Wednesday, March 11, 2015

Texas Governor Greg Abbott Fails Dental Health Patients- Again

By Michael W. Davis, DDS

Dr. Michael Davis Bio

This report begins in a small Appalachian town in the hill country of East Tennessee; Bristol. Many call this community the birthplace of country music. It also boasts of a very modest but proud NASCAR track. This community is not wealthy by the standards of Westchester County, Marin County or Beverly Hills. Its wealth is in its people, traditions and strength of community. Folks have lived together as friends and family for generations. Success is more often measured in terms of spiritual values and connections with neighbors, than numbers in bank accounts. It’s a place where people trust and rely on family and neighbors. It’s a community where doctors still hold an esteemed position.

This may not be a town which “sophisticated” people on the East or West Coasts can relate to. In fact, they may use demeaning terms like “hillbillies” or “rednecks”, to dismiss these hardworking Americans. However, most of America absolutely respects people and towns like Bristol, Tennessee. That’s definitely true for most Texans, who hold similar values.

A doctor allegedly betrayed the trust of Bristol, TN, back in 2013. This dentist took the money from many patients of very modest financial means, most often for lay-away and payment plan dentures. Then he simply locked the doors to his clinic, and left the state. Unlike the Texas Alamo hero, Davy Crockett also from East Tennessee, Dr. Hardev A. Patel had a different spin on the phrase, “You may all go to hell and I will go to Texas”.

In January 2014, over 100 people filled the Bristol Tennessee General Session Court Room, to discuss the closure of Dr. Patel’s dental clinic and loss of their very hard-earned money. By then, Dr. Hardev Patel had already voluntarily retired his Tennessee dental license and relocated, and allegedly retired to Texas. But, was Dr. Patel truly retired from dentistry? The Tennessee Board of Dentistry listed no disciplinary actions against his license. In effect, weren’t they opting for a geographical solution to abuses on the public interest? Dr. Patel now potentially became the problem of Texas.

Dr. Hardev A. Patel earlier obtained a Texas dental license on 12-06-2013. All the while, multiple reports were in the public domain on his alleged abuses to the people of Bristol, TN. As of this report, the Texas State Board of Dental Examiners (TSBDE) has no public advisories relating to Dr. Patel. Any computer search engine will quickly arrive at numbers of highly disturbing stories concerning Dr. Patel. Any reasonable due diligence background check by the TSBDE on Dr. Patel would have raised a serious alert.

Today, Dr. Hardev A. Patel is publicly listed as a dentist provider at San Filipe Dental Health Center, in Del Rio, TX. Working for this non-profit clinic requires Dr. Patel be credentialed in Texas, as a Medicaid provider. He must pass background checks by this non-profit organization, as well as the Texas Department of Health Services.

Are authorities in Texas all asleep at the wheel, or is there a massive corrupt cover-up in play? Regardless, this isn’t the first cluster-f’ed dental rodeo for Governor Greg Abbott. We all recall the recent debacle and closure of Austin Cosmetic Dentistry, and unlicensed practice of dentistry by an unlicensed manager. We recall the corrupt oversight of dental Medicaid mismanaged by Xerox (ACS) for years. We also remember the troubling oversight efforts by the Texas Health and Human Services Commission relating to dental Medicaid abuses and fraud.

There’s a clear pattern of misconduct from Texas state authorities relating to dental healthcare. Former state attorney general and today, Texas Governor Greg Abbott is leader of the pack. It’s well past time to stop focusing on the myriad of smaller ethical and criminal breaches, from low level political hacks. The top dog needs to be held to account.

Thursday, March 05, 2015

Smile Magic Dental Clinics Settle Texas Medicaid Fraud Allegations for $4.5 Million

Waters & Kraus, LLP is pleased to announce a qui tam lawsuit it filed has resulted in the largest recovery to date in a Texas dental Medicaid fraud case. 
DALLAS – March 5, 2015 – Four dental clinics of the Texas Smile Magic chain have agreed to settle Medicaid fraud charges for a total of $4.5 million. The four clinics that will pay the record-setting settlement include: Smile Magic of Denton, PLLC; Smile Magic of Lewisville, PLLC; Smile Magic of Garland, PLLC; and Smile Magic of El Paso, PLLC.

Amy Smith, represented by Waters & Kraus, LLP, blew the whistle on Smile Magic. To protect Texas children and taxpayers, Ms. Smith first reported to Texas officials that Smile Magic was allegedly engaging in several acts of misconduct that violated the rules of the Texas Medicaid program and later filed a qui tam lawsuit under the Texas Medicaid Fraud Prevention Act (TMFPA).

It was alleged in the qui tam lawsuit that Smile Magic defrauded the Texas Medicaid program by performing unnecessary or excessive dental services on young children, billed Medicaid for dental services never-performed, targeted young Medicaid beneficiaries through improper financial incentives, and used paid recruiters to round up poor kids to be used to commit Medicaid fraud. At times, the clinics allegedly solicited young Texas children by targeting their parents in grocery store parking lots, bus stops and other locations in poor neighborhoods, paid money to parents to induce them to have their kids treated at these Smile Magic clinics, and orchestrated teams of solicitors to round up Texas kids for all of these purposes. As further alleged in the qui tam lawsuit, once these young, mostly poor kids were in the dentist’s chair, Smile Magic’s goal was to maximize the amount it could bill Texas Medicaid, regardless of whether the services were medically necessary or, in some cases, even provided to the patient.

Based upon the allegations by Ms. Smith and another whistleblower, the Texas Health and Human Services Office of Inspector General (OIG) and the Civil Medicaid Fraud Division of the Texas Attorney General (OAG) conducted their own investigation of Smile Magic and determined that Smile Magic submitted improper claims to the Texas Medicaid program. The OAG intervened in Ms. Smith’s qui tam lawsuit.