Cleaning up DSO's is Essential to Increasing Access to Dental Care for Low-Income Children

“…For most Americans, going to the dentist isn't at the top of the list of things we want to do, but we go anyway, because dental care is necessary for our health and well-being. However, many of the poorest children in America don't have the luxury of dreading a trip to the dentist.

According to the Centers for Medicare and Medicaid Services (CMS), 43 million children in the U.S., including half of all low-income children, receive health coverage through Medicaid. This coverage includes dental services as part of the Early and Periodic Screening, Diagnostic, and Treatment benefit.”

“…While the DSO model has been successful, there remain areas of concern. A 2012 joint investigation by PBS's Frontline and the Center for Public Integrity (CPI) uncovered the questionable practices of some DSO's that raise red flags with state Medicaid officials.

The piece did, however, hold up one particular DSO as an ideal model that is "showing hope." Sarrell Dental, a nonprofit dental practice with 17 locations throughout Alabama, received a glowing review. However, some unsettling changes have occurred at Sarrell Dental since that Frontline broadcast.

In 2013, Sarrell Dental was acquired by Massachusetts-based DentaQuest. DentaQuest's President of Care delivery is Todd Cruse, who previously ran a company called FORBA Holdings LLC, a dental management company that provides business management and administrative services to 69 clinics nationwide known as "Small Smiles Centers."

Read the entire piece at Huffington Post

 

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Arizona’s Dental Dangers: Reports by ABC15 News Phoenix

“Dr. Michael W. Davis maintains a general dental practice in Santa Fe, NM. He serves as chairperson for Santa Fe District Dental Society Peer-Review. Dr. Davis also provides a fair amount of dental expert legal work for attorneys. He may be contacted via email: MWDavisDDS@comcast.net
 
Arizona’s Dental Dangers: Reports by ABC15 News Phoenix
By Michael Davis, DDS

This year investigative reporters, Dave Biscobing and Shawn Martin presented a series of very insightful reports for ABC15 News out of Phoenix, AZ. These investigative journalists openly challenged policies of the Arizona State Board of Dental Examiners (ASBDE). They took their investigations directly to the state legislature and governor. In our modern era of diminished resources for investigative journalism in the media, these local media market reporters exemplify the highest standards for service to their profession and the public interest.
The entire series of “Dental Dangers” stories can be accessed via this link:
http://www.abc15.com/dentaldangers
Mrs. Biscobing and Martin have detailed problems as diverse as the protective “old boy’s club” for deviant dentists, within the state dental regulatory board. They exposed the dental board’s failure to disclose public record material on dentist violators. Their report on unlicensed and unregulated dental laboratories was also disturbingly informative. Patients and doctors may have no idea from what nation, and under what safeguards, their dental prosthetics may be fabricated. In fact, ABC15 uncovered that Arizona failed to provide criminal background checks for newly licensed dentists.
This reporting goes far beyond the interests of Arizona. It has significant merit nationally. Dental dangers to the public welfare can be found in most states. Our dental public regulatory agencies, which are supposed to serve the public interest, are often primarily serving a variety of other interests. This investigative reporting did in fact stimulate the process for positive changes to the operation of the ASBDE, although much more is required.
The courageous reporting of Mrs. Biscobing and Martin exposed elements within the state legislature and governor’s office, which discounted the public interest. That unfortunate fact came forth loud and clear. We witness a form of journalistic integrity, which is too infrequently seen on the national media stage, let alone a local media outlet.
We all owe a tip of the hat to Dave Biscobing, Shawn Martin, and the entire crew at ABC15 News in Phoenix. I encourage Dentist the Menace readers to click on the above link, and enjoy an inspired series of reports on dental investigative journalism.

Dental Assistant of Howard S. Schneider, LaTosha Bevel-Hillsman Arrested

Florida’s attorney general’s Medicaid Fraud Control Unit and the Jacksonville Sheriff’s Office have issued another warrant in the medicaid / abuse criminal case related to Jacksonville dentist Howard S. Schneider. Schneider was arrested yesterday. Read more about that here. They arrested and booked his assistant LaTosha Bevel-Hillsman on charges of practicing dentistry without a license, defrauding the Florida Medicaid program and child abuse. Hillsman was booked into the Duval County jail just after 5 p.m. Tuesday, November 17, 2015. What has been identified as her facebook page has very risque (and unhygienic) photos. Her license cannot be found on the State’s license verification as her name doesn’t match.

According to the JSO Inmate Information Search, Bevel-Hillsman is being held on a $30,009 bond. She is not yet scheduled for a court date. It is unknown if the practice will be providing her with a criminal defense lawyer.

Here is her booking report:

Warrant Issued for LaTosha Bevel-Hillsman, Dental Assistant of Dr. Howard S Schneider

JACKSONVILLE, Fla. —

The Jacksonville Sheriff’s Office has issued a warrant for one of Dr. Howard Schneider’s former dental assistants.

LaTosha Bevel-Hillsman is accused of practicing dentistry without a license, defrauding the Florida Medicaid program and child abuse.

Bevel-Hillsman is facing a child abuse charge and the state says she practiced dentistry without a license at Schneider's former office. The state also said she defrauded the Medicaid program while she worked at the office.

The embattled pediatric dentist Schneider was arrested Monday for Medicaid fraud by submitting claims for dental procedures he performed without parental consent. 

- See more at: http://www.actionnewsjax.com/news/news/local/schneiders-former-dental-assistant-accused-practic/npPjK/#sthash.Hwi9N95M.dpuf

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Duval County Pediatric Dentist Arrested for Medicaid Fraud

TALLAHASSEE, Fla.—Attorney General Pam Bondi’s Medicaid Fraud Control Unit and the Jacksonville Sheriff’s Office today announced the arrest of former pediatric dentist, Dr. Howard S. Schneider, 78, for defrauding the Florida Medicaid program.

The MFCU’s investigation revealed that Schneider, the sole owner of Howard S. Schneider, D.D.S. P.A., defrauded Florida Medicaid by submitting claims for dental procedures he performed without parental consent. The procedures allegedly fell below the standard of care and produced unauthorized claims submitted to the Medicaid program for reimbursement.

In conjunction with Schneider’s arrest, the MFCU and the Jacksonville Sheriff’s Office have an active arrest warrant for one of Schneider’s former dental assistants, LaTosha Bevel-Hillsman, for practicing dentistry without a license, defrauding the Florida Medicaid program and child abuse. Hillsman, 39, allegedly performed an extraction on a pediatric patient; a procedure that Hillsman is not authorized to perform. The investigation revealed that this procedure caused harm to the child and produced unauthorized claims submitted to the Medicaid program for reimbursement.

Schneider faces 11 counts of Medicaid provider fraud of $10,000 or less, a third degree felony. If convicted, Schneider faces up to 55 years in prison and more than $825,000 in fines and restitution.

The State Attorney’s Office for the Fourth Judicial Circuit will prosecute this case. Hillsman faces one count of practicing dentistry without a license, one count of Medicaid provider fraud of $10,000 or less, and one count of child abuse, all third degree felonies. If convicted, Hillsman faces up to 15 years in prison and more than $15,000 in fines and restitution.

 

 

Mugshot of LaTosha Bevel-Hillsman from a previous arrest for writing bad checks

 

 

 

 

Mugshot of Howard S. Schneider Nov 2015 arrest

Dr. Howard S. Schneider Arrested for 11 Counts Medicaid Fraud

Nov. 16, 2015

Dr. Howard S. Schneider of Jacksonville, Florida has been arrested this afternoon.

Pediatric dentist accused by a group of parents of hurting children, was arrested Monday.
According to the Jacksonville Sheriff's Office Inmate Information Search, Schneider was arrested on 11 counts of unauthorized Medicaid claims.
Schneider turned himself into to JSO around 4 p.m. Monday, according to the office of Attorney General Pam Bondi.

His total bond is listed at $110,033, according to JSO's Inmate Information Search. Schneider does not have a court date scheduled at this time.

- See more at: http://www.actionnewsjax.com/news/news/local/dr-howard-s-schneider-arrested-medicaid-fraud-char/npPGs/#sthash.5rQ156kR.dpuf

On November 13, 2015, Schneider filed for an emergency distribution of marital funds in anticipation of his arrest.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Charges:

Howard Schneider Charges.pdf by Dentist The Menace

Business Service Agreements: A Tool for Deception within the Corporate Dental Support Industry

Business Service Agreements: A Tool for Deception within the Corporate Dental Support Industry
By Michael W. Davis, DDS

Business Service Agreements (BSAs), also called Business Service Contracts or Management Service Agreements (MSAs), are a tool created by the dental support industry (a/k/a dental support organizations) to mask their true business operational models. These contracts are generated between the unlicensed ownership (corporate beneficial owner) and the sham figurehead owner (nominee owner dentist(s)).
These agreements contain a variety of misrepresentations specifically designed to circumvent the rule of law. These BSAs serve as a lynchpin supporting the unlawful house of cards, of largely unlicensed and unregulated healthcare entities. Please note: the term “dental support organization” is also an intentional misrepresentation, to mask beneficial ownership.
Case precedent was established in federal Fifth Circuit ruling 07-30430)¹., in which the court determined a Dental Support (Service) Organization (DSO), Orthodontic Centers of America (beneficial owner of dental clinics), was engaged in the unlicensed and unlawful practice of dentistry. The court also ruled the business agreements with so-called “owner” dentists were unenforceable and non-severable (denying one part could be enforced while another could not), because elements in these contracts were unlawful, the entire contract was rendered unenforceable.
Nationally, every DSO has created different BSAs. And, within different states, different DSOs will produce different agreements. However, there exist common features worth examination in the vast majority of these contracts.

Dental Clinic Ownership
The DSO generally will deny ownership of the dental practice. Yet, the DSO usually owns the facility or is the landlord on the lease agreement. The DSO owns the dental equipment, supplies, and any possible leasehold improvements.
The DSO enjoys contract rights to control what dentists or entity may be artificially designated as “owners”. An owner dentist(s) may not freely sell “their” asset of a dental practice, and thus are merely façade nominee owners. The DSO controls the bank accounts of the “owners’” clinic bank accounts, which are swept out several times per week, or daily. These are central points in the lawsuit against Dental One Partners, DentalWorks, et al, by 14 duly licensed North Carolina dentists enjoined by the North Carolina Board of Dental Examiners, in 2013.^2.

Ben Carson Wants Jail Time For Health Care Fraud -- Except For Dentist Friend

"We became friends about a decade ago because we discovered that we were so much alike and shared the same values and principles that govern our lives."

 

"…Pittsburgh dentist Alfonso A. Costa pleaded guilty to a felony count of health care fraud after an FBI probe into his oral surgery practice found he had charged for procedures he never performed, according to court records."

"At Costa's 2008 sentencing hearing, Carson described the dentist as "one my closest, if not my very closest friend...”

"We became friends about a decade ago because we discovered that we were so much alike and shared the same values and principles that govern our lives," Carson told the judge, adding that their families vacationed together and that they were involved in "joint projects."

"Next to my wife of 32 years, there is no one on this planet that I trust more than Al Costa," Carson said."

Read The Entire Story Here

AOL Accuses Dr. Richard Malouf of Gaming The Texas Judicial System

Everyone remember the Texas dentist, Dr. Richard Malouf, who sued nearly everyone in sight that had the gall to report or offer comment on the “House That Medicaid Built”?  The place got so big he had to purchase the house next door and he installed his own personal waterpark; dubbed here as 6 Flags Over Malouf.

The story won investigative reporter Byron Harris and WFAA a 2013 Edward R. Murror Award:

WFAA won a 2013 Edward R. Murrow Award for its investigation of Texas Medicaid fraud, including the allegation that Malouf used taxpayer money to build his personal waterpark. Texas law generally prohibits the seizure of one's home, even in the event of wrongdoing, but there is a loophole.
"If that home is purchased with stolen money, or that home is purchased based on money that has been earned by falsehood or deceit, then that home is not protected at all," attorney Jim Moriarity told WFAA.

Malouf sued a long list of folks, including actor Owen Wilson’s mom, who lived next door, for trespassing, invasion of privacy, and defamation which included America Online (AOL) for publishing the story.
Apparently Malouf , and his wife LeAnne find themselves in the 11th hour of trial without legal representation in his defamation suit which continues with AOL, Graham Wood and Candace Evans. 
AOL is basically calling “bullshit”, saying Richard and Leanne Malouf have a pool of a dozen or more attorney’s across Texas and should not need 4 months to hire another one.
I agree!
This is a must read! Enjoy!

PS. That is not the only system Mr. and Mrs. Richard Malouf gamed.  Just saying.

Malouf v AOL_Wood - Response to Motion for Continuance

Grassley Welcomes Exclusion of Two Pediatric Dentists from Federal Health Care Programs

Nov 06, 2015

Earlier this year, Sen. Chuck Grassley of Iowa asked key government agencies what they’re doing to prevent and punish Medicaid dental fraud, including billing for unnecessary and painful treatments for children, in light of inspector general audits and related media reports documenting worrisome practices.  This week, the Department of Health and Human Services Office of Inspector General notified Grassley that it has excluded two pediatric dentists from federal health programs.  One dentist is in Florida.  The other dentist is in Colorado.  Grassley made the following comment on the exclusions.

“The taxpayers pay for quality health care services.  If doctors and dentists are bilking the taxpayers and mistreating patients, they need to be shut out of Medicare and Medicaid, period.    The inspector general is right to use this tool whenever it’s appropriate.”

The Department of Health and Human Services Office of Inspector General provided the following details of the two newly excluded dentists:

On September 30, 2015, OIG excluded Howard Sheldon Schneider, DDS, from participation in all Federal health care programs because his license to practice in the State of Florida was revoked, suspended, or otherwise lost for reasons bearing on his professional competence, professional performance, or financial integrity.  OIG conducted an investigation of Dr. Schneider which revealed that the State of Florida Board of Dentistry issued a Final Order for a Disciplinary Voluntary Relinquishment of his dental license after the Florida Department of Health opened an investigation into allegations of Dr. Schneider’s abuse of his pediatric dental patients.  Dr. Schneider cannot apply for reinstatement until his dental license is reissued by the State of Florida.  

On August 12, 2015, Dr. Robert E. Hackley, Jr., DDS, agreed to be excluded from participation in all Federal health care programs for a period of three years. OIG conducted an investigation of Dr. Hackley for dental care he provided to patients at Small Smiles Dentistry for Children in Colorado Springs, Colorado. OIG's investigation revealed that Dr. Hackley furnished dental services to patients of a quality which failed to meet professionally recognized standards of care, including: performing medically unnecessary dental procedures, failing to treat existing dental conditions, and performing dental procedures that were below professionally recognized standards of care.

Grassley’s letters to the Justice Department and the Department of Health and Human Services Office of Inspector General from June are available here and here.

In 2013, following a year-long investigation, Grassley and then-Finance Committee Chairman Max Baucus of Montana issued a report and recommendations urging the administration to ban dental clinics from participating in the Medicaid program if the dental clinics circumvent state laws designed to ensure only licensed dentists own dental practices to prevent substandard care.  In 2014, the inspector general moved to disqualify a firm from Medicaid. 

Grassroots Efforts of Texas Dentists Challenge Activities of the American Dental Association

Dr. Michael W. Davis maintains a general dental practice in Santa Fe, NM. He serves as chairperson for Santa Fe District Dental Society Peer-Review. Dr. Davis also provides a fair amount of dental expert legal work for attorneys. He may be contacted via email: MWDavisDDS@comcast.net.
 
 


A newly formed group of grassroots Texas dentists has challenged activities of the American Dental Association (ADA), with the Association of Dental Support Organizations (ADSO). In an open letter to ADA House of Delegates members, Concerned Dentists of Texas, Inc. has expressed their concerns about ADA leading officials meeting with ADSO representatives. The ADSO has gone so far as to highlight these meetings in their public online marketing. Concerned Dentists of Texas contend these clandestine meetings were unsanctioned and violate established ADA rules and protocols.  They also express that the ADA’s appearance of collusion is highly evident and problematic.
Membership of the ADSO raised more than a few eyebrows. Of note in the ADSO membership is Aspen Dental Management, Inc. Aspen Dental in recent months has formally signed individual and separate legal settlement agreements, with the state attorney generals of Massachusetts, New York, and Indiana. These settlements allege specific violations ranging from unlicensed practice of dentistry, violations to consumer protection laws, false and misleading advertising, violations to full disclosures in consumer borrowing, bait-and-switch business schemes, etc.
Another ADSO member, Heartland Dental Care, Inc., in 2008 settled with the federal government for alleged Medicaid fraud for falsification and misappropriation of doctors’ Drug Enforcement Agency (DEA) numbers. This DSO also settled with the State of North Carolina in 2011, for alleged unlawful attempt to purchase a dental practice.
To follow is the open letter of Concerned Dentists of Texas, Inc. to ADA House of Delegates membership:

Concerned Dentists of Texas, Inc..

October 27, 2015
Dear ADA Delegates and Alternate Delegates,
Approximately 80% of ADA members practice as independent dentists in small local offices. We are a concerned part of that group. There is an effort by our ADA to support a corporate form of dentistry that we believe is counter to the best interests of our members and our patients. We must ask ourselves, will the ADA support its members or will it support organizations controlled and owned by hedge funds, private equity firms, and public pension plans? The increased proliferation of this type practice model poses serious risks to our 175 year established philosophy of patient care and the doctor-patient relationship.
By not taking a stand to inform and represent the majority of its current members the ADA actively supports the DSO philosophy. This is a membership gamble that the ADA cannot afford to take.
See attachments (pages numbered 1-4) documenting these major changes in the focus of ADA activities:
Page 1 &2. Breaking News Notable Joint Meeting: ADSO & ADA … Several workforce group meetings were held with ADSO (Association of Dental Support Organizations) and ADA representatives seeking a memorandum of understanding.
Page 2 & 3. The last 2 pages of a presentation asking for “collaboration”, “harmony”, and “input” between the ADA and DSOs given at the 2015 ADSO Summit that demonstrates the position ADA is taking regarding the DSOs mode of practice.
Page 1 & 4. The ADSO website screen shots showing proof of this presentation given by the ADA at the 2015 ADSO Summit and then subsequently removed from the website while the other presentations remained.
These changes are affecting the future of the private practice of dentistry and are occurring without bringing it before the House of Delegates for your vote or discussion.

• What does our House of Delegates want in regards to support of the private practice of dentistry?
• What do 80% of our practicing members want in support from their Association? Will the Tripartite support its members?
• What are our ADA candidates’ opinions and beliefs on the future models of dentistry?
• Will they be willing to support the majority of our ADA members and their autonomy?

Over five years of steadily decreasing membership will not be corrected by failing to inform and represent our current practicing members. Rather, the reversal of the trend will be affected by building relevancy and reason for belonging based on representation, transparency, accountability and adherence to long-established principles of professionalism, patient care, and enhancement of the traditional doctor-patient relationships.
Thank you for allowing us to express our concerns and personal opinions. Opinions are our own, but facts are facts. Please look forward to a blog, Concerned Dentists of Texas, which will further address these issues. The blog will serve as an informational source and reference site in order that members may stay informed. Please feel free to contact us at concerneddentistsoftexas@gmail.com.
Sincerely,
Concerned Dentists of Texas, Inc.
Attachments

Link to the entire letter including attachments