Update March 16, 2011:
HB 2241 was introduced February 9, 2011. Originally, the Kansas Board of Dentistry and the Kansas Dental Association rejected the idea of open the boarders for Corporate Dentistry. Between February 9th and 24th deals were made, the bill was amended and passed with a vote of 120 to 1. My hat goes off to the person who had the guts to vote no. Read about the deal here.
On February 24, 2011 the bill was sent to the Senate for consideration and referred to the Kansas Senate Public Health and Welfare committee. Here is the report from the Kansas Health Institute.
This bill is NOT good for the citizens of Kansas for reason stated below. The amendments to the bill do nothing to stop the corporate legal games that are played to hide the real owners of these chains/franchises.
So far the Kansas Dental Board has done NOTHING to protect the citizens of Kansas from the abuses and fraud perpetrated by the Small Smiles clinics the board allowed to open up shop a few years ago.
KWCH Part 1 report on Small Smiles Dental Centers
KWCH Part 2 report on Small Smiles Dental Centers
See the Youtube Channel featuring 40+reports from across the country on chain dentistry who profess to treat the underserved.
Related Article:
Kansas about to open gates of hell
Kansas Dental Board asking fake owner to prove it ( the board took no action!)
Follow the bill here
Contact Senate Committee Member immediately and ask them to vote NO to Kansas HB 2241.
Chair Sen. Vicki Schmidt - Vicki.Schmidt@senate.ks.gov
Vice Chair Sen. Pete Brungardt - Pete.Brungardt@senate.ks.gov
Ranking Minority Member Sen. Laura Kelly - Laura.Kelly@senate.ks.gov
Members
Sen. David Haley - David.Haley@senate.ks.gov
Sen. Terrie Huntington - Terrie.Huntington@senate.ks.gov
Sen. Dick Kelsey - :Dick.Kelsey@senate.ks.gov
Sen. Mary Pilcher-Cook - :Mary.PilcherCook@senate.ks.gov
Sen. Roger Reitz - Roger.Reitz@senate.ks.gov
Sen. Chris Steineger - Chris.Steineger@senate.ks.gov
December 20, 2010
A report from Kansas on the issue of Corporate Dentistry by Dave Ranny along with my commentary in black.
By Dave Ranney
Monday, December 20, 2010
Corporate dentistry debate looming
Law prohibiting dental franchises will likely be challenged this session
Dave Hamel, one of three dentists in Marysville, examines a patient’s teeth. Hamel, who’s also president of the Kansas Dental Association, defended state laws that prohibit corporations from owning dental clinic. “I think a dentist ought to be able to look at a patient and say ‘What can I do for you? How can I be accountable for your care?’ I don’t know that you get that with corporate dentistry,” he said. Also pictured: dental assistant Courtney Luedders and patient Amanda Foley.
TOPEKA — Under Kansas law, only a licensed dentist can own and operate a dental clinic. A corporation cannot. It’s illegal.
This blogger is applauding Betty Wright, Kansas Dental Board Executive Director. The law absolutely protects citizens.
It’s been that way for as long as most dentists can remember.
“The law protects the public,” said Kansas Dental Board Executive Director Betty Wright. “It puts patient care ahead corporate profits.”
When a corporation is involved, dentists, hygienist, office managers and other corporate staff have to answer to shareholders and investors. When this happens, your dentist is failing in his fiduciary duty to have "your" best interest in mind. He/She is worrying about the report they are going to have to fill out at the end of the day and what will result when the production numbers are too low.
Many people who contribute, read and follow this blog could have told the Kansas Joint Committee on Health and Policy Oversight things that would give them nightmares for years to come.
Some legislators aren’t so sure that allowing corporate clinics that are owned and operated by Kansas dentists would diminish the quality of care that patients received. During a recent meeting of the Joint Committee on Health Policy Oversight, several members noted that so-called franchise clinics tend to accept more Medicaid patients.
Kansas Dental Board Executive Director Betty Wright testifies during a recent meeting of the Joint Committee on Health Policy Oversight. She defended current state laws restricting corporate-owned dental practices. “The law protects the public,” she said. “It puts patient care ahead of corporate profits.”
A recent Kansas Department of Health and Environment survey (PDF) found that less than one-third of the traditional dentist-owned clinics in the state see Medicaid patients.
“I think it’s pretty clear that we’ll be talking about this next year,” said Rep. Brenda Landwehr, R-Wichita, referring to the 2011 legislative session, which convenes Jan. 10.
Lobbying effort underway
Mr. Barrientos is not being completely truthful here. He is referring to the fact they find a "good ole boy" dentist to put his name on the Corporate papers filed with the Secretary of State Office. Just like FORBA Small Smiles does currently.
Earlier this year, Comfort Dental, a Colorado-based company, sought the Kansas Dental Board’s permission to open dentist-owned franchises in Kansas. The request was denied.
Kansas law, Wright said, specifically forbids “...the franchise practice of dentistry.”
Company officials were taken aback by the ruling.
“They practically slammed the door in our face,” said Lawless Barrientos, a spokesman for Comfort Dental.
Lawless Barrientos, a spokesman for Comfort Dental, listens to testimony during a recent meeting of the Joint Committee on Health Policy Oversight. The Colorado-based company has asked legislators to consider dropping laws that prohibit dentists from entering franchise agreements.
“A lot of states don’t allow corporate dentistry – that’s not unusual,” he said. “But as far as we can tell, Kansas is the only state in the nation that prohibits dentist-owned franchises, which is what we are.”
The law, Barrientos said, stifles competition.
“Everybody keeps talking about how health care costs keep going up and about how dental care is too expensive,” he said. “The way to fix that is competition, to make dentists compete, to make them find ways to bring down their costs, to let the free market work.”
This is one case "competition" does NOT keep costs down. It only allows another corporation to siphon off more Medicaid dollars to line their coffers. Where is will go to build mulit-million dollars homes for themselves; maybe even their very own football stadium as in the case of the DeRose family, also of Colorado.
Comfort Dental has almost 80 franchise practices, involving 286 “partner dentists,” in seven states: Missouri, Colorado, Wyoming, New Mexico, Texas, Kentucky and Ohio.
Typically, Barrientos said, Comfort Dental franchises are owned by two to five dentists.
A corporation who hires a lobbying firm to help them buy their way into the state tells me the piggy bank is appealing and they want a huge piece of it. It also tells me these clinics are NOT owned by dentists.
The company has hired Federico Consulting, a Topeka-based lobbying firm headed by John Federico, to oversee its campaign to convince Kansas lawmakers to repeal the prohibition on dental franchises.
A group of dentists who get together, form a legitimate corporation and hang out their shingle have no need for a lobbying firm to begin to treat patients.
It’s about accountability
The Kansas Dental Association is expected to oppose efforts to repeal the restriction blocking franchise practices.
“At this point, there isn’t a specific proposal so it’s difficult to say whether we’re for it or against it,” said KDA Executive Director Kevin Robertson. “But, yes, we have a lot of concerns about corporate dentistry.
“Our position is that the person who owns a practice or a clinic ought to be person who’s in contact with the patient,” Robertson said. “That person, that dentist, should not be having his or her arm twisted by some middle man who’s main concern is meeting their quota for the month.
“That,” he said, “can result in abuse and fraud, quite frankly.”Nor should they be distracted by the thrill of this month's bonus check. There is no patient anywhere who wants their medical professional to be thinking about bonuses and meeting treatment goals set by some corporation. The patients treatment will not be based on the needs and well being of the patient, it will be based on goals, quotas and bonuses. It's not that it could open the door for fraud and patient abuse, it's that it does. See the video above for a real good look at it, up close and personal.
The nine-member Kansas Dental Board – six dentists, two dental hygienists, one lay representative – shares the association’s concerns.
“Once the dentist becomes simply an employee or an absentee owner, the office tends to focus on maximizing profits rather than on maximizing care for the patient.” Wright said.
Kansas law allows a clinic to have more than one owner, but each owner has to be a dentist. A dentist or a group of dentists can own more than one office, but each owner is required “...to be present in the office a majority of the time the office is operating.”
Dave Hamel is one of three dentists in Marysville. He owns his own dental practice and is serving a stint as president of the state dental association....
...Like the association he represents, Hamel has strong concerns about corporate dentistry.
“I think a dentist ought to be able to look at a patient and say ‘What can I do for you? How can I be accountable for your care?’ I don’t know that you get that with corporate dentistry,” Hamel said.
“People want that accountability. All of us, I think, have had the experience of calling an insurance company or a government office and not being able to find anyone who’s accountable.
“We don’t have that in Kansas (dentistry) now, which I see as a strength,” he said.
In 2005 FORBA Holding was FORBA, LLC and owned 100% by 5 individuals from Pueblo, Colorado; , Dr. Eddie DeRose, Dr. Michael A. DeRose, Dr. Adolph R. Padula and Dr. William Mueller and Dan DeRose.
One exception already OK’d
In 2005, the Kansas Dental Board agreed to allow FORBA Holdings, a management company based in Nashville, Tenn., to market its services to dentists in Kansas.
Subsequently, three dentist-owned clinics entered enter contracts with FORBA to help them manage their practices. They are:
• Topeka Dental Clinic, Topeka;
• Indian Springs Dental Clinic, Kansas City;
• Small Smiles Dental Clinic, Wichita
The Colorado Dental Board among others let these individuals run wild within the state until the state finally had to pass laws trying to limit the amount of abuse they inflicted on children, but not before one child died in one of their clinics in Arizona.
Dr. Michael DeRose finally had his licenses revoked and locked out of the Medicaid system, but not until 2009. Dr. William Mueller was locked out in March 2010. The Colorado Dental Board let Dr. Eddie DeRose "retire" his licenses. However, their tentacles and spawns reach far and wide and still live very nicely from your tax dollars. See:
Small Smiles Scam
Spotlight on Small Smiles
Dr. Michael DeRose and another partner, Dr. Trish Ballance opened clinics in North Carolina. They were investigated for mistreating children and performing up to 18 baby root canals in one sitting on several children. Dr. Michael DeRose never lived in North Carolina, let alone treated any children there, he just "owned" the corporate clinics and pushed for "production". They settled with the government for $10 million in April 2008.
Are they still involved in the clinics in North Carolina? Yes. They just put it in the name of a loyal employee, Dr. Raf Rivera. If corporate dental clinics are allowed to invade your state, it will literally take an act of congress to get them out.
Nationally, FORBA-run clinics are marketed as Small Smiles Centers. But in Kansas, the restrictions on corporate ownership prohibit the three clinics from marketing themselves as part a chain, consequently only one of the three calls itself Small Smiles.
In November 2007, ABC News reported several parents in Washington, D.C., accused a local Small Smiles clinic of mistreating their children.
Months later, The Wichita Eagle and KWCH TV Channel 12 ran similar stories on the Small Smiles clinic in Wichita. (Watch the 3-part video series on Small Smiles in Wichita).
In January 2010, the U.S. Department of Justice announced that FORBA had agreed to pay $24 million to “resolve allegations” that it had billed Medicaid for “medically unnecessary dental services.” FORBA agreed to alter its billing practices.
If Mr. Smoot does not know that he is making a false statement, he should know. If all of this only involved those clinics on the East Coast, why did Kansas get a cut of the pie? Mr. Smooth used to be in the Kansas Attorney General's office.
Kansas’ share of that settlement was $517,959.60.
Earlier this month, Brad Smoot, a Topeka attorney who represents FORBA, assured members of the Joint Committee on Health Policy Oversight that the accusations of impropriety involved FORBA clinics “on the East Coast” and were unrelated to the three in Kansas.
Here is where I almost puked. These dentists do not own one item in the building, let alone
“FORBA did not admit wrongdoing,” he said.
Smoot, who also lobbies on behalf of Blue Cross Blue Shield of Kansas, said the FORBA clinics in Kansas were in full compliance with state law.
“Each of these clinics is owned by dentists who work there,” he said. “They are independent of each other – the dentist owns the building, the equipment...everything.
the buildings themselves. Does Mr. Smoot actually believe Dr. Tom Corcoran owns this whole shopping center in Topeka?
Click on topekadentalclinic.com, it will take you right to Small Smiles with a map to all of the other dental clinics they own.
What about the Wichita clinic? No, Dr. Mohammad Reza Akbar does not own it either.
You can look for yourself if you like, click here. Here is a link showing a campaign donation from Pueblo, Colorado in the name of dentist, Dr. Mohammad Akbar to Kansas State Representative, Bob Bethell campaign in 2006 in the name of Small Smiles of Wichita Health Care. In Dr. Mohammad Reza Akbar's NPI record, it asks if this is a "Sole Proprietorship " his answer is NO!
Mr. Smooth, you really should take time to know what you are talking about before going before a government body. Please do not let Todd Cruse give you his line of crap and you believe him. I have personally caught him in three lies this month alone. He just did not know I knew the answer to my questions before I asked them. Clearly he has not had children. If you have children, you must always know the answer prior to asking.
What about the Indian Springs clinic? Well, if I were to pull up Dr. Blacknall's NPI information it would look just like Dr. Akbar's.
But here is Indian Springs NPI record:
It is not that hard to debunk the "ownership" issue with FORBA's clinics in most states.
"They also have management contracts (with FORBA).”Not exactly, Mr. Smoot. The dentists have "Employment" contracts with FORBA." But you almost had it right. Close but no cigar.
Smoot said that approximately 95 percent of the patients treated at the clinics are on Medicaid.
I do not think Mr. Lawless Barrientos was wise to say "the same would be true of his company's franchise clinics".
“These are exactly the people, the critically underserved population, you’re hoping will be served,” he said.
Barrientos, the spokesman for Comfort Dental, said the same would be true of his company’s franchise clinics if they were allowed to operate in Kansas.
“We are one of the largest Medicaid providers in Colorado,” Barrientos said. “Forty percent of our patients are either underinsured or uninsured. They come to us because we’re 40 to 60 percent cheaper than what other dentists’ charge.”
There is none.
Distinction without a difference
Rep. Jim Ward, D-Wichita, a member of the health oversight committee, challenged Smoot’s assessment, saying he didn’t see much difference between a dentist signing a management agreement with FORBA and a franchise agreement with Comfort Dental.
“It sounds to me like you’ve created an exception that makes the (no-franchise) rule unnecessary,” he said, referring to the Smoot-crafted agreement with the Kansas Dental Board.
This is where the "Prove It" letter come in to play. Dr. Tom Corcoran was sent a form to fill out and he had 10 days to do it. If that form was filled out honestly and was back in the hands of the board by the deadline, I’m not sure what else there is to investigate. After the quote from Rep. Ward, I’m afraid they are working on another “deal”. I hate being cynical, but after watching these people for over 3 years now, I can’t control it. Surely the board is not trying to protect FORBA/Small Smiles/Church Street Medical Management’s playground? No, that can’t be it, or the board would not have sent the “prove it” letter. But there are always those dog and pony shows. I’m giving the Dental Board the benefit of the doubt on this one though.
“This, for all practical purposes, is what a corporate practice would look like,” said Ward, who’s also an attorney.
After the FORBA settlement was announced, the Kansas Dental Board, Wright said, decided to take a second look at whether the management contracts comply with state law. The investigation, she said, is ongoing. She declined further comment.
Don't. Kick the FORBA owned clinics to the curb as well.
The board rejected Comfort Dental’s request after it started its re-examination of the management contracts.
Dave Sanford runs one of the state’s largest safety-net clinic, GraceMed Health Clinic in Wichita. He, too, has concerns about corporate dentistry.
But he said the Kansas Dental Board may find it difficult to justify allowing the FORBA clinics while disallowing Comfort Dental.
It won't take five minutes to evaluate the "quality of care" delivered by any of these dental mills. Google.
“At some point, there needs to be an evaluation of the quality of care that a corporate model would produce and how it would compare to the model we have now,” Sanford said. “I don’t know that we know that.”
photos by Dave Ranny
Testimony: Betty White for Kansas Dental Board |
 Download .PDF |
| Testimony: Lawless Barrientos for Comfort Dental |
 Download .PDF http://media.khi.org/news/documents/2010/12/20/corp-dentistry-cd.pdf |
Here is how you can contact Rep. Brenda Landwehr and Rep. Jim Ward:
Legislative Hotline: 800-432-3924 (Jan.-April) Rep. Brenda Landwehr: Chair of the Health and Human Services Committee
2837 N. Edwards Wichita, KS 67204-4646
Pho
ne: 316-821-9800
E-mail: blandweh@ink.org Capital Office for Rep. Landwehr:
Room: 151-S
Phone: 785-296-7683
Email: brenda.landwehr@house.ks.gov
Rep. Jim Ward
3100 E. Clark
Wichita 67211
Phone: 316-683-3609
Email: jwardks88@gmail.com
Capital Office for Rep. Ward:
Room: 359-W
Phone: 785-296-7675
Email: jim.ward@house.ks.gov
Kansas Dental Association
5200 SW Huntoon
Topeka, KS 66604
Telephone (785) 272-7360
Fax (785) 272-2301
Kansas Dental Board
E-mail: info@dental.state.ks.us
Call: (785) 296-6400
Kansas Health Institute
212 SW Eighth Ave., Suite 300
Topeka, KS 66603-3936
785-233-5443
Related:
Kansas Dental Board Asking Dr. Corcoran To Prove He Owns Small Smiles Clinic
