Friday, August 09, 2013

Academy Of General Dentists (AGD) and the American Dental Association (ADA) Respond to Scathing Senate Report on Corporate Dentistry

If you read this blog at all I’m sure you haven’t forgotten the Joint Staff Report issued a couple of weeks ago, by Senators Baucus and Grassley, where they told of the abuse and illegal activities of Small Smiles Dental and other corporate dental chains.  With Small Smiles in particular they laid it out for everyone; from the founders to the current CEO and Garrison Group. 

To top it off, they all but call the folks at HHS/OIC who are supposedly “monitoring” this company, incompetent imbeciles.  It for certain shed light on the “pay to play” action going on between HHS/OIG and Small Smiles Dental Centers; sounded more like a game of Cat and Mouse Extortion between the two to me.  If HHS/OIG were actually assessing the fines for this company laid out in the 2010 Corporate Integrity Agreement, I’d say it would add up to $4 Billion by now.  (ok, I’m exaggerating, but it would be HUGE!)  A couple of years ago, I was told by someone I won’t quote (they don’t like being quoted at HHS/OIG) that they…being OIG…take “Quality of Care Corporate Integrity Agreements very seriously.  I say HA! (as I role my eyes) 

Anyway, below are the responses from the AGD and ADA to the Baucus- Grassley Report.  Hard to believe they are housed at the same address in downtown Chicago.

(I may have messed with the picture a little, but I couldn’t help it.  I only have so much control, ya know)

The AGD Response

AGD applauds Senate report on corporate dentistry

AGD Applaude Senate Report - Dental Tribune w-DTM


Dental Tribune

Jul 26, 2013

CHICAGO, Ill., USA: The Academy of General Dentistry (AGD) is applauding a jointly issued U.S. Senate report that criticized large corporate dental practices that engage in deceptive overtreatment of patients. The report, co-released July 23 by Sen. Max Baucus (D-Mont.), chairman of the Senate Committee on Finance, and Sen. Chuck Grassley (R-Iowa), the ranking member of the Senate Committee on the Judiciary, is titled “Joint Staff Report on the Corporate Practice of Dentistry in the Medicaid Program.”

The report says that the Office of Inspector General of the U.S. Department of Health & Human Services (HHS) “should exclude from participating in the Medicaid program” any other corporate entity that employs a “fundamentally deceptive business model resulting in a sustained pattern of substandard care.”

W. Carter Brown, DMD, FAGD, Academy of General Dentistry president-elect and chair of the AGD Corporate Dentistry Task Force, and AGD Immediate Past President Jeffrey M. Cole, DDS, MBA, FAGD, met with Grassley on this and other matters earlier this year. “We sincerely thank Sen. Grassley for meeting with us and for the efforts of his investigative team,” Brown says. “The AGD appreciates the opportunity to provide information and feedback.”

“We need to make sure that the care being provided to all dental patients is the best care available, that it is provided in a doctor-patient relationship so that the appropriate treatment for each patient can be determined,” said Brown. “This standard applies to solo or small group practices, school-based practices, even corporate practices — the goal of providing the best patient care should be the same.”

“The report is not a broad-brush discussion of all of the corporate models,” Brown says. “Rather, it offers an in-depth analysis that states may use to determine when business models, actions, or contractual agreements of dental management companies may not be providing the appropriate level of treatment planning, care, and oversight.”

Included in the report are discussions for improving the utilization of existing care by those who do not routinely seek care. The AGD does have concerns about one of the report’s conclusions concerning non-dentists being used to provide dental treatment to underserved populations.

“The AGD fully supports efforts to empower the community to be active in its own health maintenance,” Brown says. “Dental disease is for the most part preventable, and when patients understand and participate in preventive and healthy behavior, the community’s overall health will improve. Data has shown that relying on treatment-based solutions does not create improved health outcomes for the community — only more fillings placed.”

In July 2012, the AGD released the white paper “Barriers and Solutions to Accessing Care,” delineating the barriers to care and proposing proven solutions for improving access to and utilization of care, including promoting oral health literacy, improving Medicaid administration, and utilizing patient navigators rather than non-dentists who perform dentistry.

“The dental profession cannot implement prevention programs, oral health literacy, and other solutions without the support of our state and federal legislators, as well as the support of other organizations such as the W.K. Kellogg Foundation and the Pew Center on the States,” Brown says. “We at the AGD look forward to working with Sen. Grassley and others to improve oral health by advancing these solutions.”

(Source: AGD)

AGD Press Release

Yahoo News

The ADA Response

Senate Report Alleges Fraud and Abuse by Private-Equity Backed Dental Practices, Underscores the Need for Major Action for Dental Health

WASHINGTON, July 26, 2013 /PRNewswire-USNewswire/ -- The U.S. Senate Committee on Finance this week issued a discouraging report on ways in which some large dental practices are putting profits before patients.  The report is particularly disturbing in that most of the alleged fraud and abuse of patients involved children.  Such conduct is inexcusable, and should be prosecuted vigorously. However, equally disturbing is the broad brush that implicates a whole class of practice models rather than focusing on the actual offenders.

[ATTENTION ADA – When you have an enormous canvas, it takes an enormous brush!  Hell, this needs an industrial paint sprayer!  In 2012 the Board of Trustees and House of Delegates of the New Mexico Dental Association issued a report suggesting these corporate owned, private equity, greedy SOB’s opened nearly 700 offices between 2009 and 2011, and that 2500 offices are owned by 25 companies. (They didn’t say it exactly like that, but…) BTW, the report states they got those numbers from YOU!]

The Senate report identifies companies in which dentist employees have been pressured or required to perform unnecessary procedures in order to maximize profits.  This is a clear violation of the ethical principles of the profession, as set forth in the ADA Code of Professional Conduct.   

The Code states that "professionals have a duty to act for the benefit of others," and that "contract obligations do not excuse dentists from their ethical duty to put the patient's welfare first."  The ADA strongly believes that any pressure applied to dentists in conflict with this code should be reported and pursued aggressively.  Regardless of how they are employed, dentists must protect and promote the best interests of the patient above all else.  That is the purpose of the ADA Code, by which all member dentists agree to abide.  We believe that all dentists, whether they are ADA members or not, should follow this code.  States have legal and regulatory power to hold all dentists providing care within their jurisdictions to the same legal standards, regardless of who owns those dentists' practices.  State dental boards should exercise that authority.

Included in the Senate report is a stated concern about the ability of the dental profession to provide access to care to millions of low-income families and other vulnerable populations.   

But the causes of what amounts to a dental health crisis affecting these underserved Americans are complex and require a comprehensive set of solutions.  The ADA, state dental societies and individual dentists have for decades wrestled with this situation as advocates before state and federal governments, in addition to their traditional roles as caregivers.  There has been significant progress made, especially in bringing more children into dental offices for much-needed care.  But much more is needed, especially with regard to young adults, who have the lowest rate of dental visits of any age group.

Healthy teeth and gums are not a luxury—they're essential.  Dental health is a crucial part of people's overall health.  Prevention is a critical change factor.  The majority of dental disease in children and adults can be prevented, if they receive oral health education and regular dental care.   Without a seismic shift away from solutions based solely on intervention and toward prevention, the nation will continue to fight an uphill and ultimately losing battle against dental disease. 

It is with this in mind that the ADA and all of the state dental societies this year launched Action for Dental Health: Dentists Making a Difference, a major initiative aimed at bridging this dental divide by targeting specific, proven and community-based solutions toward specific problems.  Action for Dental encompasses numerous initiatives that fall into three categories:  Providing care now to those with the most immediate needs, strengthening and expanding the public/private safety net, and bringing dental health education and disease prevention into communities.

Through Action for Dental Health, we're helping states replicate programs that move patients out of hospital ERs and into the dental chair.  We're helping dentists provide care to the 1.3 million nursing home residents who cannot travel to a dental office.  We're advocating for increased water fluoridation, getting more private practice dentists to contract with safety net clinics, training Community Dental Health Coordinators, and enlisting other health professionals to make oral health a greater priority.  We are providing a wealth of information to the public through the ADA's new patient website,  And we are continuing and increasing our advocacy at the state and national levels for Medicaid programs that work, not only for children, but also for the almost entirely ignored population of low-income adults. 

The nation should be greatly concerned with the findings of the Senate report, which we hope will spur more progress.  Only a multi-faceted, targeted approach to the numerous barriers that impede dental health will work.  Action for Dental Health represents our commitment to leading the way toward the day when all Americans who seek it get the care they need to enjoy good oral health they deserve. 

The ADA reports to have over 157,000 members.  Memberships average costs is right around $500. That amounts to $78,500,000.00.  In fine print way down at the bottom of the application it states they are using around 9% for lobby efforts, up from 8.8 in 2012.  (you will have to really zoom in to see it)

The ADA may say it’s non-profit, but it’s still big business!  You know they want to keep the money flow acomin’ and these private equity firms and doing just that.  Of course it’s sold to the dentists working for the companies as a “benefit”.  “We pay all your ADA or AAPD membership fees”, they say. Calling it hush money just doesn’t fit, calling it a bribe doesn’t either, seems like they are just “partners in crime” and this is how the ADA gets their piece of the big ole pie, be it Medicaid $’s or private $’s.

I’m sure Senator Grassley isn’t surprised at the ADA’s response, he’s asked them hard questions in the recent past.  Such as “where do you guys get all your moola"?”

ADA responds to Senator Grassley’s questions regarding it’s funding. (Includes ADA Employee Manual.

Frankly I don’t see why the ADA , private equity firms, HHS/OIG, CMS, state medicaid organizations and malpractice carriers don’t just have a monthly Texas Hold ‘em poker game, to exchange the cash and leave the public’s health and teeth out of it all together! All they do is swap $’s anyway.

Anywhoo, the ADG is accepting noms for next years achievement awards, think I’ll get one.  LOL LOL LOL

AGD Accepting Nominations for 2014 Awards

Nominations should be submitted by Nov. 1 to the following address:
AGD Awards Committee
Office of the Executive Director
211 E. Chicago Ave., Suite 900
Chicago, IL 60611-1999
For more information, call 888.243.7392, ext. 4330.