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Monday, April 28, 2014

Pop the corn, it’s show time! Let the battle of true ownership begin: CSHM sues one of their “owner dentists”

CSHM, LLC/Small Smiles Dental Centers/”fill in the blank” Youth Dental Center” was granted a Temporary Restraining Order against one of its fake “owner dentists” in US District Court last week.(April 25, 2014) The Order was granted after a Complaint was filed against Dr. Jodi Kuhn for allegedly breaching her various Management Service Agreements (MSA’s) with CSHM, LLC.

The Complaint states in January 2013 Dr. Jodi Kuhn Kuhn purchased 4 clinics in Colorado for $100 each from Randall W. Ellis, DDS—the prior fake owner dentist. Ellis purchased from Robert Andrus, DDS, the prior prior fake owner.

(That’s a damn good deal! But I don’t believe it to be true; not much of of anything in these documents is actually true. Kuhn’s name doesn’t’ appear until December 2013. If she purchased the clinics in January 2013, why is CSHM’s Linda Zoeller name still plaster all over the 2013 annual reports. After all Jodi did it herself in December of 2013.)

Thursday, April 17, 2014

How do the folks at Small Smiles-CSHM keep it all straight? A Rant.

How the people at CSHM keep it straight as to when they own the Small Smiles clinics and when they don’t is beyond me; since it always depends on who they are communicating as to whether they own them or not. Of course, the truth is they do own them, and Sen. Grassley’s report provided that evidence.

Church Street Health Management (CSHM) f/k/a FORBA had to divest in the Manassa, Virginia clinic in March of 2012. HHS-OIG sent them a Notice to Exclude. Here is the HHS-OIG agreement sent to Sheila Sawyer, General Counsel and Chief Administrative Officer of CSHM at the time.

On April 30, 2012, the sham owner of the Small Smiles of Manassas, Gillian Robinson-Warner supposedly signed a Termination Agreement with CSHM. The Termination Agreement states Small Smiles of Manassas, LLC, a Virginia limited liability company, “owns and operates a dental practice in a dental office at 9012 Mathis Avenue, Manassas, Virginia 20110”. Apparently the Manassas clinic was the worst of the worst of the Small Smiles clinics. However, all clinics have been under a Quality of Care Corporate Integrity Agreement since January 2010.

As the Manassas Termination Agreement reads one would assume Small Smiles of Manassas, LLC is a living breathing human-being. Gillian Robinson-Warner signed as President of Small Smiles of Manassas, LLC and agreed to pay CSHM $80,000 to CSHM if they would terminate the said MSA.

The very next day—May 1, 2012—two Motions were filed seeking the Bankruptcy Court’s approval to terminate the contracts.

Motions? Contracts? More than one, you ask? 

Yes, there were two!

The same day the Manassas Motion was filed in Tennessee Bankruptcy Court, so was a Motion seeking the courts approval to terminate the Management Services Agreement between CSHM and the Pueblo clinic. The Pueblo clinic is the flagship clinic of the DeRose-Padula family; the ones who created this monster. Isn’t that odd? The Pueblo clinic agreed to pay CSHM $300,000 to terminate their imaginary agreement. Dr. Randall W. Ellis supposed signed as president of the Pueblo clinic.

We know, the Small Smiles of Manassas, LLC is just a shell corporation, like all the others; each clinic has its own LLC or PC designation. Each controlled and operated by the people at CSHM and backers. Those are facts that have been proven over and over.

Despite that being common knowledge; CSHM will tell you the grass is purple while you are standing there looking at it and know its green; maybe they have lived in the fantasy world of “we only provide support services to dentist owned dental clinics land” for so long, they believe their own BS.

It is understandable where all of this might lead to an identity crisis for anyone working at CSHM or any of their Small Smiles clinics; particularly troublesome for Linda Zoeller. She isn’t even sure of her title at the various, LLC’s or PC’s. Here are 4 different titles she gave herself at just one of the Indiana clinics. Stop laughing!

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Reading over both Motions and Termination Agreements, I had to laugh out loud a couple of times. (Ok, I’ll be honest, it was more than a couple, and it was more like a couple in “I’ve only had a couple of drinks” kind of way.)

Besides all the stated facts in the document being anything but factual, I had to laugh at the language.

More than once “abundance of caution” was used. By my very favorite was “The Termination Agreement reflects the product of extensive arm’s length negotiations”. I’ll admit I blew coffee across the room when I read that one. I don’t know how a PC or LLC verbalizes its intent in negotiations; sign language?

Wednesday, April 16, 2014

Herbert Salisbury, III, DMD vs. Heartland Dental: Seller Beware

So you want to sell the dental practice you worked years to establish instead of just retiring and closing the doors? Were you offered, a “too good to be true” deal by Heartland Dental, or some other Dental Practice Management organization?

Do yourself and your patients a favor and decline. Take the lesson’s learned by Dr. Salisbury and don’t be swayed with visions of riches offered by Rick Workman. Otherwise be ready to become the slave of white collar suits sitting in a Canadian board room. Why? Because you will have to hit their production goals in order to receive the your final installment payments. (Read the lawsuit below).

Leaders in Dentistry: Kianor Shah, DMD

DrBicuspidLeaders in Dentistry: Kianor Shah, DMD

By Tony Edwards, Editor in Chief

DrBicuspid.com talked with Dr. Shah about what drove him to found Dental Equities, what he believes are the advantages of private practice, and where group practices may go wrong.

DrBicuspid.com: How did you go from a thriving private practice to founding a firm to help other dentists in private practice?

Dr. Kianor Shah

Kianor Shah, DMD.

Dr. Shah: Throughout dental school I was interested in the concept of delegating tasks within a practice to enable my colleagues to be more focused on the patient. I graduated from dental school, associated with a doctor, and learned so much from him. After six months, I purchased my first practice with the help of that other doctor and a conventional bank loan.

After you built your practice, you became a practice management consultant, working with group practices. But now you have founded an organization that works to strengthen private practices. Why is that?

Over the course of these last eight years, I have worked with a dozen members of the largest dental management services organizations and members of the Dental Group Practice Association and have observed their operations very thoroughly…

To Read more and comment, click here.

Wednesday, April 09, 2014

Praise for prosecutors: Ind. attorney general sets high standard

Praise for prosecutors: Ind. attorney general sets high standard

By Michael W. Davis, DDS, DrBicuspid.com contributing writer

April 9, 2014 -- On April 1, 2014, the Office of the Indiana Attorney General filed criminal charges against principles and employees of Anderson Dental Center. Defendants are alleged to have engaged in variety of criminal conduct, including dental Medicaid fraud, forgery of documents, money laundering, theft, corrupt business influence (racketeering), prescription drug fraud, and practicing dentistry without a license. All defendants are presumed innocent until or unless found guilty beyond a reasonable doubt by a court of law.

Several elements make this case very special. First, in the spirit of governmental full disclosure and transparency, the complete investigative report of Diane Hedges, the state investigator for the Indiana Medicaid Fraud Control Unit (MFCU), was posted on the Office of the Indiana Attorney General's website. This report and investigation, assisted by Sheila Green of the U.S. Health and Human Services Office of Inspector General (HHS-OIG) and Neal Freeman of the FBI, was exemplary in its thoroughness and detail. This type of evidence and report is the solid backbone of a criminal case for any state or federal criminal prosecutor. Good governmental investigators such as these are not paid nearly enough, nor appreciated enough by the public. Their work deserves great praise.

Too frequently, criminal charges are not brought forth in prosecution of dental Medicaid scams. Often, only civil charges are rendered, and cases are usually settled for pennies on the dollar, with no admission of guilt. Prosecutors are allowed to close a case. Nondentist owners who may be pulling all the criminal strings are rarely indicted. The crooks go back to business as usual, poor children are hurt, and taxpayers are ripped off once again. The cycle continues. Perhaps this time a chain was broken?

Read Complete Article At Dr. Bicuspid

Monday, April 07, 2014

Non-Dentist dental clinic owner arrested for Medicaid fraud in Indiana

Heads up all you others out there! Round of applause to Indiana AG, however, this is small peas, you have much bigger ones doing the same. Time to put some corporation executives in there with Ms. Metzner.

Anderson Dental Center Busted for Alleged Medicaid Fraud

By Mike Corbin - mcorbin@wibc.com | @WIBC_MikeCorbin

wibcAn Anderson-based dental group has been busted for alleged Medicaid fraud and corruption.

The Indiana Attorney General's office says the unlicensed owner of Anderson Dental Center, three dentists and four employees all face charges they bilked Medicaid of at least $300,000. Authorities say owner Sally Metzner and others submitted false and inflated claims to the Indiana Medicaid program for dental service payments. They say some of the documents were forged to get higher reimbursements than they were due.

The dentists 73-year-old Paul Pangallo, 69-year-old Jeffrey Rich and 46-year-old Thomas Dubois are also charged with money laundering, Medicaid fraud and theft. The four office workers are charged with corrupt business influence. A fifth worker is charged with prescription drug fraud. An affidavit alleges the fraudulent billing continued even after authorities executed search warrants at the office.

Sally Metzner

Thursday, April 03, 2014

CSHM and Small Smiles Dental Centers sign Exclusion Agreement

OIG Excludes Pediatric Dental Management Chain From Participation in Federal Health Care Programs

April 3, 2014

CaptureRelated Information

CSHM, LLC Exclusion Agreement

CSHM, LLC, formerly known as FORBA Holdings and Church Street Health Management (CSHM), signed an Exclusion Agreement that bars CSHM from participating in Medicare, Medicaid, and all other Federal health care programs for a period of 5 years, Daniel R. Levinson, Inspector General of the U.S. Department of Health and Human Services, announced today. The exclusion is based on CSHM's alleged material breaches of its Corporate Integrity Agreement (CIA) with the Office of Inspector General (OIG). CSHM manages and operates the national chain of Small Smiles Dental Centers, which provides services primarily to children on Medicaid. CSHM's corporate predecessor entered into the CIA in 2010, as part of the resolution of a False Claims Act case involving allegations that the company had provided dental services to children on Medicaid that were medically unnecessary or failed to meet professionally recognized standards of care.

To minimize immediate disruption of care to the hundreds of thousands of children treated at CSHM clinics and to enable an orderly, controlled shutdown of the company or divestiture of its assets, the exclusion will be effective on September 30, 2014. CSHM waived its right to appeal this exclusion in any judicial forum.

"CSHM has committed repeated and flagrant violations of its obligations under the CIA—violations that put quality of care and young patients' health and safety at risk," said Inspector General Levinson. "This exclusion underscores our commitment to enforcing our integrity agreements designed to promote quality of care and protect patients in Federal health care programs." Mr. Levinson said that this exclusion "makes clear to the provider community that OIG closely monitors our CIAs, critically evaluates providers' representations and certifications, and will pursue exclusion actions against providers that fail to abide by their integrity agreement obligations."

On March 7, 2014, OIG issued a Notice of Exclusion to CSHM based upon numerous material breaches of its obligations under the CIA. CSHM failed to report serious quality-of-care reportable events, take corrective action, or make appropriate notifications of those events to the State dental boards as required by the CIA, OIG found. CSHM also failed to implement and maintain key quality-related policies and procedures, comply with internal quality and compliance review requirements, properly maintain a log of compliance disclosures, and perform training as required by the CIA. Finally, CSHM submitted a false certification from its Compliance Officer regarding its compliance with CIA obligations.

This exclusion marks the culmination of a series of alleged failures by CSHM and its corporate predecessors to comply with its CIA. Under the CIA, an independent quality monitor conducted more than 90 site visits and reviews to monitor CSHM's compliance. Since the 2010 settlement, OIG repeatedly cited CSHM and took actions to address those violations, promote improved compliance, and maintain access to care for an underserved population. These actions included imposing financial penalties and forcing the divestiture of one of the company's clinics.

Despite these actions, CSHM remained in material breach of its CIA and OIG issued Notices of Intent to Exclude to the company in December 2013 and January 2014. In such cases, providers have the opportunity to demonstrate to OIG that they have cured, or are in the process of curing, the material breaches. CSHM represented to OIG that it would cure the material breaches. However, through meetings with CSHM and its Board of Directors and review of its written submissions, OIG determined that CSHM had failed to cure the material breaches and proceeded with the exclusion.

Until the exclusion goes into effect on September 30, 2014, an independent monitor will continue to monitor the quality of care being provided to patients at CSHM clinics. CSHM is required to inform patients at least 30 days before closing a clinic. CSHM is also required to keep State Medicaid agencies abreast of developments and provide monthly status reports to OIG. Any divestiture of assets by CSHM must be through bona fide, arms-length transactions to an entity that is not related to or affiliated with CSHM.

The Inspector General credited Special Agents from OIG's Office of Investigations, Miami Regional and Nashville Field Offices, with assisting in this investigation. OIG was represented in the investigation and litigation of this matter by Senior Counsel Felicia E. Heimer, Maame A. Gyamfi, Robert M. Penezic, and Tamara T. Forys, with assistance from Paralegal Mariel Filtz.

CSHM disputed OIG's determination that it was in material breach of the CIA.