Significance of Criminal Indictment to Dr. Edward R. HillsBy: Michael W. Davis, DDS, Guest Contributor
Dr. Michael W. Davis maintains a private general practice in Santa Fe, NM. He also advocates for disadvantaged citizens, and provides expert legal work for numbers of attorney clients. His publications and lectures are on ethical and whistleblower issues within the dental profession, as well as numbers of clinical research papers.
Dr. Edward R. Hills was formally indicted on October, 19, 2016, by the US Justice Department for a variety of alleged criminal violations, in US District Court for the Northern District of Ohio (Eastern Division). Co-defendants included three other dentists, Drs. Sari Alqsous, Yazan B. Al-Madani, and Tariq Sayegh. The government contends Dr. Hills and other defendants engaged in a variety of actions inclusive of Medicaid fraud, bribery, extortion, interference in a federal investigation, witness tampering, tax fraud, defrauding of a non-profit hospital, an interstate kickback scheme, and racketeering. The government also invoked claims of Racketeer Influenced and Corrupt Organizations Act (RICO Act) violations. The indictment was laid out similarly to an action against an organized crime figure and their subordinate mob crew. [Click here to read 93-page, 33-count indictment: https://assets.documentcloud.org/documents/3178765/MetroHealth-Indictment.pdf ]
Dr. Hills formerly served as chief operations officer (COO) for Cleveland’s MetroHealth Hospitals from 2010-2014. During that tenure, his salary ranged from over $400,000 to just under $3/4 Mil per year. He also served for 6-months as interim chief executive officer (CEO), following a previous scandal and resignation by Mark Moran at MetroHealth. In this capacity, Dr. Hills had direct supervisory control of the dental residency post-graduate program (which the three other defendants directly ran). Dr. Hills also served on the Ohio State Dental Board from 1999-2008. From 2001-2004, Dr. Hills was the president of the state dental board.
Alleged Extortion of Dental Residents
The government contends foreign national doctors were shaken down (extorted) for cash to apply to the dental residency program at MetroHealth. They were further extorted for additional cash to maintain their dental residency positions. Residents were also forced to work for no compensation, at two private clinics owned and operated by two of the defendants (Noble Dental Clinic & Buckeye Family Dental).
Many of the dental resident doctors were Jordanian citizens, and required an H1B (green card) work visa to obtain an Ohio dental license. Without a green card visa sponsored by an employer (Dr. Hills and/or his crew), these doctors were not eligible for licensure, as they were not US citizens. Obviously, these dental resident doctors were in a particularly vulnerable position.
Two dentists of Dr. Hills’ crew were allegedly accepting full-time incomes from MetroHealth, as preceptors of the dental residency program, and at the same time running two large scale private dental practices. These were the same private dental clinics were resident doctors were allegedly required to deliver patient dental care, without compensation. These same two crew members allegedly benefited unlawfully, by having MetroHealth fully pay their malpractice insurance premiums.
Dr. Hills allegedly authorized substantial bonuses from accounts at MetroHealth for these two alleged dentist conspirators, in their frequently no-show supervisor jobs (under $93,000 in 4 years). In exchange, payoffs were allegedly afforded Dr. Hills. Kickbacks allegedly included a lap-top and an apartment to entertain Dr. Hills’ girlfriend, bedroom furniture, cash (hundreds of thousands of dollars), a Louis Vuitton briefcase, airplane tickets for the lovers, a flat screen TV, and controlled prescription medications (exact medication name redacted from indictment).
Paying the Lawyer
A former Cleveland city prosecutor was owed fees for legal services rendered to Dr. Hills. Allegedly, Dr. Hills arraigned for a trade of services, via very extensive dental care for his attorney at MetroHealth, inclusive of dental implant services, veneers and dental crowns. The expressed intent of the dental residency program at MetroHealth is to advance the education of dental residents, and serve the poor and disadvantaged. If proven, this goes beyond a conflict-of-interest and ethics violations, but into a failure to report income subject to lawful taxation and a defrauding of MetroHealth.
The Hustle of Impaired Doctors
While serving on the Ohio State Dental Board, Dr. Hills incorporated a company, Oral Health Enrichment. This company was seemingly established to assist doctors’ recovery, suffering from the disease of chemical dependency. It is widely estimated that approximately 10% of all healthcare providers have suffered or are currently suffering from chemical dependency. These doctors are most frequently in danger of losing their dental licenses, and are desperate for help. As such, they may be vulnerable to unscrupulous recovery providers. The indictment basically alleges Dr. Hills established a shell company, Oral Health Enrichment, when in fact recovery services were provided by MetroHealth. MetroHealth was allegedly defrauded of time, staff services, and property, while Dr. Hills pocketed the revenues for chemical dependency recovery services.
State dental board members in Ohio, Kentucky, Texas “and elsewhere” were allegedly solicited and offered kickbacks, to generate referrals of impaired doctors for Oral Health Enrichment’s doctor recovery program. In this scheme, Dr. Hills allegedly enlisted the support of “Public Employee 1”, who served as an employee (executive director) of the Ohio State Dental Board.
Lili Reitz, attorney and former executive director of the Ohio State Dental Board suddenly resigned in 2015, after serving the dental board since 1996. [https://www.documentcloud.org/documents/3213532-Lili-Reitz-Case.html http://watchdog.ohio.gov/Portals/0/pdf/investigations/2016-CA00016.pdf ]
Early this year, Ms. Reitz accepted a guilty plea involving the MetroHealth investigation of leaking confidential information of a complainant to Dr. Hills. Her ethics violation charge was reduced to misdemeanor disorderly conduct and $100 fine. It is highly probable that Lili Reitz is “Public Employee 1” cited in the government’s indictment. The alleged actions of “Public Employee 1” (if Lili Reitz) could have potentiated disbarment, and a criminal conviction. It’s highly possible a very culpable party walked away with a wrist-slap. However, sometimes “it takes a crook, to catch a crook”.
Kickbacks to Acquire Medicaid Patients
The indictment also cites kickbacks paid to Dr. Hills for generation of dental Medicaid referrals (from MetroHealth), by the two private dental clinics owned and operated by two of the dentist defendants. Defendants allegedly attempted to misrepresent the true nature of financial kickbacks with terms like “consultation fees”. Violations to federal Stark laws and federal anti-kickback statutes may apply. This potentially represents a serious defrauding of taxpayers. It also potentially represents healthcare referral not based on the best interests of patients, but a deleterious money-making scheme only benefiting the defendants.
Obstruction of Justice
The government claimed once defendants learned of the investigation, they encouraged witnesses not to cooperate with investigators or the grand jury. Evidence was allegedly hidden from investigators of both the FBI and IRS. Kickbacks and bribes were misrepresented as “repayments on loans”, “although, as they well knew, no such loans existed”. IRS 1099 forms were given Dr. Hills by his crew of defendants, in a lame attempt to conceal his acceptance of kickbacks, well after the fact.
After learning of the FBI and IRS investigations, Dr. Hills was recorded on a court ordered wiretap. He attempted to hold his alleged criminal gang intact, “The s**t we got ourselves in this year is because mother*****s running they mouth snitching… y’all know about Law and Order, they do it every f*****g week… What does Law and Order do? Snitches. Y’all watch 48 Hours? Snitches....”. On several subsequent occasions, Dr. Hills again strongly encouraged his allegedly criminal crew to remain silent with federal investigators. He allegedly instructed criminal subordinates to reclassify kickbacks and bribes as a “finder’s fee”, for purchase of Noble Dental Clinic, when Dr. Hills played no role in such a clinic purchase.
This unfortunate story reads like a crime novel from the Gambino or Bonanno organized crime families. This should never be tolerated in the dental profession. Yet, alleged criminal conspiracy took place for many years, and at the highest levels of dental education, healthcare delivery for the disadvantaged, and dental regulation of the dental profession. Multiple systems were totally corrupt at their cores. Yet, we hear precious little from organized dentistry.
This indictment brings question to the integrity of our state regulatory dental boards. Can they be trusted? What was the full extent of Ohio State Dental Board members engaged in this unlawful scheme? Which state regulators in Kentucky and Texas became involved, as well as elsewhere?
Our foreign national doctors are at a distinct vulnerability from extortion shakedowns, by dishonest employers. This disturbing unlawful activity is present in both the private and public sectors, as was demonstrated in this indictment. What employment protections can be established?
The integrity of the institution of dental residency programs must be questioned. Resident doctors need to secure and maintain their hospital positions based on merit and positive patient service, not cash payoffs or bribes. Whistleblowers of deviant programs must have protections. This is too rarely the case today, as whistleblowers for the public welfare are usually hung out to dry by their powerful supervising doctors.
Again, where is leadership from organized dentistry? Too often, like the Three Wise Monkeys, who can see no evil, hear no evil, and say no evil; these shams hide under their desks in blind ignorance. Grassroots doctors can’t accept this as status quo.
On the positive side, a good number of doctors, although not dentists of formal leadership standing, fully cooperated with investigators. The indictment listed numbers of these dentist heroes by confidential numbering. In my personal investigation for this report, I discovered numbers of other dentists who assisted the government’s investigation, who were not cited in the indictment. Again, these are dentist heroes, who will never receive kudos, but stood tall for the dental profession and public welfare. This reporter is very proud of you. You represent the heart and soul of the dental profession. I view you as patriots, even if some of you may lack US citizenship. Thank you!