Email: brian@cohenlg.com
    Web
    : www.cohenlg.com


    Aspen is not alone, most, if not all of these are operating illegally as well:

    Affordable Care, Inc – American Capital
    Allied Dental Practices
    American Dental Partners
    Aspen Dental Management, Inc
    BrightNow!
    Children’s Dental Group
    ClearChoice Dental Associates
    Dental Care Alliance
    DentalOne Partners, Inc . – MSD Capital – Michael Dell
    Dentistry For Children
    Gentle Dental Group / Northwestern Management Services – Linden Capital
    Gentle Dental of New England/Gentle Dental Associates
    Gentle Dental/InterDent, Inc
    Great Expressions Dental Centers
    Heartland Dental Care – Code Hennessy & Simmons, LLC
    ImmediaDent - James Ferrell – Samson Capital
    Kool Smiles – FFL Partners
    Lumino The Dentists
    Midwest Dental – FFL Partners
    Monarch
    Mountain Dental
    Ocean Dental
    Pacific Dental Services, Inc – Scott A Beck and Jeff Butler
    Perfect Teeth – Birner Dental Management
    ReachOut Healthcare America – Morgan Stanley
    Refresh Dental
    ImmediaDent – James Ferrell – Samson Capital
    Small Smiles – Garrison Investment
    Smile Brands, Inc – Welsh, Carson, Anderson & Stowe
    TownCare Dental Partnership, Inc - FL. State Representative Michael Bileca
    West Coast Dental Services, Inc
    Western Dental Centers

    Texas expands Medicaid dental fraud estimates to $154 million

     

    ;

    by BYRON HARRIS Bio | Email WFAA-TV Posted on October 17, 2012 at 10:03 PM Updated today at 12:01 PM Story

    NEWS 8 INVESTIGATES

    WFAATexas Medicaid dental expenditures quadrupled in recent years, from $400 million in 2006 to $1.43 billion in 2011. The Office of Inspector General is now tracking more than $383 million of potential fraud and overpayment, it told a Texas House of Representatives committee.

    In a House hearing on Monday, News 8's investigations of Medicaid dental fraud were praised by state representatives. "I have to tip my hat to WFAA in Dallas for doing what they've done," said Rep. Lois Kolkhorst (R-Brenham), chairwoman of the Public Health Committee.

    The state has suspended payments to 26 orthodontic organizations under a policy called Credible Allegation of Fraud (CAF). The state can hold money back from Medicaid providers if it suspects it was billed fraudulently. Texas estimates that $229 million in Medicaid payments to put braces on kids' teeth may have been improper.

    Audits show as many as nine out of 10 payments may have been fraudulent. For general dentistry, more than $154 million may have been overpaid. Expert analysis shows half the bills checked were erroneous. Eighty-nine dental providers have had payments withheld under CAF.

    The OIG told a the public health committee of the Texas House that more manpower, more interest in fraud, and improved software are helping catch more fraud going forward. E-mail 

    E-mail bharris@wfaa.com

    Wednesday, October 17, 2012

    What will Harlingen Family Dentistry fight for, and what will they not?

    The same Harlingen Family Dentistry that killed ten year old Marcos Tirado in September won a skirmish with the Office Of Inspector General’s  (OIG) office yesterday. But that is far from winning this war.
    Harlingen Family Dentistry is one of the top 25 Medicaid billers in Texas and under investigation by the OIG. The Texas Tribune has Harlingen Family Dentistry rated at number 17 in claims for fiscal year end 2011.
    Dr. Juan Villarreal, owner of Harlingen Family Dentistry is a former member of the Texas State Board of Dental Examiners, appointed by Governor Perry in 2001.
    As standard practice, while under investigation,Office of Inspector General (OIG), began to withhold 40% of all reimbursement payments.
    Not very happy about that, Villarreal appealed OIG’s decision. Despite OIG having evidence that 84 of 85 records reviewed failed to meet requirements necessary.
    Harlingen hired their own witness who said he would have approved all but 8 of those 85.

    WOW, that’s a HUGE difference!! Too huge to not look a bit suspicious on Villarreal’s part. After all he’s the one wanting “you” money and looks like he’s willing to kill children to get it.
    Yesterday, Administrative Law Judge Susan Fekety, agreed to reduce the payment hold from 40% to 4%.
    Always the victim, Villarreal said, "I am afraid to say that it appears that honest dentists are being ‘gamed’ rather than the other way around so the state can try to collect back funds its contractor had pre-approved years ago and that they want to claw back regardless of consequences to providers and patients. It just shows how broken Medicaid really has become.”
    Would Marco still be alive if Villarreal were not such a greedy man? One thing is clear; what Dr. Juan Villarreal will fight for and what he will not.
    Father claims no one tried to save his son

    All About Dentistry–Dr. Farahani confronted about kidnapping. One dentist flees the country.

     

     

    DALLAS — This summer, News 8 discovered some dentists were luring kids to their offices with pizza and pocket change without their parents' permission, then billing Medicaid for dental procedures that were unneeded.

    Tiara Truelove said she and six other kids were offered cash on the campus of Dallas Can Academy in March when they were on their lunch break. A dental recruiter then drove them to All About Dentistry on Scyene Road.

    After the recruiter fed the students pizza, their teeth were cleaned and they were each given $10, Tiara said.

    When her mother, Tiffney Truelove, found out, she went to the office to complain and said she was met with indifference by the staff.

    "You picked up my — at the time 16-year-old — and took her to the dentist, and you bribed her, and you basically kidnapped her," Truelove said. "And after you fed her, you supposedly cleaned her teeth. And then you brought her back and you don't think that you did nothing wrong?"

    Challenge to recent studies on DSO’s by Laffer, Winegarden and Arduin: Put your mouth where your studies are.

    October 15, 2012 Sally Pipes, President of Pacific Research Institute, published an op-ed piece at Forbes.com whereby Wayne Winegarden and Donna Arduin had studied Arthur Laffer’s study and yep, they agreed, dental management services organization are simply scrumptious. [cough]

    Here is a chance for each of them to put their mouths where their “studies” are.

    Here is the challenge to each; Laffer, Pipes,Winegarden and Arduin:

    1. Go to your regular dentist for a check-up. Keep any treatment plan you receive or report on the state of your dental health.
    2. Pick two DSO clinics that treat adults and two that are geared toward children on state insurance programs. I’m sure there are some nearby. It probably won’t cost you a dime, all of them have coupons for free exams and x-rays.
    3. Go for your appointments. Voice record the entire visit or it doesn’t count.
    4. Bring back any treatment plans, credit applications and other paperwork you receive.
    5. Next grab one of your toddlers, better yet, a grandchild, preferably under the age of 5 years old.
    6. Take them to their regular dentist for a check-up. Keep any treatment plans you receive or report on their dental health.
    7. Run them down to each DSO Medicaid clinic you chose for a check-up.
    8. Here too, you must record each visit. Don’t be scared. if you are brave enough to put your name on these “studies”, you should balls enough to send you “child of choice” back there alone.
    9. You must get copies of their treatment plans as well, if any. I say that since chances are good the treatment will already be completed when you get your child back.
    10. Interview the child after each visit.

    When you’re done, each of you should have 6 reports, 3 for you and 3 for the “child of choice”.

    Now, you have some real life data!

    Tell us how it went.

    Monday, October 15, 2012

    Student denied dental degree after failing to meet production quota at New York University College of Dentistry in 2009, gets her degree in 2012

    There are hoards of evidence that dentists and employees of dental chains owned and operated by Wall Street fat cats have production quotas to meet. Some chains call a daily “budget” amount, while others call it “goals”, “targets” or “forecasts”.  Be it the number of patients or dollar amount the company expects the employee to bill or sell, it’s still a quota.

    The pressure to meet these quota’s appears to be the foundation on which the overtreatment, mistreatment, malpractice, and brute force used on children is based.

    It’s not just the private equity firms, like Morgan Stanley, or the regionalized dental management organizations like Dental Professionals of Texas (now MB-2) bilking the Medicaid system.  It’s also our medical colleges it appears.

    A  student used to be denied his or her degree because they were short credits. At New York University College of Dentistry (NYUCD), graduating is based on meeting a production goal.

     

    NYUCDKatie Kickertz attended NYU College of Dentistry. The day before graduation in May of 2009, Dr. Harry Meeker, Katie’s instructor, told her degree would be denied. Not because she was a couple of credit hours short, not because she had failed to meet clinical training expectations.

    It was because she had failed to meet the $38,000 in production quota at NYU’s David B. Kriser Dental Center.

    What does New York University College of Dentistry call its production quota system? It’s called “Practice Model Value” (PMV). It is purportedly to train dentists to treatment real patients for a fee. Well, golly gee, wonder if they had no clue that would happen if they used their skills after graduation?

    I wonder if it’s some kind of scoring system to see how much value any particular student can be to a corporate dental chain. That seems to be what the name of the program implies.

    We know for sure it is a revenue generating system for the college at the expense of patients health and the taxpayer. NYUCD accepts several Medicaid managed care programs.

    I know what you’re thinking, maybe this was some kind of program to aid in payment of her education. That answer is, no. Meeting the $38,000 quota is required by each student in addition to the $70,000 a year tuition.

    According to court documents, students were required to meet a quota $38,000 in their last two years of dental school. In the spring of 2009, Dr. Harry Meeker, Katie’s instructor, says he notified Katie about her deficiency. But the earliest records showing any communication to the fact was May 25, 2009.

    So, what did Katie do? Again, according to court documents, after hearing of her situation and before she planned to move to Boston in two days, Katie did what others pressured to meet quota’s do. She fabricated patient records. She charted she  she provided patients with 16 extractions, and bleaching on one afternoon and ponied up the $2000 herself. The treatments never happened.

    Thursday, October 11, 2012

    Texas Task Force Hunting Down Medicaid Dental Fraudsters

    Texas finally appears serious about the state’s extraordinary Medicaid dental fraud. Hopefully indictments will soon be coming. I hear at least one bunch of merry bandits, are locking doors on some of their clinics and owners are scurrying like the nasty rats they are.

    tribune

     

     

     

    Joint Task Force Tackles Medicaid Dental Fraud

    by Becca Aaronson October 10, 2012

    Through a new joint task force, the Texas attorney general’s office and the office of the Inspector General at the Health and Human Services Commission have teamed up to strengthen investigations of fraud and abuse in the state’s Medicaid dental program for children. And because the task force allows the agencies to coordinate limited resources, state officials say, the state can advance investigations and recover misused taxpayer funds more quickly. 

    “The Medicaid and orthodontic fraud task force was convened to ensure the state had a comprehensive and coordinated response to a dramatic uptick in fraud by Medicaid providers,” said Daniel Hodge, the first assistant for Attorney General Greg Abbott. “The highest levels of all affected agencies and divisions are actively involved in advancing the investigation as efficiently and effectively as possible."

    John Scott, the deputy attorney general for enforcement litigation, chairs the task force, which also includes officials from the Medicaid Fraud Control Unit and Civil Medicaid Fraud Unit at the AG's office, and officials from the inspector general and other departments of the HHSC.

    In 2010, Texas spent as much on orthodontic services as every other state combined, according to a report released in April by the U.S. House Committee on Oversight and Government Reform. "The state has admitted that widespread fraud was occurring and that the organization the state hired to assess prior authorization forms was essentially rubber stamping forms for approval," the report states. An orthodontist consulted by the inspector general's office at HHSC estimated that 95 percent of approved claims should have been denied, according to the report.

    State officials said the task force, which was created this year, allows the agencies to take advantage of what each group brings to the table. For example, the inspector general’s office has software to monitor whether a provider’s claims data looks suspicious and can put payment holds on providers it suspects are committing fraud. And the AG has teams of lawyers from the two Medicaid fraud units who follow through on investigations, subpoena records and press charges. 

    The state is also getting an assist from whistleblowers like Dr. Morna Staffel, a pediatric dentist in Fort Worth, who said she has stacks of evidence — in the form of patient records — of children being overtreated and, in effect, abused by dental clinics seeking to profit off the state’s dental program for low-income children.

    On Monday, for example, she had to remove six teeth in a child’s mouth that had abscessed less than six months after Medicaid paid for the child to be treated at a nearby dental clinic. “When I see this type of situation, I’m pulling patient records, I’m keeping patient records, I’m calling the [Office of the Inspector General],” said Staffel.

    Evidence turned over to the state by whistleblowers is filed under seal. And state officials cannot disclose how many investigations they are currently pursuing. But one provider, All Smiles, which was the focus of a WFAA-TV report in October that brought the allegations of fraud into the national spotlight, appears to be in their crosshairs.

    State authorities familiar with the task force’s investigations said the group is committed to recovering all taxpayer funds lost to dental fraud, from both dental providers and the Texas Medicaid and Healthcare Partnership, which was responsible for evaluating the medical necessity of dental claims and approving payment.

    The state audited TMHP’s process for evaluating dental claims in 2008 and recommended that the contractor increase the number of licensed dental professionals reviewing orthodontia claims, according to a State Office of Administrative Hearings report related to a recent allegation of Medicaid dental fraud. “TMHP responded to the audit’s recommendation by saying that an increase in the use of dental professionals would require a change in TMHP’s contract, which did not occur,” the report states. 

    TMHP recently renewed its state contract, and state officials familiar with the investigations said they plan to work with the company on negotiations to recover state funds lost to medically unnecessary claims.

    In an email to The Texas Tribune, Ken Ericson, a spokesman for TMHP, said, “Several providers are under state attorney general investigation — and we are cooperating with that investigation.”

    Most of the rise in Medicaid dental claims was probably legitimate, said Stephanie Goodman, spokeswoman for HHSC, because the state had increased reimbursement rates by 50 percent to expand access to care. “Those other factors kind of masked the fact that there was also probably an increase of bad actors in the program,” she said.

    Texas became a target for dental fraud after 2007, when the Legislature allotted an additional $1.8 million for Medicaid children’s dental services, as part of a legal settlement to increase access to care.

    State authorities familiar with the task force's investigations confirmed it has found that some dental clinics have illegally solicited Medicaid patients by standing outside large retailers and grocery stores and handing out gift cards in exchange for signing up for a free dental exam. And the inspector general recently issued a statement that said, “Offering inducements to Medicaid clients is a violation of state and federal law and is subject to a penalty of up to $10,000 per violation.”

    As the Tribune reported in July, the crackdown on orthodontic fraud has left many patients with untended braces, and a difficult transition to Medicaid managed care has exacerbated problems with access to care. The state is currently severing ties with Delta Dental, one of three Medicaid managed care plans, in part because state officials said the company failed to establish a computer system for providers to submit claims in a timely manner. In December, 1.1 million individuals enrolled with Delta Dental will be transferred to the other two managed care dental plans.

    Staffel said the transition to managed care has limited the number of orthodontists willing to take referrals for Medicaid patients, and many patients have been left "hanging in limbo," after the state shut down their orthodontic clinic by withholding Medicaid payments while the state investigates allegations of fraud.

    HHSC has informed orthodontic providers that the dental board can suspend or revoke their license for abandoning Medicaid patients. 

    "We’ve worked really closely with the dental board on that issue," said Goodman, adding many orthodontists have also stepped up to help address the problem with access to care. "Even providers that didn’t normally take Medicaid patients have agreed to take a few."


     

    • Dr. Staffel worked for Dr. Eugene Kouri at Eugene Kouri, DDS MSD, Inc. 2921 Lackland Road #201, Fort Worth, TX 76116

     

    • Gene M. Kouri, DDS, MSD - Dr. Kouri received his MSD in Pediatric Dentistry and his doctorate in Dental Surgery from Baylor University. He began his private practice in 1961 with a brief interruption for service as a captain with the United States Army Dental Corps. Dr. Kouri’s professional associations include the Texas Society of Dentistry for Children, American Academy of Pediatric Dentistry and the Southwestern Society of Pediatric Dentists. – http://genekouriddsmdfortworthtx.com/texas-pediatric-dentists

    Dr. Eugene Kouri came in at number 8 in 2010 Texas’s Top Stainless Steel Crown  state records, topping off at 6,108. In 2011 his office billed the state over $2M, nearly $700M for stainless steel crowns alone!

    2010 Top Ten Dentists to bill Texas for stainless steel crowns:

    1. Linda T. Burke -  Harlingen, TX
    2. Trueblood Dental Associates - Austin, TX
    3. Buckner Market Place Dental - Dallas, TX
    4. Smile Center – San Antonio, TX
    5. Robert Morgan DDS MSD – Irving, TX
    6. Kool Smiles Laredo, TX
    7. Valley View Smiles/ All Smiles Dental – Dallas, TX
    8. Eugene Kouri, Fort Worth, TX
    9. Bill Pope, McAllen, TX
    10. Robert Morgan DDS, Richardson, TX

     

    Wednesday, October 10, 2012

    Beekman Group, unloads Gentle Dental on Linden Capital Partners. Just in time?

    October 10, 2012

    PRESS RELEASE

    Harris Williams & Co., a middle market investment bank focused on the advisory needs of clients worldwide, announces the sale of Northwestern Management Services, LLC (NMS) doing business as Gentle Dental (Gentle Dental), a leader in the dental service organization (DSO) industry, to Linden Capital Partners (Linden). Gentle Dental was a portfolio company of The Beekman Group, LLC (TBG). Harris Williams & Co. acted as the exclusive financial advisor to Gentle Dental. The transaction closed on October 5, 2012 and was led by James Clark, Geoff Smith and David Allebach.

    “Gentle Dental has established itself as a clear leader in the attractive South Florida dentistry market through its commitment to quality, operational excellence and results-driven approach to physician and practice support. In addition, this transaction demonstrates investors’ continued strong interest in the DSO sector driven by investors’ desire to find scalable business models in markets positioned to benefit from positive demographic trends,” said James Clark, a managing director in Harris Williams & Co.’s Healthcare & Life Sciences (HCLS) Group.

    Tuesday, October 09, 2012

    A peek under the sheets at Heartland Dental

    I ran across a propaganda piece today on – dentalhealthcarecenter.net. about the super duper fantastic Heartland Dental Care.
     
    heartland
    It tells about Heartland Dental, in Effingham, IL and what they can do for dentists who are finding it hard to develop their own dental offices. It tells dentists, that by becoming an “affiliate” of Heartland, it can “make your career better.” Their career will be better because Heartland “will increase your creditability and reputation”. It goes on to say:

    • “Working with this company will never lead you to regret”
    • ”your office will be way better”
    • “The company will help in marketing your office, providing you qualified staff,, managing your office, advertising your services and many more.”
    • ”people consider that dentists who are working under the name of the company are all professional”
    • “it is not the company that decides how your office should work. You can decide how you run your business yourself. The company just helps you reach your dream.”
    • “if you face serious problem when running your office, the company will give you effective suggestion in how to break the problem.”
    • “you will likely to become a partner of the company”

    But what really happens?

    Here is what I’m told

    Monday, October 08, 2012

    Richard Malouf’s Six Flags Over Malouf WaterPrik Park–Update!

     

    WFAA

     

     

    by BYRON HARRIS

    Bio | Email

    WFAA
    Posted on October 8, 2012 at 10:03 PM
    Updated today at 10:03 PM

    DALLAS — There's a different kind of skyscraper going up in one of Dallas' most exclusive neighborhoods on Strait Lane. Mavericks superstar Dirk Nowitzki, former Rangers owner Tom Hicks and even Mayor Mike Rawlings live close by.

    This "skyscraper" is really a three-story water slide and lazy river in the backyard of Texas' most famous dentist. 

    Dr. Richard Malouf made millions from putting braces on children under Medicaid. 

    In a whistleblower lawsuit, the Texas attorney general says much of Dr. Malouf's work was fraudulent. All Smiles Dental Clinics — which Malouf founded and still owns part of — filed for bankruptcy earlier this year.

    Work on the water park and an addition to Malouf's huge chateau on Strait Lane continues. malouf2

    A turquoise pigtail of a water slide curls over the backyard and peeks through neighbors' trees. A five-foot wide, concrete-lined Lazy River water feature is taking shape below.

    But a News 8 investigation finds the Bentley-driving Malouf has a history of being sued for failing to pay his bills.

    Dental Service Organization (DSO) Affordable Care/Affordable Dentures Dentist Stripped of License

    Affordable Care is owned by American Capital, the same Private Equity firm who invested in the disgraces and bankrupt Small Smiles Dental Centers. Affordable Care and it’s President, Douglas W. Brown, were behind the big push in North Carolina to make life easy for Dental Service Organization in that state.
    Affordable Care and it’s “affiliated” clinics go straight to the top of the nasty DGPA organization and has so many tentacles that it would make an octopus jealous!


     
    By DON DARE
    6 On Your Side Consumer Investigator
    MORRISTOWN (WATE) - Disciplinary action taken by the Tennessee Board of Dentistry against David Harrison has been swift and decisive.
    The board revoked the Morristown dentist's license, stripping him of his ability to work in Tennessee. It was the most extreme punishment available to the state.
    In the consent order, "unprofessional conduct" was cited as one of the grounds for taking such extreme measures.
    June McClary was one of Harrison's first patients to call 6 On Your Side and one of the first to contact state investigators about Harrison's practice.



    Dr. Wendell Allen Racette sentenced to 15-30 years in prison for sexual assaulting a child patient

    Now, if you can just get the same for physical assault, progress will have been made. Could this be Dr. Thomas Floyd’s future? I hope it is.

     

    lsl

     

     

    racette

    Written Laura Misjak

    A former Lansing pediatric dentist convicted last month of sexually assaulting a child patient was sentenced Wednesday to 15-30 years in prison.

    A jury in August found Dr. Wendell Alan Racette, 65, guilty of five counts of first-degree criminal sexual conduct and 10 counts of second-degree criminal sexual conduct.

    Ingham County Circuit Judge William Collette sentenced Racette to 15-30 years in prison for each of the first-degree charges and seven years two months to 15 years for the second-degree charges. Those will be served concurrently.

    Racette also was sentenced to a lifetime of electronic monitoring when he’s done with prison, and ordered to not contact the victim’s family directly or indirectly.

    Racette declined to give a statement during the hearing. His attorney, Chris Bergstrom, was not immediately available for comment following the hearing.

    Prosecuters said Racette sexually assaulted a boy in his Lansing dental office between 1996 and 2000 when the boy was between the ages of 5 and 10. He came forward with his story in 2010.

    Arthur Laffer’s study on Dental Service Organizations (DSO’s) is questioned

    Dr. Biscupid
    By Donna Domino, Features Editor

    October 8, 2012 -- A new study conducted by a well-regarded economist but paid for by the dental chain Kool Smiles found that dental service organizations (DSOs) provide lower-cost treatment to underserved populations. The report also eschews criticisms about Medicaid fraud and unnecessary procedures that have been leveled against many DSOs. ellisquote

    The report, released September 19, was compiled and written by Arthur Laffer, PhD, a former advisor for President Ronald Reagan who is known as the father of supply-side economics. The 17-page paper, "Dental Service Organizations: A Comparative Review," evaluated all Texas Medicaid data from fiscal year 2011, including 25.9 million procedures.

    "DSOs are providing dental care to some of the poorest, most underserved segments of our society," Laffer wrote. "DSOs are not only providing much needed care, but they are providing that care expeditiously and relatively inexpensively when compared to non-DSO affiliated dentists."

    DSOs have operated since the 1960s but have become much more prevalent since the late 1990s, he noted.

    Full Article can be read here.

    Frank Catalanotto, DMD, …said he also questions the report's integrity.

    "Any time an organization is under investigation, you'd always look suspiciously that Kool Smiles has a self-serving motive in paying for studies like this," Dr. Catalanotto told DrBicuspid.com. "We have to assume the investigations are also valid and based on complaints and specific reasons. But in any organization you have to determine what's driving the organization. Is there a profit motive, and does that result in bad behavior?"…

    Full Article can be read here.

    Houston attorney Jim Moriarty, who is part of a whistle-blower case against Dallas-based All Smiles Dental Centers, agrees that DSOs violate state dental practice laws.

    "The elephant in the room is what Kool Smiles and Small Smiles and the rest of the DSOs are doing is illegal," he told DrBicuspid.com. "No private equity firm spends a billion dollars buying a dental practice unless they get complete control over the business and complete control over the income stream. So Laffer's premise that the private equity firms that own most of them do not have control over the clinics is a lie, and he glosses over this."

    Laffer did not respond to calls for comment.

    Sunday, October 07, 2012

    Dr. Thomas Floyd, on Dr. Thomas Floyd

    Dr. Thomas Floyd was recently arrested in West Palm Beach, Florida for, among numerous other charges, beating, choking and gagging children. One such child was being stabbed in the mouth so badly by Dr. Thomas Floyd, his assistant ran through the office screaming for someone to call the police, she though Floyd was going to kill the child!

    Below is Floyd’s bio he posted on classcreator.com. Sounds like such a lovely man, but I believe his bio needs a bit of updating!!  What a creepy mean old man.

    Thomas Floyd Bio on ClassCreator.com

    Thursday, October 04, 2012

    Roben Brookhim–Arrested for using identity of deceased dentist Larry Kirkland, Jr.

    A dentist in New Jersey who had his license to practice dentistry temporarily suspended in 1999 for fraudulent billing practices.  His license was permanently suspended in 2004, for continuing to practice dentistry using another dentist’s identity while under the 1999 suspension. In 2011, Roben Brookhim took on another identity.

    This time it was of deceased dentist, Dr. John Kirkland, Jr. Dr. Kirkland’s dental license was renewed one day before he passed away in October 2011. It appears Kirkland and Brookhim were dentists at  Associated Dental in New Providence , Associated Dental in New Springfield and Associated Dental in Springfield in addition to Family Dental Center in West New York.  Dr. Brookhim allegedly assumed Dr. Kirkland’s identity to practice at all locations, according to northjersey.com.

    The company website – associateddentalofnewjersey.com is registered to Dr. Roben Brookhim, Associated Dental NP, LLC, P.O. Box 589, Milburn, NJ 07401 973-339-2105.

    Associated Dental NP, LLC was registered to do business in NJ 12-2005. But there are several companies beginning with Associated Dental in NJ, two of which were created in 1999, when Brookhim had his license temporarily suspended – Associated Dental Center, LLC and Associated Dental Group, PA.

    This is just speculation, but maybe when Brookhim owns these 4 clinics. After he lost his license to practice dentistry he needed a fake owner dentist, enter Dr. Kirkland. Kirkland up and dies, leaving Brookhim in a real bind.

    One thing for sure, Brookhim has been mascarading as someone else for years. I wonder who he was between 2004 and 2011?

    I’m sure there is much more to this story.

    Presss Release: October 4, 2012

    NEW PROVIDENCE – Attorney General Jeffrey S. Chiesa and the New Jersey Division of Consumer Affairs today joined with Union County Prosecutor Theodore J. Romankow and the New Providence Police Department, to announce the arrest of an unlicensed dentist who is accused of falsely using the name and license number of a dentist who died last year, in order to treat patients.

    Tuesday, October 02, 2012

    Are High-Volume Dental Chains Exploiting Kids on Medicaid?

    Are High-Volume Dental Chains Exploiting Kids on Medicaid?

    by Olga Pierce ProPublica, Oct. 2, 2012, 2:27 p.m.by Charles Ornstein and Lena Groeger, ProPublicaby Dan Nguyen, Charles Ornstein and Tracy Weber, ProPublicaby Robin Fields, Al Shaw and Jennifer LaFleur, ProPublica

    David Heath of the Center for Public Integrity recently investigated a new breed of corporate dental care chains that cater to low-income adults and children. Heath collaborated with Jill Rosenbaum of PBS FRONTLINE on "Dollars and Dentists." They found a high-volume business model that scored dentists on production and offered bonuses based on the revenue they brought in. Heath and Rosenbaum reported that Georgia-based Kool Smiles, the biggest Medicaid dental provider, has been accused by state regulators of giving shoddy or unnecessary care to some of America's poorest kids. (Kool Smiles' response is here.)

    As part of our ongoing look at patient safety, we occasionally interview other journalists who've examined health care quality.

    PP: What did you find in your reporting? Heath: I looked at what impact corporate dentistry is having on the care being provided. We looked at two of the larger chains, and found evidence that these companies were putting pressure on their dentists to produce at certain revenue targets, thus encouraging them to do procedures that may have been unnecessary.

    PP: Can you say a bit more about the harm or overtreatment to patients that you saw? Heath: One of the chains focused on kids on Medicaid, and the reimbursement rates for Medicaid are pretty low. So in order to get a lot of revenue from these patients they were doing things like taking x-rays that were not needed, or putting stainless steel crowns instead of fillings on their teeth. They could make twice as much money from Medicaid on these crowns versus just putting a filling on a tooth. Kids were getting treatments that they really didn't need. We also looked at a chain that focuses on adults who haven't been to the dentist in years.  What were found there is again, patients would come in and everyone was given the same treatments. They were given these deep cleanings and a lot of people would get dentures and we were finding that in some cases maybe they didn't need those services. We had one example of an 87-year-old woman who had already been to the dentist and she went in to have two teeth pulled, thinking it would be cheaper at [New York-based] Aspen Dental. Instead they looked at her mouth and they came up with a treatment plan that was going to cost $8,000. They convinced her though hard-sell tactics to borrow that money through a credit card, and something like $2,000 of that was just to clean her teeth. (Aspen Dental's response is here.)

    PP: So, in some cases, you're talking about pulling someone's teeth unnecessarily? Heath: There was a case where a woman went in who needed to have some teeth pulled, but they pulled all of her upper teeth, and several dentists told us she didn't need that.

     PP: What are the market forces that have resulted in private equity-owned chains providing dentistry? Heath: These days, when dentists get out of dental school, they often owe anywhere between $200,000 and $300,000 dollars. Dental school is actually more expensive than medical school. So they come out with these huge debts, in a lot of cases they can't really afford to start their own practice. These dental chains hire people, a lot of the time right out of dental school, and they pay fairly decent salaries and they have a bonus system where the more work you do on a patient the more you get paid. That's true for a private dentist as well, but the difference is that these companies are owned by private equity firms, and they're managed in a different way. You have people who are not dentists coming up with a business plan that's based on metrics. They try to get new patients in who haven't been to the dentist in a while, and they've already calculated how much revenue the average new patient should generate. If you happen to go in and you don't really have anything wrong with your mouth and you're a new patient you're not fitting the model. That creates pressure for the dentists to find things that are ‘wrong.'

     PP: Is dentistry particularly ripe for these kinds of abuses? Heath: In dentistry there's not really any peer review or oversight. So there's really not anyone to challenge dentists. And patients almost never challenge that kind of thing either. For somebody who's not ethical, there's a lot you can do and get away with in dentistry.

     PP: How is it that so many kids in Medicaid have ended up relying on corporate chains for their dental care? Heath: Not that many dentists actually accept Medicaid. There are some states where the reimbursement rates are so low that even the chains don't go there. Like in Florida, for example, the Medicaid rates are so low there that chains don't really even bother. So children end up going to the emergency room because they have a toothache and there's nothing else they can do. They end up in hospitals to treat a tooth. There was a famous case in Maryland where a 10-year-old boy had a toothache and it was abscessed and he ended up dying because he didn't have a dentist. [Note: According to a recent study, only about a third of children in Medicaid-- which covers more than 30 million American children -- will see a dentist in a given year. In Florida, where reimbursements are particularly low, only a quarter of the children in Medicaid see a dentist.] In other states, like Connecticut, Texas and Virginia, they have dramatically increased reimbursement rates. You have more options there, but not the same options a someone who can afford it. Dentistry is a little unusual from doctors because a lot of people don't have dental insurance, and even if you do have dental insurance it often doesn't cover a lot, and a lot of dentists don't take insurance any more because of low reimbursement rates. So even if you have dental insurance, finding a dentist can be a challenge. So there is a real problem, especially for children, to find a dentist if they don't have money.

    PP: Are changes under way as a result of your story? Are there solutions on the table? Heath: There is a [U.S.] Senate investigation still ongoing, I don't know what will come of that. There are investigations in some of the states, Texas being one, looking at this issue. I think there are things in the works we really won't really know the full impact of for a while yet. We definitely got the attention of the dental community; we got a lot of feedback from them. This whole issue of accepting patients who have limited resources is a real issue in dentistry and something I think the dental community has to sort out.

    Dr. James Fruehan - “token” arrested dentist for October 2, 2012 ?

     

    PA-AG

    October 2, 2012

    Wayne County, PA dentist charged with Medicaid Fraud

    HARRISBURG - A Wayne County dentist was arrested today on charges that he fraudulently billed the Medical Assistance program for more than $75,000 worth of patient procedures that were allegedly not properly performed or not administered.

    Attorney General Linda Kelly identified the defendant as James Fruehan, 52, 51 Marshwood Bend, Clarks Summit. Fruehan is a licensed dentist and owns and operates Fruehan Family Dentistry, 15 Fruehan Drive, State Route 590, Hamlin, Wayne County.Fruehan

    According to the criminal complaint, Fruehan submitted claims to Medical Assistance for sealants and prophylaxes (teeth cleanings) that were not provided by Fruehan or licensed dental professionals.

    The charges state that Fruehan allowed dental assistants, who did not have a a proper license, to perform teeth cleanings on patients. Fruehan allegedly billed Medical Assistance more than $31,000 for prophylaxes that were provided by the dental assistants. 

    Kelly said that more than $35,000 worth of fraudulent claims were allegedly submitted for dental assistants writing "sealants" in the patients? charts, which indicates that they were not done by a dentist, dental hygienist, or expanded function dental assistant.

    Teeth Whitening Booth at Oklahoma State Fair Closed By Dental Board

    There is no doubt – I’m an idiot. One with a “God Complex”, I’m told. I know this to be true, since I don’t understand the difference between shutting down a teeth whitening booth at the county fair and shutting down illegally operating dental clinics. Here, the Oklahoma dental board actually “staked” out the place and words like “felony” were used.

    TULSA, Oklahoma -

    Posted: Oct 02, 2012 5:01 PM CDT Updated: Oct 02, 2012 5:39 PM CDT

    Lori Fullbright, News On 6

    9newsThe State Board of Dentistry shuts down a teeth whitening booth at the Tulsa state fair. The Board got an injunction against EuroShine USA for practicing dentistry without a license.

    The Board got a complaint, then staked out the booth Monday and watched them treat six people. The Board says there was a lack of knowledge and sanitary cleanliness that put people's health at risk. tulsa

    On Monday, the Dentistry Board told the booth workers to stop operating, then went back the next day with the court order.

    Read the application for temporary restraining order

    Read the temporary restraining order

    When the booth opened Tuesday, the employee began taking down the signs advertising teeth whitening for $40. The Dental Board says the blue light they saw the employee using isn't supposed to be used on people with cataracts or who've had cataract surgery, yet no medical histories were taken.

    Nothing out of DC, or anywhere else, on Organized Criminal Dentistry - Why? When?

    It's October 2, 2012. Organized criminal dentistry continues with as much vigor today as in 2007. Still, only silence out of Washington.

    On November 4 it will be 5 years since the public saw the first video of what these Medicaid dental mills were doing to children. It's been 5 years since I learned of this abuse and I'm still fighting mad over it. It shakes me to my core to think what would be happening if i weren't. As a select few of other Americans, I devote every day to squashing this, dead in its tracks. Does anyone, besides these few  give a shit care?

    How many times in the last five years have we heard the cry of corporations at the feet of Congress pleading for more money, citing the death of one child over a tooth infection that migrated to his brain – Deamonte Driver? Too many! This poor child’s death is being used, by corporations and associations, as a tool to abuse other children and be paid by the taxpayer to do so.

    How many times have we heard the cry of corporations at the feet of Congress over the abuse of Miguel, seen in the exclusive video? None! N.O.N.E! None! Has any company, or association for that matter, been to Congress pleading for someone to stop the practice of children being tied up in straight jackets, held by 3 or 4 misguided dental assistants only to receive what can only be called barbaric dental treatment? No!

    It was 2003 - 9 YEARS ago - when a young reporter – Stuart Watson- in North Carolina first reported about the DeRose family's child abuse for tax dollars scheme. Most enduringly referred to as - "serving the underserved."

    It's 2012. The abuse continues daily. The only real thing to change is one, the companies playing the game, more folks want in on the action. Two, the changed the terms used to describe the crimes. “Quota” was changed to “Goals”, the “Goals” changed to “Targets” and “Targets” to “Forecasts”. It’s hard to find new words for abuse a child for a dollar, though.

    There are mounds of evidence detailing this criminal behavior which has landed on the desks (or trash cans) of Attorney Generals, Senators and Congressmen - both Federal and State levels. More than enough to make sweeping arrests and stop this child abuse and raping of every taxpayer this very day. Yet, another day will pass and no one stops it. No one closes the doors of the dungeons or arrests the dungeon masters.

    You've seen what these children are subjected to - the videos, the testimony, the documents, the first hand accounts from employees, patients and parents!

    You've seen testimony of a small child being "waterboarded" by Small Smiles corporate dentist - Megann Scott. Yet, only a "waterboarded" terrorist gets your attention!

    You've been shown, just recently, that children are literally kidnapped at bus stops, taken thru the back doors of clinics, then coerced into forging their parents signature! Yet, you do nothing!

    You've allowed the chop shops to set up in every poor neighborhood in the country. Even given them our tax dollars to do so.  If allowing these predators this much access to our babies and children was not enough, you've allowed them access to children in our public schools, via gypsy style mobile dental clinics. You have been shown the devastation children are enduring because of this practice - Isaac Gagnon.

    You've seen the deaths of babies sedated for over-treatment of dental procedures, yet, you do nothing!

    It is a disgrace, crime against humanity, and a black mark on the entire county, to continue to allow this to happen another day. In my opinion, a much bigger than the Fast and Furious debacle.

    It's worse than disgraceful this is still happening, 5 years after first being alerted to these children being abused. I am saddened at what is becoming the biggest disgrace of all - the lack of action!

    I'm embarrassed nothing is being done - other than a few token arrests of a dentist here and there. Only one, that I'm aware of from the criminal organizations themselves - dentist and inventor Robin Lockwood in Oklahoma.

    The companies who have perfected this madness don't even try to defend their actions any longer. Kool Smiles - NCDR for example. The best they can do at this point combat their disgusting behavior is to hire someone that in essence said, "we can abuse and mangle more children for less" My GOD! Are we all insane?!

    Are lawmakers and law enforcement hoping the pool of patients will just run dry if it's ignored long enough? I'm note sure. They wouldn't have to bite the hands that feed their campaign coffers, would they? These abused children are growing up, they have not and will not forget the horrors bestowed upon them by these brutal dentists. Nor, will they forget those who sat idly by and let, if not encouraged, it to happen. I doubt they will subject their own children to these abuses, though it may mean no dental care at all for future generations. (This could explain why there is always a crisis in dental health here in America.)

    This very day – Tuesday, October 2, 2012- thousands more children will be abused in these clinics, it will happen again tomorrow. What will it take to stop this? Tell me, please. What do you need?

    Millions of tax dollars dollars will be paid to companies today to physically abuse, mangle children faces and mouths and leave crippling emotional scars. One such child who suffered these horrors well over a year ago, just this past weekend, gained the courage to leave her mom and spend a few short hours with her grandparents! How is doing nothing about this, OK?

    IMG_2820This week, I’m spending my time nurturing a grandchild or two or three. We will be decorating pumpkins, and doing anything else I can think of to give them loving memories. Hopefully they will carry these moments in their hearts and minds, long after I’m gone.

    Prosecutors, Attorney Generals, everyone on Capitol Hill, this is to you:

    Will you stop the barbaric child abuse and torture by greedy dentists today?

    Will you please end this nightmarish treatment that is emotionally crippling our most vulnerable – our children, our grandchildren?

    The millions of children who have been permanently scared by abusive dentistry can’t enjoy “Kodak moments”, as above. Their  minds, emotions, as well as their mouths are forever damaged. We as parents and grandparents can’t give them enough loving memories to erase these horrors from their minds.

    Do something today?