Smiles Starters North Carolina Still Delivering Overtreatment to the Underserved via Elysa Bailey de Morias, DDS

Thousands of complaints made on Internet "message" and "review" boards.

Hundreds of legitimate complaints filed. 

At least 8 lawsuits.

Ten Million dollars ($10M) in restitution to the government for fraud. 

Under observation since 2003. 

Under my watchful eye since 2007.

Name changes of the facilities.

North Carolina State Board of Dental Examiners spending hundreds of hours reviewing complaints on former owners, current owners, past employees, current employees. 

Warning after warning issued, Consent Orders for Disciplinary Actions passed out like programs at a school play.

Surprise inspections from state and federal agencies.

It is almost October 2010 and we still we have Elysa Bailey de Morias, DDS.

Elysa may well be a very nice person, there are a lot of people who are stupid and/or crooks. 

 Here is the Compliant and Consent Order for Dr. DeMorias

Highlights

Practicing at Smiles Starters in Greensboro, North Carolina

A three year old girl was seen by Dr. Elysa on November 3, 2008, we will call the child HW.

Dr. Elysa “was unable to conduct an adequate visual clinical exam or take sufficient radiographs to support her treatment plan.

Dr. Elysa decided to develop a treatment plan anyway that consisted of restoration of 6 of HW’s teeth, “with possible stainless steel crowns on three of her teeth.”

Dr. Elysa placed “watches” on six of HW’s other teeth. That should be about all the three year old had in her mouth. Looks like Dr. Elysa was going to get at least ½ of them.

HW’s mother felt this was not right and took her child to a second dentist the very same month.

The second dentist wasn’t able to perform a through examination on HW.

In June 2009, 7 months later, HW’s mom took her to the second opinion dentist again who then was able to perform a full and comprehensive assessment.

All the second dentist found, 7 months after Elysa de Morias of Smile Starters saw this child, was a discoloration on tooth A and a minor fracture in the enamel of tooth N. He found NO decay on ANY of the teeth Dr. Elysa de Morias has supposedly found 7 months earlier.

In November 2009, more than a year after Dr. Elysa de Morias wanted to drill away and put stainless steel crowns on 6 of HW’s teeth, HW was seen by yet a third dentist. Dentist three found the very beginning decay on tooth A which he felt probably was not there a year earlier when Dr. Elysa laid claim to a mouth full of restoration needed, but found no other tooth problems what so ever.

All the Board nailed Dr. Elysa for was “violating the standard of care for dentists licensed to practice dentistry in North Carolina by proposing a definitive treatment plan without having conducted an adequate clinical examination and sufficient radiographs.”

Dr. Elysa de Morias agreed that there was sufficient evidence against her, but did not admit any wrong doing but decided not to oppose the allegations and agreed to whatever the Board decided to hand out as punishment.

Elysa Bailey de Morias, DDS has her dental license suspended for 30 days. For the next 2 years she must:

Not do that anymore

Not direct her employees to do that anymore

Allow random inspections and interviews

Complete continuing education designed especially for her at the North Carolina School of Dentistry

Reimburse the board $650.00 for their time and trouble.

Have her name reported to the National Practitioner Data Bank (which is no big deal these days).  Former owner and rumored to be current financier, Dr. Michael DeRose was put on that list many years ago and kept his licenses until 2009!  As did his partner in crime, Dr. Tish Ballance-she is still practicing.

Dr. Elysa Bailey de Morias has been in operation in North Carolina since September 2007!  Imagine the number of underserved she has overserved.

The Possibilities

I'm sure I've missed some billing codes and this isn't exact, but it sure is close.

North Carolina Reimbursement rates:

D0150 – Comp oral evaluation - $44.61
D1120 Prophylaxis (aka cleaning)- $27.21
D0210 Intraoral-complete series w/bitewings $71.79
D1203 Fluoride $16.04
D3220 Therapeutic pulpotomy - $81.09
D3220 Therapeutic pulpotomy - $81.09
D3220 Therapeutic pulpotomy - $81.09
D3220 Therapeutic pulpotomy - $81.09
D3220 Therapeutic pulpotomy - $81.09
D3220 Therapeutic pulpotomy - $81.09
D2950 Core Buildup, including pins $98.25
D2950 Core Buildup, including pins $98.25
D2950 Core Buildup, including pins $98.25
D2950 Core Buildup, including pins $98.25
D2950 Core Buildup, including pins $98.25
D2950 Core Buildup, including pins $98.25
D2950 Core Buildup, including pins $98.25
D2930 Prefab stainless steel crowns –primary tooth $144.28
D2930 Prefab stainless steel crowns –primary tooth $144.28
D2930 Prefab stainless steel crowns –primary tooth $144.28
D2930 Prefab stainless steel crowns –primary tooth $144.28
D2930 Prefab stainless steel crowns –primary tooth $144.28
D2930 Prefab stainless steel crowns –primary tooth $144.28
D2940 Sedative filling $39.77
D2940 Sedative filling $39.77
D2940 Sedative filling $39.77
D2940 Sedative filling $39.77
D2940 Sedative filling $39.77
D2940 Sedative filling $39.77

Total - $2339.99

If the procedures was upcoded to the D3230/D3240 it would be an additional $50 per tooth totaling just over $2600.00.

It's not uncommon to upcode the pulpotomies (D3220) to pulpal therapy (D3230/D3240).

D3220 - Pulpotomies are performed on vital teeth, while pulpal therapy (D3230/D3240) is performed on necrotic primary teeth, with resorbable medicament placed down the canals.

Conclusion

The only conclusion I can come to is Dr. Elysa de Morias  unnecessarily tortures and mutilates children, defrauds the medicaid system and got caught this one time. 

However, all that happened was a slap on the greedy little hand and back to work. 

Nothing was mentioned about the full extent of her attempts, just the actions; “violating the standard of care for dentists licensed to practice dentistry in North Carolina by proposing a definitive treatment plan without having conducted an adequate clinical examination and sufficient radiographs.

Questions

As with all of these cases, we have to ask what caused a person who spent thousands of dollars for her education to attempt not only fraud, but needless suffering of a 3 year old child, and to do it as casually as taking her next breath.

How many patients does she see in a week, a month, that she tries and succeeds in this exact scam?

Why are dentist caught doing this not prosecuted?  Doing an investigation, slapping a seeming large fine on them, but letting them keep right on is doing nothing to stop it.  So I have to assume the powers that be support.

Why do support staff not report this? 

Does it make those in the office who turn their head just as guilty?

Smile Starter and the EEOC

I've not been able to confirm this but I did receive an email reporting that Smile Starters in North Carolina, the same company fined $10 million dollars for medicaid fraud in 2008 are back under federal investigation once again. Only this time it's for discrimination.

Smiles Starters was originally owned and operated by Michael A. DeRose and Letitia Ballance, but soon after investigation for fraud, over treatment of children (doing root canals and crowns on perfectly good teeth, sometime up to 16 at one visit) they supposedly sold the clinics to Dr. Raf Rivera, but that sale remains in question since Dr. Raf was an employee of DeRose and Ballance. Many think DeRose still has his hands in that business.

Both Dr. DeRose and Dr. Ballance were sanctioned by the North Carolina dental board. Dr. Ballance went on to open more medicaid dental clinics, one in Waynesville, NC going under the name of Carolina West Dental.

Why she (Dr. Ballance)is still allowed to bilk medicaid and earn a living using the medicaid system in North Carolina is a question the baffles those who know about it. In fact it is baffling why either of these dentist still have a licenses to practice dentistry in ANY state, and certainly baffling as to why they are not in jail.

Wheather FORBA (of Small Smiles) fame is still associated with these clinics is also in question. At times over the past couple of years, Dr. DeRose has made mention he still owned them, and other times he's stated he sold them with Small Smiles to FORBA. But if asked FORBA will tell you they don't 'own' any dental clinics, they only manage them.

Here is the email I received"

Yes, Smile Starters is back under the eye of the Federal Government. Now they are under investigation for employee discrimination. Look into the EEOC, there are three counts of discrimination against them. They are now firing their most experienced staff and replacing them with unexperienced staff for half the salary. I assume they are trying to make up for the $10 million they had to dish out for Medicaid fraud.

Report on Tish Ballance Still Going After Medicaid Dollars-ABC 13 news.

I told you guys a few weeks ago, that Tish Ballance was opening up a new 'State of the art" clinic in Ashville. Finally it's hit the news on Ashevilles ABC13, Frank Fraboni reporting (requires IE not Firefox). See Here for the video report.

This reports says that this particular Smile Starters wasn't involved in the 10 million dollar law suit, but failed to mention that every dentist in ALL Smile Starters go to the same boot camp for training. This particular office just didn't have any parents step forward.

Note how those employees look like deer caught in the headlight. Wonder why no reporter has ambused DeRose over the years. Come on guys, let's get on that one.
(see that's what's this site is all about, gathering information for reporters and agencies so they don't have to spend the same hundreds of hours researching this whole mess and it's all in a nice package right her to pick through and decide what each wants to report on, or agency wants to file what chargers, call it my gift to the world)

In the report above documents show that even today, DeRose and Ballance still own Smile Starters, even though they say it's been sold to Dr. Raf Rivera. They employees still acknowledge DeRose and Ballance still own Smile Starters, and DeRose said months and months ago he sold them or they were under "new management", depends on who he's talking to at the moment. Wouldn't you hate to have him for a client. Honestly he can't tell the same story twice.

"Mike DeRose, this is to you personally: Changing the name over the door, does not mean "New Management"....duh! And how many dental management company names do you have now, I'm up to at least 5 or 6 in the management area alone. Let's see, BBJ (your relatives) Root Management (your accountant) FORBA, LLC (you and your brother) FORBA Management, LLC (you and your brother) ...shoot I've done lost track. You know, I myself would love to have you on the witness stand, oh what a joyous day for me that would be."

According to other reports Dr. Rivera took over ....clearing throat.... I mean bought all the Smile Starters across the area. (Funny wonder how many times DeRose can sell the same clinics..didn't he once say he sold them to FORBA, Oh wait, forgot....FORBA is owned by DeRose...excuse me)

My guess they've already hired a new ad agency to come up with another new name for Smile Starters, design another sweet little logo and look for new signage to arrive at any time. Of course I could be wrong.

When it comes to this bunch I'm usually not too far off. So I guess they can advertise "new management" right? (Rolling on the floor laughing) that has taken over Smile Starters.

Of course this is standard procedure for DeRose, say they've been sold or at the least under new management (picking myself up off the floor) as pretend he's wiped his hands of the whole thing. I've uncovered at least 25, or was it 27 different names where he's done this exact thing.

Dr. Rivera will now be the so called owner and Root Dental Management to run the terrorist camps, as known as, dental management. Don't think for a minute that Michael DeRose is not involved or getting a cut off the top, he's now the probable "consultant". It's not hard to figure out the business model since it's been status quo for years.

Dr. Rivera is an old employee of Medicaid Dental Centers-Carolina Dental Centers-Smile Starters, I would bet money he's as guilty as Tish Ballance or Heather Berkheimer in gross overtreatment of the children's teeth as well as tying them up on papoose boards.

My guess (and I guess pretty well) is that the only reason he was not officially sanctioned and named in the current lawsuits is that no patient seen by him in particular came forward with complaints. ?This is where you parents out there have to step up.

That would make him the perfect candidate to take over wouldn't it. He's trained well in the standard procedure, yet not named in lawsuits. The we have the new "Root Dental Management" with Ryan Root in charge of that. Knowing full well Ryan Root has been the sidekick of Dr. Michale (Mike) DeRose for years. Actually Ryan Root is the staff accountant for FORBA I do believe. Bob Root's company, Ryan's dad, Rice/Root or something like that , then Ryan came on over to work exclusively for FORBA.

I sure hope DeRose pays Ryan Root well, since DeRose has conned Ryan into sticking his neck out there to be cut off and it will.


Tish, honey this is to you: Look, your name is mud in the dental world. It's time for you to just get back in school and find another profession. And I'd lose the "Tish" in your name. I know you've been brainwashing by DeRose, thinking you are as Teflon coated as he's been through the years, but his reign as Teflon king in the dental world in rapidly coming to an end and you need to just find something else outside the dental profession to do with your life. Now I know you are a strong person and can start over, preferably in another country....say Bahrain maybe.

(I was just thinking... I've got a lot of vacation time this summer, and I've had a few suggestions on where I could go...he he he. I also have a very nice expensive sony video recorder, and I know Colorado is very nice this time of year..... )

Can You Believe It Took 5 Years To Decide 16 Baby Root Canals At One Sitting Isn't A Good Idea

You know what I've been thinking?

Since the State Of North Carolina, it appears, is going to let Tish Ballance open up another medicaid dental clinic...

...and Michael DeRose be the "consultant" for Dr. Raf Rivera's new and improved Smile Starters.


....why don't they just save the children years of Post Traumatic Stress Syndrome and thousands of night terrors and write Tish Ballance, Raf Rivera, and Michael DeRose a check and keep their asses at home away from the children!

I mean, honestly, they haven't stopped them from getting into the medicaid piggy bank, nor has the state pulled their licenses so evidently they want them to have the money....

...cut the assholes a check!

Where's The New Mangement @ SmileStarters?

At the Link Below there is another ad place in February 2008, listing Roger Walters as the contact to SmileStarter Dental Clinics in North Carolina. The ad says Michael DeRose is the owner.

http://ratemds.com/social/?q=node/28873&did=148374

It give Roger Walters email address as walters.rdm.gmail.com.

rdm stands for Root Dental Management as in Ryan Root.

Type the name google Ryan Root Colorado and you want to take guess what you get... just click here for the surprise...............

It's clear that Ryan Root has been in business with Michael DeRose and still is in business with Michael DeRose.

So where's the new management SmileStarters keeps talking about. As far as I can tell back in February it was Root Dental Management and it currently Root Dental Management. Now maybe they are claiming that BBJ Dental Management isn't in charge anymore, but that isn't saying a whole lot now is it?

Just because Brad Bryson and Johnson Enterprises (BBJ) isn't there anymore doesn't mean much. Not that I'm sure Brad Bryson and Dan Johnson aren't still getting money out of this whole venture anyway. Hard to believe DeRose would throw his cousin and brother in law out of the money pool. (I believe Brad Bryson is DeRose's Cousin, Dan Johnson-married DeRose's sister, but I could be wrong.)

Think maybe they are just going to say that Michael DeRose is a "Consultant" with SmileStarters?

It's a question worth asking, but since he never actually physically practiced dentistry in North Carolina, nothing changed there either did it. Just replace Tish Ballance's name with Dr. Rivera and it's the same ole crap isn't it.