Showing posts with label DMSO's. Show all posts
Showing posts with label DMSO's. Show all posts

Tuesday, October 20, 2015

DSO Business Model Includes Violating State Labor Laws

Dr. Michael DavisDr. 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:

David Sohn David Sohn is the principal attorney at SOHN LEGAL GROUP, P.C., which prosecutes and defends employment and business disputes on behalf of individuals, small businesses, and non-profit organizations.  Prior to starting his own law firm, David worked at several prominent national law firms in San Francisco.  He received his bachelor’s degree in Economics from Stanford University and his law degree from Harvard Law School.  Due to the successful results he has achieved for his clients, David has been recognized as a Northern California Super Lawyer by Super Lawyers Magazine. David can be reached at 415-421-1300 and
David Sohn is an attorney in San Francisco specializing in employment litigation matters. Last year, he represented a dentist in his wage and hour lawsuit against Western Dental Services, Inc. (“Western Dental”) for misclassifying him as an exempt employee and not paying him overtime wages and providing proper meal and rest breaks, among other things. Mr. Sohn tried this case in San Francisco Superior Court against an army of big law firm lawyers hired by Western Dental – and prevailed. As a result of his trial victory, the overwhelming majority of dentists in California are now misclassified. They should be receiving overtime wages, proper meal and rest breaks, and all of the benefits and protections of California’s employment laws.
The case is entitled Nanda v. Western Dental Services, Inc . (Case No. CGC-13-529601).

Dr. Davis: Mr. Sohn, I sincerely thank you for taking the time and effort to address matters of this case. I understand much of your legal work involves labor workplace rights. The public may not appreciate how even a licensed dentist may have their rights violated in the workplace. Could you give our readers an overview of the merits of this case and how your client was damaged? 

Mr. Sohn: Thank you, Michael, for giving me an opportunity to discuss with you and your readers my trial victory against Western Dental. This is a very important, game-changing case that all dentists and to-be-dentists need to know about so that they understand what their workplace rights are.

When I decided to take on this case back in 2013, I didn’t know anything about the dental industry. I took it on because I saw a very interesting legal question. That question was: are dentists employed by Western Dental compensated in the form of a “salary?” Western Dental compensates its dentists by a fixed daily rate and/or a percentage of their production. They are not guaranteed in advance a minimum weekly or monthly amount of compensation.

This legal question is important because in order for dentists and other licensed professionals to be exempt from all of the benefits and protections of California’s employment laws – such as overtime wages and proper meal and rest breaks – they must be paid in the form of a “salary.” If they are not, they must be provided these benefits and protections.

California law does not provide a definition for the term “salary.” Instead, California courts look to federal regulations for the definition of “salary.” The pertinent federal regulation, 29 C.F.R. § 541.602(a), states that an employee is paid on a “salary basis” if he or she “regularly receives each pay period on a weekly, or less frequent basis, a predetermined amount constituting all or part of the employee's compensation, which amount is not subject to reduction because of variations in the quality or quantity of the work performed.” This same federal regulation also explains that if an employee is ready, willing, and able to work, but he or she does not work due some reason occasioned by the employer, he or she is not being paid on a “salary basis.”

At the conclusion of trial, the judge held that the dentist I represented was not paid in the form of a “salary.” The dentist never received on a weekly, or less frequent basis, a predetermined amount of compensation which was not subject to reduction based upon variation in the quality of quantity of work performed. He was only paid for the days that he worked and on occasion received a percentage of the production he generated. On numerous occasions, even though he wanted to work, if he was not called into work, he was not paid. Given these circumstances, he was entitled to overtime wages and proper meal and rest breaks like other non-exempt staff employed by Western Dental.

As a result of the judgment issued in my case, all dentists – and for that matter any licensed dental healthcare professional (such as orthodontists, periodontists, etc.) – in California paid on any basis other than a salary basis are “non-exempt” employees who are entitled to overtime wages, and proper meal and rest breaks.   

Dr. Davis:  The defendant in this case, Western Dental, is the largest employer of dentists in the state of California. They also operate dental clinics in Nevada and Arizona. They are the largest provider of dental Medicaid services for California. As large of a dental industry operation as is represented by Western Dental, is it reasonable to speculate on the pervasiveness of dentist/employee workplace labor violations (both in Western Dental and the dental service organization (DSO) industry, as a whole)?   

Mr. Sohn: During the course of my case against Western Dental, I discovered that Western Dental’s approach to how it compensates its dentists is not unique. I spoke to a number of dentists and specialists who worked for other practices large and small, including other DSOs and small private practices, and the impression I received was that the overwhelming majority of dentists and specialists in California – and in the country – are paid on a similar non-salary basis. That’s when I realized my case could have significant industry-wide consequences.

Wednesday, December 17, 2014

Rick Perry and Greg Abbott Culpable in Debacles of Corporate Dentistry DSO Poster-Boy, R. Kirk Huntsman


Michael Davis DDSby Dr. Michael Davis


December 17, 2014

Soon to assume the Texas governor position, from his prior office of Texas state attorney general, will be Greg Abbott. Mr. Abbott takes over the governor’s office from another dental industry failure, current Governor Rick Perry. Mr. Perry is most noted in dentistry for his dubious appointments to the Texas State Board of Dental Examiners (TSBDE). The consumer protection group, Texans for Dental Reform, have highlighted a number of these self-serving and corrupt appointments. Members of the TSBDE included a number of notorious Medicaid fraudsters, and at least one convicted sex offender.

pull quote 1Hapless state watchdogs for Texas citizens extended not only to the TSBDE and their incompetent legal counsel, but also to the Texas Office of Inspector General. Despite the fact that Texas is currently the state most recognized for the severity and volume of dental Medicaid fraud, the Texas Office for Inspector General has so far failed to effectively prosecute violator after violator. These habitual failures go directly to the (in)activity of Greg Abbott and Rick Perry.

Federal Fifth Circuit Ruling 07-30430

Let’s examine a case in point. Federal Fifth Circuit Court ruling 07-30430, which is largely based on Texas state statutes, determined that non-dentist ownership of a dental practice in Texas represents the unlicensed and unlawful practice of dentistry. The ruling further stipulates that corporate violators are to receive the same legal penalties, as individual person violators, with no special treatment. The acts of establishing doctor production quotas and bonuses are an action only lawfully permitted by a licensed dentist. State dental regulatory boards are charged under this federal ruling with the responsibility and obligation, of disciplinary actions against both individual person violators and corporate violators. The federal court also determined OCA (f/k/a Orthodontic Centers of America) could not enforce employment contracts with duly licensed Texas doctors, because the corporate entity OCA was not in fact a licensed doctor. The dentist employment contracts were determined unlawful and unenforceable, in their entirety, without being severable.

The federal court clearly saw though the sham presented by OCA (a dental service organization, “DSO”). OCA presented licensed dentists, whom they retained to misrepresent themselves as clinic “owners”. OCA controlled the dental clinics’ bank accounts. OCA held the power to buy and sell assets, such as the doctor employment contracts and individual clinics. In reality, these “owner dentists” were merely nominee owners. OCA, like nearly all DSOs, was the true and unlawful beneficial owner.

In conflict with this federal ruling —and further, avoiding addressing this ruling —the TSBDE has repeatedly stated they have no mandate to enforce the unlicensed practice of dentistry by a corporate entity. This flagrant obfuscation of law by legal counsel for the TSBDE is highly disturbing. Even more troubling is watching Rick Perry and Greg Abbott hide under their desks. Additionally, Mr. Abbott further abandoned his duty as Attorney General by failing to provide a legal advisory opinion based on clear and current legal precedence.

Xenith Practices, LLC & Austin Cosmetic Dentistry

Let’s examine another case, where Mr. Abbott was asleep at the wheel leaving dental consumers in harm’s way. In October 2014, Austin Cosmetic Dentistry simply closed and locked their doors. No notice of the closure was given to patients or staff. The staff was left unexpectedly unemployed and patients were illegally abandoned. Many patients were in the middle of their treatment. Many others, who had pre-paid, were scheduled to begin or finalize their restorations.

Representatives of Xenith Practices purchased the now-failed Austin Cosmeticpull quote 2 Dentistry clinic from Dr. John Schiro, a couple of years earlier. The highly disturbing public record of Dr. Schiro with the TSBDE must have been aware to Mr. Huntsman and principles of Xenith Practices. It’s easy to download from the TSBDE website, with the slightest due diligence check. The earlier legal disputes between Dr. Schiro and Dr. Douglas Terry, who openly spoke out about alleged improper clinical care by Dr. Schiro, were also of public record. I have no idea what matters the investors were informed, by way of a lawful full disclosure by Mr. Huntsman. None of this should have escaped the attention of the Texas attorney general’s office, governor’s office, nor the TSBDE.

Xenith Practices, LLC, a DSO, managed the failed Austin dental clinic. Mr. R. Kirk Huntsman, —a business executive with no formal dental education and unlicensed to practice dentistry—formerly served as CEO of Xenith. As we shall see, Mr. Huntsman has quite the storied history in the dental industry. As for the true beneficial ownership of Austin Cosmetic Dentistry, that will be for the courts to sort out. It is alleged that Mr. Huntsman’s son-in-law—a Texas licensed dentist who lives and works in Colorado— signed on as the figurehead, “owner dentist”. Mr. Abbott could not have missed this obvious violation to Fifth Circuit ruling 07-30430, and negative fallout to the public health and safety.

Wednesday, March 12, 2014

Vice Chairman and Ranking Member of House Committee on Energy and Commerce-Oversight and Investigation subcommittee express continued concerns of dental management service companies (DMSOs).


In a letter (see below) to Inspector General Daniel R. Levinson, Rep. Michael Burgess (R-TX) and Rep. Diana DeGette (D-CO) express their continued concerns about “deceptive practices of dental management service companies (DMSOs)”.

They further call on HHS OIG to exclude any corporate dental companies from participating in the Medicaid program, saying, “Based on the report by the Senate Committees and the prior findings of HHS OIG, we concur with our Senate colleagues and recommend that HHS OIG should consider excluding any corporate entity that employs deceptive business practices that result in substandard care, from the Medicaid program.”

Burgess and DeGette are also concerned about the length of time it has taken to bring one of these companies—Small Smiles Dental Centers—to justice.

The letter recounts the history of the Small Smiles investigation, starting with the “2008 investigative news report” by WJLA in Washington. That report actually aired in November 2007; so it’s even worse, right?

The 3 page letter also states:

  • “based on evidence undertaken by our offices, we are very concerned that the corporate structure and management of dental clinics often results in a failure to meet basic quality and compliance standards.”

Tuesday, December 04, 2012

Children’s Dentistry of Rome bills taxpayers $13,407,134.34 in less than 4 years

Bet’cha some these folks used to (or still does!) work for Small Smiles, Kool Smiles, Ocean Dental maybe… or one of the other Medicaid dental mills?

At least in Georgia, the police departments are using the tools in their toolbox. -O.C.G.A. Title 16, Section 16-5-70, Cruelty to Children. #dentalboardsareuselessinprotectingpatients

UPDATE December 4, 2012 – 9:42 AM


Office bills $13 million in Medicaid claims since ’08

by Lauren Jones, Staff Writer

Federal agents are conducting an investigation into Children s Dentistry of Rome on Nov. 29, 2012.  (AJ Pierce/RN-T)

After numerous allegations of child abuse and fraudulent activity flooded the Rome Police Department over the weekend, detectives are continuing their criminal investigation into Children’s Dentistry of Rome, officials said on Monday.

According to the search warrant affidavit filed in Floyd County Superior Court, MCG Management Inc., doing business as Children’s Dentistry of Rome, billed more than $13 million in Medicaid claims since 2008, and some victims and other dentists alleged that dental work provided by the doctors and hygienists was unnecessary.

Employees from the dentist office issued the following statement on Monday evening: “The dentists operating their practice at the MCG facility care about patients and provide quality care. Dental visits are not always pleasant, but we believe that the practitioners will be able to show they exercised sound judgment and compassion when treating young patients with significant dental problems.”

Following complaints of improper use of restraints and improper or unnecessary performance of dental work on children, agents with the Department of Health and Human Services Office of the Inspector General and Rome Police Department investigators executed a warrant on Thursday and searched the office for billing and medical records pertinent to the criminal investigation.
No arrests have been made in the case and Rome police Lt. Gary Clayton declined to comment on the number of reports the detectives division has received.

The affidavit listed more than 300 patients with Medicaid whose records are being thoroughly investigated.

Medicaid claims
The affidavit, written by detective Joe Costolnick, lists 11 reports of excessive dentistry work performed on 14 children that resulted in serious medical problems and trauma. Reports recounted that children left the office traumatized, scratched and bruised.

Some children were allegedly tied down on papoose boards for unnecessary dental work, and some children needed additional medical attention for improperly done dental work they received at Children’s Dentistry of Rome.

Costolnick, who is specially trained with regard investigating criminal violations relating to cruelty and abuse to children, is working with Special  Agent Connie Murray with the Department of Health and Human Services who investigates Health Care fraud.

Murray obtained a summary of the dental office’s Medicaid claims data from January 2008 to August 2012, the affidavit reported.

The Georgia Medicaid program provides health services to beneficiaries who qualify based on financial need or other circumstances.

In providers’ contracts, the provider agrees to abide by state and federal laws when submitting claims and the Medicaid program requires that providers not bill for services not performed or delivered, and not to submit false or inaccurate claims.

Providers must maintain records to fully disclose the extent of services provided to members for a minimum of five years and the records must also explain the medical necessity for the services provided.

Since 2008, the company billed Medicaid for a total of

  • $3,146,084.38 in 2008,
  • $3,215,831.81 in 2009,
  • $2,908,993.61 in 2010,
  • $2,395,811.79 in 2011
  • $1,740,412.75 as of August of 2012

Unnecessary dental work?
In the affidavit, some reports by parents of children who received dental work at Children’s Dentistry of Rome claimed that children went in to the office for routine checkups but left having had more dental work performed, as well as traumatized and in tears.

Monday, March 12, 2012

Lost files on R. Kirk Huntsman discussion

The Dental Leader no longer exists other than in cached format. But I located this discussion and going to repost it.  I’m not sure when it was written, but here is the cached copy. By looking at the Wayback Machine, it was archived the first time in February 2001, and this News Letter was there at that time.  So this goes back a while. I guess, sadly, no one listened to Dr. Maroon.  Look where we are in 2012! Maybe too much nitrous in the operatories and folks were sleeping!

The Dental Leader Inc - Michael Maroon, DMD, FACE, FAGD - Editor & Publisher
39 Webster Square Road, Berlin, CT 06037
Email: (no longer works)

Great Article...Great Newsletter


I thoroughly enjoyed the June issue of your newsletter, especially "There’s Always Tomorrow." I read quite a few parallels to my own life in that article.

The rest of the newsletter also contained quite a bit of meat along with some thought-provoking, insightful articles. Keep up the good work!

Dr. Kit Weathers, Griffin, GA

The Devil Revisited

Well, I don’t quite know how to respond to all this DPMC (Dental Practice Management Company) stuff that is starting to manifest in our profession. However, I do know when I see a biased and self-serving article when I read one. Case in point, the reply of a one Mr. R. Kirk Huntsman (sounds like an attorney to me Vern) to the article written by a fellow dentist Mike Maroon.

I believe Mr. Huntsman referred to Dr. Mike’s article as a condescending diatribe (a long, violent, or blustering speech, according to Webster). This description would more appropriately fit the pen that wrote the reply. Dear R. Kirk, should I call you "R" or "Kirk", the R. Kirk just didn’t sit well with my simple Midwestern mind. Makes me feel like I gotta have sum one ta represent me. So I’ll jist call ya Kirk then. I’m sorry, I’m jist a Dennust. Ya know...sore on the hind end from rollin’ over so many times to ya’all. So Kirk, please enlighten me on your credentials that enable you to speak so intelligently about the dental profession. Are you one of us? Do you have a DDS or DMD degree? Or, are you yet another wonderful, charismatic and caring purveyor of management expertise who beckons to save us by convincing us that big brother (DPMC) is here for the good of all?