Friday, May 10, 2019

$2.3 Million Malpractice Lawsuit in Filed in Virginia Against Kool Smiles

May 9, 2019

In January 2018, Dental Service Organization (DSO), Benevis, who operates Kool Smiles dental clinics across the country agreed to a Settlement of $23.9 million dollars to settle fraud charges with the federal government. Why the company was not placed under a Corporate Integrity Agreement is beyond me, not that they mean a whole lot, but still. 

“Today’s settlement sends a very clear signal:  Fraud in the federal healthcare system will not be tolerated,” said U.S. Attorney John F. Bash for the Western District of Texas. “Especially when that fraud involves performing unnecessary procedures on kids—here, unnecessary baby root canals and tooth extractions, among other procedures—we will not hesitate to use every tool at our disposal to punish those who break the law.”



“It is intolerable when health care companies seek to boost profits by defrauding Medicaid and exploiting children," said Special Agent in Charge Phillip M. Coyne, HHS-OIG. "Systematically performing and billing for medically unnecessary dental procedures undermines the well-being of these young patients, corrupts the impartiality of medical decision-making, and diverts money from taxpayer-funded health care programs designed to pay for legitimate medical needs.”

Soon after they began rebranding each clinic to appear more individually owned and operated. But did they change their ways?  Uh....nope!  

The Complaint states that at least 50 children were treated with unsterilized instruments in March and April 2019.

Thursday, March 14, 2019

Private Equity Firm Arby Partners Invests in Dental Service Orgainization Dr. Dental Management, LLC

Abry Partners has made an investment in Framingham, Massachusetts-based Dr. Dental Management, a dental management service organization. No financial terms were disclosed.

March 13, 2019
PRESS RELEASE
BOSTON–(BUSINESS WIRE)–Abry Partners (Abry), a Boston-based private equity firm, today announced that it has completed a strategic investment in Framingham, Mass.-based Dr. Dental Management, LLC (Dr. Dental), a dental management service organization that provides comprehensive management and administrative services to Dr. Dental-branded offices.

Dr. Dental has a unique playbook for growth, successfully scaling the company exclusively through new site openings to become one of the largest dental management service organizations in New England, with 100 active dentists treating over 250,000 patients a year. With this infusion of capital from Abry, Dr. Dental will continue to expand organically by opening new locations but will now also target strategic acquisitions of dental practices and groups throughout the Northeast.
Dr. Dental was founded in 2004 by the brother and sister team Alex Faigel, CEO, and Dr. Julia Faigel, DMD, clinical director, with the mission of providing quality dental care and great service at a lower cost in convenient neighborhood locations. The organization has grown from a single location to now 44 locations with 250 operatories throughout Massachusetts, Connecticut, New Hampshire and New Jersey.

The Dr. Dental management service organization supports its patient-care locations in all non-clinical aspects of dental practice, including staffing, patient scheduling, billing and collections, financial reporting and analysis, group purchasing, payroll, marketing, education and training. This suite of services enables affiliated dentists to focus exclusively on delivering high-quality patient care, making Dr. Dental one of the leading brands as measured by patient satisfaction in the Northeast.
“Abry’s investment in Dr. Dental is a true testament to our company and the dedication of our doctors and their loyal patients,” said Alex Faigel, Dr. Dental’s co-founder and CEO. “We’re excited to build on our recent growth with Abry Partners and look forward to all that we can achieve together. By combining our first-rate reputation and expertise in organic growth with Abry Partners’ resources and guidance for strategic acquisitions, we see Dr. Dental achieving record growth and rapidly expanding its footprint over the next few years.”

The funds will also be used to hire additional management and administration staff, and expand marketing and brand awareness for Dr. Dental and its affiliates. Dr. Julia Faigel and Alex Faigel will continue in their current management roles and run day-to-day operations.

“We see a very bright future for Dr. Dental,” said T.J. Rose of Abry Partners. “Alex, Julia and their team have built a strong business ripe for further growth. This investment perfectly aligns with Abry’s multi-site healthcare specialty platform – including dermatology, dental, autism and urgent care – and we look forward to leveraging our expertise to help accelerate growth organically by expanding with new locations and through acquisitions.”


About Dr. Dental Management
Headquartered in Framingham, Mass., Dr. Dental is a leading Dental Management Service Organization (“DSO”) in New England. Dr. Dental has 44 branded locations across four states (Connecticut, Massachusetts, New Hampshire and New Jersey). Dr. Dental is focused on providing quality and affordable care for all and has established itself as a leader in patient satisfaction. For more information, visit www.mydrdental.com.

About Abry Partners
Abry Partners is one of the most experienced media, communications, and information services sector-focused private equity firms in North America. Since its founding in 1989, the firm has completed over $80 billion of transactions, including leveraged buyouts, growth financings and recapitalizations. Currently, Abry manages over $12.0 billion of capital in its active funds.

Dr. Dental Locations 
Arby Partners Portfolio

Thursday, February 21, 2019

Xerox Pays $236 Million to Settle State of Texas Dental Fraud Case Legal Team: Whistleblowers Dr. Christine Ellis, Madelayne Castillo, Yarubi Morales and others Are Vindicated

Xerox Pays $236 Million to Settle State of Texas Dental Fraud Case
Legal Team: Whistleblowers Dr. Christine Ellis, Madelayne Castillo, Yarubi Morales
and others Are Vindicated


AUSTIN, Feb. 20, 2019 – The $236 million settlement of the State of Texas’ Medicaid fraud
claims against Xerox Corp. business units vindicated whistleblowers Dr. Christine Ellis,
Madelayne Castillo, Yarubi Morales and other whistleblowers, their legal teams said today. The
settlement is the largest recovery ever in a healthcare fraud recovery suit in Texas for Medicaid
related claims.

The State’s lawsuit alleged that Xerox violated the Texas Medicaid Fraud Prevention Act and
“rubber-stamped” prior authorization requests by unqualified clerical employees, allowing “vast
numbers” of orthodontic procedures for children whose condition did not meet Medicaid criteria
for treatment. The company, formerly known as Affiliated Computer Services, Inc., before Xerox
acquired it, also was accused of making false statements or representations in Medicaid filings
with the state.

Dr. Ellis, an orthodontist in Dallas, testified before a congressional committee in Washington in April 2012 about alleged Medicaid fraud in orthodontic billings by Texas dentists.

Ms. Castillo was an employee of the now-defunct All Smiles dental chain and West Texas Dental. Ms. Morales was a former employee of the now defunct All Smiles dental chain and Rodeo Dental.

Dr. Ellis, Ms. Castillo, Ms. Morales and several other whistleblowers all filed suits approximately
two years before the State filed its suit. The State has acknowledged that the facts underlying its
suit are the same as those underlying the whistleblowers’ previous filings.

Xerox became the state’s Medicaid administrator in 2003. Between 2004 and 2012, Texas
expended approximately $1.1 billion on orthodontics under the Texas Medicaid program.
According to the State’s lawsuit, Xerox, and ACS, Inc. before it, repeatedly represented to Texas
Medicaid officials that their prior authorization system ensured proper predeterminations of
qualifications.

Ms. Castillo, Ms. Morales and several other whistleblowers who filed cases against ACS/Xerox
are represented by Rusty Tucker of the Law Offices of James R. Tucker, P.C. of Dallas and MikeTibbals of Dallas. Ketan U. Kharod, of Guerrero & Whittle, PLLC, of Austin, Charles S. Siegel
and Caitlyn Silhan, of Waters and Kraus, of Dallas, Daniel L. Hargrove, of the Hargrove Law Firm
of San Antonio, and James R. Moriarty, of the Law Office of James R. Moriarty of Houston
represent Dr. Ellis.

Charles Siegel of Waters and Kraus said, “Because of Dr. Ellis and other whistleblowers who
brought lawsuits against ACS/ Xerox, the State of Texas ultimately showed how Xerox and ACS,
Inc. deeply compromised the integrity of the Texas Medicaid program. They faced vicious legal
attacks in their courageous efforts to set the record straight.”


Rusty Tucker of the Law Offices of James R. Tucker, P.C. said, “Our legal team hopes this
settlement sends a strong message that companies that prey upon Texas families and defraud the
state will face the judgment of the courts. Companies who commit unlawful acts in violation of
the Texas Medicaid Fraud Prevention Act will be held accountable. Dr. Ellis, Ms. Castillo, Ms.
Morales and other whistleblowers who came forward should be recognized for helping expose this
massive fraud.”

The case is “The State of Texas v. Xerox Corporation, et al.,” Cause No. D-1-GV-14-000581 in
the 53rd Judicial District of Travis County, Texas.

CONTACTS:
Rusty Tucker, Law Offices of James R. Tucker, P.C. (214) 505-0097
Charles Siegel, Waters and Kraus (214) 357-6244
James Moriarty, Law Offices of James R Moriarty (713) 857-1212

Wednesday, February 20, 2019

After WFAA investigation, company settles with State of Texas for record $235.9 million

Xerox Corporation and its former subsidiary, Conduent, agreed Tuesday to a record $235.9 million settlement with the State of Texas, according to the Texas Attorney General's Office. 
It was the largest single Medicaid fraud-related settlement in a case filed by the Texas Attorney General.

The settlement comes after a three-year WFAA investigation that uncovered millions of dollars in alleged overbilling by Texas dentists targeting low-income children for unnecessary and often harmful dental and orthodontic work.

Read entire story at WFAA website

Related:

 WFAA's Byron Harris reports 

Saturday, February 16, 2019

Tailwind Capital's Dental Service Organization Investments: Benevis and Lone Peak

Just an FYI, since I'm sure this information will be needed one day:

Smiles 4 Kids, which had been purchasing many old Small Smiles clinics and Kool Smiles are both now operated by Tailwind Capital.

Benevis is Kool Smiles and Resolution Dental
Lone Peak is Smiles 4 Kids as well as a few other names.


Financing for Benevis's sale to Tailwind seems to be, in part,  by New Mountain Finance and happened during the 1st quarter of 2018. Probably before the ink on the Kool Smiles settlement was dry. 

In a May 2018 conference call transcript New Mountain states:
Our new investments were highlighted by a larger-size directed origination of a unitranched loan for Benevis, several club deals including a loan to ACA Compliance and one addition to both our net leased portfolio and our SBIC investing program. We believe that the consistency of our deal flow in this competitive market shows the strength of the broad sourcing network that we have built.
(unintranched debt: debt is a type of structured debt that obtains funding from multiple participants with varying term structures.)
 

In their 2018 holdings report, Washington State Investment Board is invested is Tailwind and New Mountain.


Although Benevis still shows up on FFL Partners website's portfolio page,  it is listed under the "Former" tab on their website.

Tailwind Captial Portfolio
FFL Partners Portfolio

Thursday, February 07, 2019

Toddler who died after dental procedure at Kool Smiles was hooked up to empty oxygen tank as staff muted heart alarm: lawsuit

Toddler who died after dental procedure was hooked up to empty oxygen tank as staff muted heart alarm: lawsuit

Jan 9, 2019

The heartbroken family of a 2-year-old boy who died after a visit to the dentist last year is suing the Arizona clinic, claiming that a staff member repeatedly muted the alarm on a heart monitor that he was hooked up to, and that the oxygen tank he was supposed to be receiving supplemental air from was either faulty or empty.

Zion Gastelum’s mother, Veronica, brought her son to the Kool Smiles dental clinic in Yuma in December 2017 after it was determined that the boy needed crowns to address severe cavities. According to a police report obtained by ABC 15, Aaron Roberts was contracted by the clinic and was supervising the procedure, and a dentist later told responding officers that the procedure had gone “well.”

According to the family’s lawsuit, while under general anesthesia Zion had nine of his baby teeth worked on, including root canals and crowns on six of them. The complaint alleges that X-rays or further investigative exams were not conducted to confirm that the nine procedures were necessary.

Read more here.


Related:

Police report offers new details in case of 2-year-old who died after Yuma dental appointment

DOJ: Kool Smiles dental clinics to pay $23.9 million, allegedly submitted false claims

Saturday, January 19, 2019

150 families have now filed lawsuits in Orange County Superior Court , Santa Ana, California against Children’s Dental Group — Number is expected to grow

By Deepa Bharath | dbharath@scng.com | Orange County Register
PUBLISHED: January 16, 2019 at 6:11 pm | UPDATED: January 18, 2019 at 2:19 pm
                              
IRVINE — Sixty-five families whose children were infected by rare bacteria when they underwent pulpotomies, or “baby root canals,” at an Anaheim clinic two years ago filed a lawsuit Wednesday, Jan. 16, naming the clinic, its operators, the company that installs and maintains water filtration systems, and several dentists.

The lawsuit, which was filed in Orange County Superior Court in Santa Ana, alleges that Children’s Dental Group and dentists who provided services there performed hundreds if not thousands of unnecessary pulpotomies on children. Potentially deadly Mycobacterium abscesses was found in several samples the county’s Health Care Agency took from the clinic’s water system. 

The children, ages 3 to 9, all underwent pulpotomies at the clinic between April and July 2016. In all, 500 children underwent the procedure during that time.

Children’s Dental Group has since become part of Western Dental. The clinic in question on East Lincoln Avenue is not owned or operated by Western Dental, but has changed hands.
So far, 150 families have filed lawsuits against the clinic and the number is expected to grow, said Dan Hodes, Irvine-based medical malpractice lawyer who is representing the children and their families.

READ THE ENTIRE UPDATE ON THIS STORY HERE