If you read this blog, then you know profits with Medicaid dentistry is made on high volume, gross excessive treatment, all at a single visit. The prime example is Small Smiles and their Production Per Patient (PPP) mantra handed out to their employed dentists. As testimony revealed in a New York malpractice case, "PPP is the Golden Goose", said one Small Smile executive. As was put another way by one of Small Smiles managers, “you eat what you kill”.
It’s undeniable, years ago, Small Smiles Dental set the gold standard of excessive treatment by restraining children with use of the papoose board.
As heat from press, parents and few state dental board followed some Medicaid accepting dentists and dental chains decided sedation would be the key even more profits, leaving the least amount of yuk in everyone's mouth—the children, the parents and especially the public.
Weekend "get-a-way" sedation courses were developed, lobbyist hired and representatives of the dental community were sent on press junkets stressing the need for higher reimbursements from insurers and Medicaid; all to accomplish the same thing—Production Per Patient. Now, as ABC news has reported in 2012, we have children being overdosed, brain damaged and dying at an alarming rate.
All the while, government regulators appear to be hiding under their desks. It is understandable that the bulk of the dental profession has given up. It’s been proven over and over there is no money to be made in Medicaid dentistry, if provided ethically. Add government corruption and ineptitude to the mix and it’s like the sadistic relationship between the addict, and their co-dependent enabler; life and death danger to both.
Governments along with the unethical Medicaid dental providers have entered into a tacit and toxic agreement. Government and regulators basically saying, “We won't regulate you to the extent we can and should. If we did, the entire dental Medicaid program would likely collapse. So, we in government will continue to give wrist slaps and enable your destructive and abusive activity— it’s easier than fixing it.”
A prime example of this is Small Smiles Dental Centers. There are other dental chains that are on the governments public watch list and have settled allegations with the government by signing Corporate Integrity Agreements (CIA). However, Small Smiles and its parent company, Church Street Health Management (CSHM) (f/k/a FORBA) is the only group who have landed on the OIG’s , Quality of Care (QOC), proverbial shit list .
Two years after signing the agreement Small Smiles continued to deliver such substandard care to children; the Office of Inspector General resorted to something it had never done before. Church Street Health Management was forced to divest in some of its clinics. Yet, the clinics across the country are still churning out substandard care and excessive treatment, with many of the same executives still in place.
It's time for the addicts and enablers to "find their bottom", with "tough love". Let the whole thing collapse, so we can reconstruct a healthy & viable Medicaid system.