Showing posts with label Dr. Juan D. Villarreal. Show all posts
Showing posts with label Dr. Juan D. Villarreal. Show all posts

Sunday, March 03, 2013

Texas Dentists For Medicaid Reform now subject of WFAA-TV report


WFAA’s Byron Harris now on the tail for Texas Dentist’s for Medicaid Reform Fraud in his latest News 8 report.






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Texas Dentists for Medicaid Reform has all the trappings of a public interest group: The State Capitol is featured prominently on its website; the Texas star is in its logo; the word "reform" is in its title.

But TDMR, as it calls itself, acts like a private interest group.

Last month, the organization held a dinner at the Omni Southpark Hotel in Austin. TDMR's website invited the public, but the event was not public after all.

An e-mail informed News 8 we would not be allowed to attend.

Board member Dr. Juan Villareal would not disclose who the organization's donors are. "Donors can be anonymous, and a lot of them don't want their names mentioned," he told WFAA, adding that TDMR does not have members, only donors.

"We basically take donations from people who are interested in our cause," Villareal said.

So what is the cause? "Due process" is a phrase overheard in the hallway outside the dinner venue. TDMR offered News 8 an interview with a lawyer — presumably on its payroll — to explain the term "due process."

A look at the name tags outside the dinner show many of of the invited guests have had their Medicaid payments suspended under a doctrine called Credible Allegations of Fraud (CAF). Under CAF, physicians and dentists can have their Medicare or Medicaid payments withheld if the government believes they've committed fraud.

Dr. Villareal had $1.2 million in Medicaid dental payments to his clinic, Harlingen Family Dentistry, suspended under CAF. He appealed his case and won in an administrative hearing, but says he still hasn't received his money.

TDMR's board consists of Villareal, his partner, and another dentist who was charged with Medicaid fraud.

TDMR's website traces to an office labeled "SLS Worldwide Transportation" at a strip mall in Austin. The same address is also home to a website for Dr. Richard Malouf, a Dallas dentist who's being criminally investigated for fraud by the state of Texas.

And the SLS Limousine office is home to the website of Harlingen Family Dentistry, Villareal's dental office.

"TDMR is not so much about the money, as it is about denying due process" Villareal said. "That's the main concern."

"Due process" may summarize Medicaid reform for TDMR's donors.

But Dr. Morna Staffel said that doesn't speak for a Medicaid system she and many other dentists wrestle with every day.

"I don't think there is a group that's speaking out for the legitimate and the ethical dentists... either general dentists or pediatric dentists," she said.

Dr. Staffel's office regularly has to re-do work done by some of the dental chains supporting TDMR.

"Yesterday, in fact, I had to do dental treatment on three different children who'd been treated at another dental clinic during a 12-month period," Dr. Staffel told News 8. "Eighty percent of the restorations that had been placed either were improperly placed, or done incorrectly, or failing."

That work will need to be redone, she says, but getting Medicaid to pay for it is a slog.

"It's very time-consuming. It requires a great deal of my office staff time." Dr. Staffel said. "In the end, if we don't do the treatment, the child gets hurt."

She said her office often ends up doing the work for free.

Dr. Staffel wants parents — even those on Medicaid — to know they have a choice in dentists. And if they feel their children are not getting treated properly, they can go elsewhere.

So who really is Texas Dentists for Medicaid Reform? Thirty-nine dental chains have had their Medicaid payments withheld under Credible Allegations of Fraud.

As for many other Texas dentists, reform means something else.



Wednesday, October 17, 2012

What will Harlingen Family Dentistry fight for, and what will they not?

The same Harlingen Family Dentistry that killed ten year old Marcos Tirado in September won a skirmish with the Office Of Inspector General’s  (OIG) office yesterday. But that is far from winning this war.
Harlingen Family Dentistry is one of the top 25 Medicaid billers in Texas and under investigation by the OIG. The Texas Tribune has Harlingen Family Dentistry rated at number 17 in claims for fiscal year end 2011.
Dr. Juan Villarreal, owner of Harlingen Family Dentistry is a former member of the Texas State Board of Dental Examiners, appointed by Governor Perry in 2001.
As standard practice, while under investigation,Office of Inspector General (OIG), began to withhold 40% of all reimbursement payments.
Not very happy about that, Villarreal appealed OIG’s decision. Despite OIG having evidence that 84 of 85 records reviewed failed to meet requirements necessary.
Harlingen hired their own witness who said he would have approved all but 8 of those 85.

WOW, that’s a HUGE difference!! Too huge to not look a bit suspicious on Villarreal’s part. After all he’s the one wanting “you” money and looks like he’s willing to kill children to get it.
Yesterday, Administrative Law Judge Susan Fekety, agreed to reduce the payment hold from 40% to 4%.
Always the victim, Villarreal said, "I am afraid to say that it appears that honest dentists are being ‘gamed’ rather than the other way around so the state can try to collect back funds its contractor had pre-approved years ago and that they want to claw back regardless of consequences to providers and patients. It just shows how broken Medicaid really has become.”
Would Marco still be alive if Villarreal were not such a greedy man? One thing is clear; what Dr. Juan Villarreal will fight for and what he will not.
Father claims no one tried to save his son

Thursday, September 06, 2012

Child dies while being sedated at the office of Dr. Juan D. Villareal, Harlingen, Texas

Dr. Juan Villarreal

While being sedated at this man’s office -  Dr. Juan D. Villarreal…





Marcos Tirado

…this 10 year old boy, Marcos Tirado…died…basically euthanized.





harlington dental

…at this place, Harlingen Family Dentistry, Harlingen, Texas




Read more: Local, News, Boy in Coma, Boy Dies, Tooth Filling, Dental Procedure, Marcos Tirado, Anesthesia, Trinity Baptist Hospital, Loss of a Child, Harlingen, Cameron County, Harlingen Family Dentistry, Treacher Collins Syndrome, Valley Baptist Medical Center, Death of Marcos Tirado, 10 Year Old Dies, Federal Patient Privacy Laws, Lamar Elementary School Third Grader, Lamar Elementary School, Dixieland Road

Just minutes after 10-year-old Marcos Tirado received anesthesia at a local dental office, he was rushed to the hospital.

The Lamar Elementary School fifth-grader died two days later. 

It’s a pain no parent wants to endure. 

The loss of a child, that’s too young to be gone.  It’s a hard reality for the Tirado family in Harlingen. 

He was undergoing a  tooth filling at Harlingen Family Dentistry off Dixieland Road.

"Every time there was a procedure there was a lot of precautions that had to be done, the time we took him to the dentist, the doctor said it was a simple procedure, but obviously is wasn't." said Marcos Tirado, Sr.

Marcos had a medical condition called Treacher-Collins syndrome; and certain precautions need to be followed. 

The family said they made doctors and nurses aware before the procedure. 

When they were told Marcos would need to use a gas to keep him calm. 

His father showed concern but says the staff assured him it was perfectly safe and routine. 

But 10 minutes into the procedure, something went terribly wrong.

"I thought he was in just a little pain, but obviously he was unable to breathe, he just stopped," the grieving father said.

Marcos was rushed to the Valley Baptist Medical Center in Harlingen where doctors were able to revive him.

He stayed in a coma as his parents prayed for a miracle. 

But by Wednesday evening, Marcos passed away leaving his family heartbroken.

"He was with us for 10 years and even though he went thru a lot medically he was a happy boy,” the boy’s father recalled. “He surprised us many times but when it’s time to go God gives the call..that's what it is, we'll respect that."

Action 4 News contacted the Harlingen Family Dentistry for comment.

They said they were deeply saddened to learn of the death of Marcos Tirado, Jr. but due to federal patient privacy laws, they said limited information could be given. 

“Our thoughts and prayers are with the parents and their family at this difficult time,” they said in a statement.