Dr. Behzad Nazari, "talented Houston general dentist". Really?

I just don't have the energy, take it away guys...expand on this... 

HOUSTON, TX--(Marketwired - May 27, 2015) - Dr. Behzad Nazari, a talented Houston general dentist, has launched a new website that includes video, easy-to-use features and convenient scheduling options for new and existing patients.

Dr. Nazari’s dental practice, Antoine Dental Center, recently partnered with SmartBox Web Marketing to build the state-of-the-art website and provide online dental marketing.

"This new partnership allows us to have a beautiful new website that provides our patients with detailed information about our practice," Dr. Nazari said. "When it comes to having a good presence on the Internet, convenience and accessibility are both key. We want our patients to have the ability to access information anywhere and schedule their appointments at any time or place."

The new website, www.antoinedental.com, includes video testimonials from staff and patients; comprehensive information about practice services; a smile gallery filled with Antoine Dental Center patients, and convenient scheduling options. Patients can access free eBooks about the power of dental implants and orthodontics, and the website will be updated monthly with blogs relating to services at Antoine Dental Center and recommendations about at-home oral hygiene.

"I'm excited for patients to visit our new site so they can see our superior dental work and hear from patients who have absolutely had their lives changed after becoming a patient at Antoine Dental Center," Dr. Nazari said.

Antoine Dental calling for a federal investigation into the judge because their win was overturned. Calling his decision “cut and paste”. What a bunch of cry babies.

Since the Antoine Dental Center's favorable ruling was overturned last week, TDMR, is calling for a Federal investigation into the judge. (God, I hate linking to these people! I think this is a ploy to get me to send them web traffic!  LOL Don’t enter a password, it’s a phishing expedition.)

Yes, they want a Federal Investigation into the judge! Talk about cry babies! These guys simply can’t stand defeat. I bet they all got trophies for participation when they were kids. 

However, to read about their game plan, you need a password. That’s right, a password. They have this big headline, then tell you to read it, you need their permission. Maybe it’s only a headline? Think?

I'd say an investigation should look at the previous decision of the administrative judges, but I try to give them a break that they just didn’t know what they didn’t know.

Frankly, the more Federal investigations into this the better. What's really odd, is this particular case is over some $400,000. Who spends $2-5 million in attorney fees to recoup that amount? Yeah, this is much bigger than Antoine Dental Centers. 

 

 

 

 

 

 

 

One thing that crosses my mind, is how Dr. James Orr and Bob Anderton trained these dentists how to cheat the system—in Anderton’s own private law office—and now Orr is the “expert” witness for the dentists and Anderton is their attorney. Talk about conflict of interest! Geez! This seems to be more about Orr and Anderton covering their own butts, than it is about Antoine Dental Center’s pay hold.

Currently Orr and Anderton are touring, teaching dentists about—of all things—record keeping!

There is just no way that this is sliced where the attorneys representing Antoine Dental Center and Dr. Nazari have their clients best interest ahead of their own. I almost feel sorry for Nazari. He could have, reached some settlement, taken his slap on the wrist, paid a little fine, and gone on about his business. At worse, a few months jail time; he would have gotten more sleep there than I bet he’s getting these days. I believe he is being coerced. Pure craziness.

Where’s the popcorn?

Analysis of ADC vs. Texas Health and Human Services Commission

Analysis of ADC vs. Texas Health and Human Services Commission

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

March 6, 2014 -- Why should anyone care about a dental Medicaid ruling from an administrative law court in Travis County in Texas? One reason is that this case involves several millions of taxpayer dollars. Other similar cases brought before this court of alleged dental Medicaid fraud and abuses have and will involve taxpayer money, in excess of $100 million. 

The vast majority of dental Medicaid fraud cases are generally resolved in settlement agreements. Alleged violators usually pay some amount of restitution to the government in exchange for no admission of wrongdoing. Often, the alleged violators return to "business as usual." We, the public and dental profession, receive little or no data on case specifics. Records of investigations are sealed upon settlement.

Public record disclosure of this particular case exposed some of the dark underbelly of the dental Medicaid industry, along with some of its nefarious inner workings.

Read the entire article on Dr. Bicuspid

Antoine Dental Centers to remain on payment hold

Judge finds credible evidence of Medicaid fraud by Texas clinic

By Donna Domino, Features Editor

March 5, 2014 -- A Texas judge has upheld payment holds on Medicaid payments for Houston dental clinic Antoine Dental Care (ADC), citing credible evidence of Medicaid fraud. The clinics billed about $8.1 million for orthodontic services in less than three years.

The 36-page ruling was issued February 28 by Judge Rick Gilpin, an administrative law judge for the Texas Health and Human Services Commission (HHSC).

Reimbursements for Medicaid claims by ADC, which has two clinics in Houston, have been on hold since 2012, pending an investigation by the HHSC and the Texas Office of Inspector General (OIG) for Medicaid fraud involving orthodontic care. ADC ranked in the top 25 providers for Medicaid payments; about 70% of ADC's patients were Medicaid recipients, the ruling stated.

Read Complete Article at Dr. Bicuspid

Houston dentist, Behzad Nazari, and Antoine Dental to remain on 100% “pay hold” due to fraud investigation

UDATED 03-03-2014

The scammers running the Texas Dentists for Medicaid Fraud Reform (TDMR) website have boasted time and time again, over rulings made against Texas taxpayers and for Antoine Dental. Heck, they have a whole section of their website devoted to their “wins”. They have also had their cronies on this website, commenting about how they are winning their cause; which appears to be “Let us continue to defraud taxpayers.” Frankly, I think their name should be “Friends of Dental Medicaid Fraud”. I’m not sure what they consider a “win”. Apparently, it’s not what you and I call a “win”. Their headlines over there are outright false! So imagine the bullshit contained within! I especially love their comment section, entitled “Speak Your Mind”, amazingly what is on my mind doesn’t seem to make it, maybe yours will. Click here.

Examples:
On November 5, 2013 their headline read, “OIG Loses Another Medicaid Fraud Court Battle” an article they were happy to assist with in the Texas Tribune.

(Battle, yes, WAR, NO!)

Then on November 6, 2013 their headline read – Antoine Dental Center Innocent of All OIG Allegations of Fraud and Misrepresentation.

(This is especially galling, since it is an outright lie! Lie!!! Lie!!)

Again, on January 17, 2014—SOAH Judges Again Reject OIG Arguments in Antoine Dental Case

(Laughable!)

Today, what’s missing from their website is the headline of this blog post;or something close to it.

It appears the Applet Court and Judge Rick Gilpin disagreed 100% with all other rulings in the Antoine defraud Texas taxpayers case. He issued a “Final Order” on Friday (February 28,2014) that walked through this case and all the hearings and ruling step by step and ruled completely opposite of all other rulings—Antoine Dental to remain on 100% pay hold.

You don’t want to miss reading the Final Order. He all but called them all, Antoine owner, Dr. Nazari—including the Administrative Law Judges—criminals and at the best—imbeciles. You read it and decide.

Texas Dentists for Medicaid Reform Press Release Re: Antoine Dental Center

Hey folks, it’s not the Office of Inspector General who “lost”, it’s not just the taxpayers of Texas, it’s all taxpayers.  The Medicaid system is funded with state and federal funds.  Taxpayers should be outraged over this ruling! 

Texas Dentists for Medicaid Fraud Reform Press Release Re: Antoine Dental Center:

Judges Finds Another Texas Orthodontic Practice Innocent of Medicaid Fraud and Misrepresentation

Two administrative law judges with the Texas State Office of Administrative Hearings (SOAH) have issued their proposal for decision in the case of Antoine Dental Center of Houston (ADC) SOAH Docket No. 529-13-0997. ADC had been placed under a 100% payment hold in April of 2012 by the Texas Health and Human Services Commission Office of Inspector General (OIG) for "credible allegations of fraud" and willful misrepresentation in their orthodontic billings from 2008 to 2011. ADC had been one of the top 25 billers of Medicaid for orthodontic services in the state. The judges, in their decision, found that ADC had not committed fraud or any willful misrepresentation and ordered the payment hold discontinued.

"I am extremely relieved and happy with this decision," stated Dr. Behzad Nazari, the owner of ADC. "We had been crippled to the point of near bankruptcy by this payment hold and the allegations that had been swirling around the practice. I have been saying for a long time that we weren't guilty and I am thankful that the judges recognized that fact. There is something wrong with the way these cases have been prosecuted by the state."

Oh, I bet Dr. Nazari is happy happy happy.  Just because some judge (or jury)says you aren’t guitly doesn’t make it true.i.e.Casey Anthony, O.J. Simpson.

Judges Howard S. Seitzman and Catherine C. Egan wrote in their decision that "the prima facie evidence failed to support a credible allegation of fraud or willful misrepresentation and failed to show that ADC filed claims for non-reimbursable services. The few non-fraudulent record retention violations that ADC committed were technical violations that do not warrant a payment hold."

Sorry, judges, I 100000% disagree!  Anyone at that hearing could clearly see the fraud, and their expert Dr. Orr, was a joke.

Antoine Dental Centers tells Texas HHSC-OIG to “Stick” it

Antoine Dental Center (ADC) and owner Dr. Behzad Nazari, was been placed on an administrative Credible Allegations of Fraud (CAF) 100% payment hold from Medicaid reimbursements/payments in Texas in April 2012.

CAF - Federal law defines a “credible allegation of fraud” as an “allegation, which has been verified by the State, from any source.” 42 CFR § 455.2 states that the source of these allegations may include, but are not limited to, “(1) fraud hotline complaints, (2) claims data mining, (3) patterns identified through provider audits, civil false claims cases, and law enforcement investigations. Allegations are considered credible when they have indicia of reliability and the State Medicaid Agency has reviewed all allegations, facts, and evidence carefully and acts judiciously on a case-by-case basis.

Since Dr. Nazari disagreed with this payment hold he filed a suit against Texas Health and Human Services Commission – Office of Inspector General (HHSC-OIG) —State Office of Administrative Hearings (SOAH) Docket No. 529-13-0997; HHSC-OIG Case number P20111316523848911.

On May 28, 2013 four days of hearings began where evidence from both sides was presented to the judges at the SOAH in Austin.

On August 23, 2013 both sides filed their written Briefs and Closing Arguments.  They can be read by clicking the links at the end. 

One Brief and Closing made perfect sense, with facts and logic along with visual aids.  One sounded like a babbling idiot recounting a fairy tale. Guess which was which.

ADC and Dr. Nazari seem to think that division, and possibly the whole OIG office, is completely unnecessary.

In the ADC Brief and Closing Argument they state:

“How can the OIG support any credible aggregations of impropriety regarding HDL score sheets when the underlying diagnostic material was made available to the State and the State pre-approved the analysis that was reflected on the HDL score sheets? “

Antoine Dental Centers Creditable Allegation of Fraud (CAF) Hearing

If you haven’t read part 1 of “Ho” Down in Texas I suggest you do so before continuing. Read it here. 

The group calling themselves Texas Dentists for Medicaid Reform posted only two cherry picked depositions on their website in relation to the Antoine Dental Centers State Office of Administrative Hearings(SOAH).  TDMR again portraying the fraudsters as victims, just like they tried to do with Harlington Dental.  Posted on the TDMR website were Dr. Larry Tadlock’s deposition and Jack Stick’s deposition.  Dr. Tadlock was the expert witness for the state.  Mr. Stick is the Director of Enforcement at OIG. You can catch up on TDMR here.

I guess TDMR didn’t want people to read the actual hearing transcripts, and I can certainly understand why.

 

“Ho” Down in Texas – James W. Orr, DDS Testifies for Antoine Dental Center

Background
Who can forget the reports by WFAA’s Bryon Harris, which spurred investigations in to orthodontic Medicaid Fraud by the State of Texas?
In the fall of 2011 and continuing today, The Texas Health and Human Services Commission (HHSC) Inspector General put Credible Allegation of Fraud (CAF) payment holds on a covey of dental clinics; some general dentistry and some orthodontic clinics.  

Deciding not to take this sitting down, a few of these highly suspect dentists decided to take it to court; appealing to the State Office of Administrative Hearings (SOAH).

Dr. Juan Villarreal, owner of Harlingen Family Dentistry, a Scientologist  and a former  member of Texas State Board of Dental Examiners (TSBDE) appealed the HHSC decision for his CAF payment hold.  In a ruling by the SOAH in October of 2012, Villarreal/Harlingen Family Dental’s payment hold was reduced from 40% to down to 4%.  The ruling for Harlingen was further upheld by an HHSC Administrative judge in January of this year (2013).  Villarreal also heads up Texas Dentists for Medicaid Fraud Reform (TDMR). 

The judge’s ruling in the Villarreal case, by the most part, was based on the testimony of one Dr. James W. Orr.  This favorable ruling no doubt was the impetus to others, like Antoine Dental Centers and M & M Orthodontics in appealing their CAF payment holds. 

One last thing, before we move on — WHAT is the HDL scoring index? Well, it is much like scoring some jurisdiction do to determine if one gets bail or not. A point for this, a point for that and if it totals up to be high enough, bam! You’re outta there. For orthodontics (braces and other appliances) children over age 12 AND have lost all their baby teeth can received services if their HDL score is 26 or higher. Like anything else there are exceptions, but this is the simple explanation.

Antoine Dental Center-Dr. Behzad Nazari
First up, for this series, is Dr. Behzad Nazari and Antoine Dental Center (ADC) vs. Texas Health and Human Services (THHSC) (SOAH docket no. 529-0997).  ADC was represented by Jose A. (Tony) Canales and Oscar X. Garcia. Robert (Bob) M. Anderton.  Many of these clinic suspected of fraud have hired dentist/attorney, Dr. Robert (Bob) Anderton, former American Dental Association president.

Dr. Behzad Nazari/Antoine Dental Center has been under a 100% (that is HUGE) CAF pay hold since March 28, 2012 totaling over $550,000.  On March 29, 2012 the Texas Attorney General’s Medicaid Control Fraud Unit (MCFU) opened an investigation into ADC.