Objection filed opposing the $39M settlement for small victims of FORBA/CSHM’s Small Smiles Dental Centers

Actually there were at least 3 Objections filed today, this is just one.

Objection to $39M Settlement for victims of Small Smiles Dental Centers

HHS-OIG Report - Questionable Billing For Medicaid Pediatric Dental Services in New York–March 2014

This same study could be done in any state these private equity owned dental clinics operate and the results would be the same, if not worse. All of this has been reported right here since 2007, it’s 2014! Just saying…

 

Questionable Billing For Medicaid Pediatric Dental Services in New York - March 2014

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Judge Orders Retrial for 1st Small Smiles Malpractice Case in New York–“Creepy” AIG Attorney Stalks Jurors

Syracuse, NY -  In October a verdict for the defendants was handed down by the jury in the 1st of 33 malpractice cases against Small Smiles and their dentists slated to be heard in New York courts.

Just after the verdict, the jury informed the judge they were stalked throughout the 15 day trial by a “creep” and “sleazy” guy who turned out to be a New York attorney by the name of Scott Greenspan.  Greenspan was hired by malpractice insurance carrier National Union Fire Insurance Company, a division of AIG .

Now, “upon examination of the facts”, Judge Deborah Karalunas. has ordered a new trial, concluding “…that Mr. Greenspan made improper contact with the jury.”

In her November 18, 2013 decision, Judge Karalunas finds AIG attorney Scott Greenspan’s conduct “violated the sanctity of the jury, raises ground for suspicion that the decision was found on something other than the evidence and was prejudicial and likely to influence the verdict.”

“This is not a matter of an isolated elevator conversation, cake for juror appreciation day or expression of condolence.  This is a case where jurors over a 15-day period believed that they were stalked, videotaped and closely monitored by a person they believed worked for the defendants,” says Judge Karalunas.

“This is a case where jurors performing their civic duty were made to feel bothered and scared.”

Under questioning by Judge Karalunas, one juror said:

“He followed us everywhere. When we would go to lunch, he’d follow us to where we were going.  One day we had an hour and 15 minutes, a little extra time, so we walked down to the Armory Square to Blue Tusk.  And I told the other jurors, this guy is following us everywhere.  So after the third time I saw him, I said look behind you, that’s what I’d say to them, and he would always be there.

“But when we would go on the elevator, he would always be there.  when we got outside, we would go to have a cigarette right out front, he’s always be standing close by.  When we got back on the elevator to come up,he was always there.”

‘…the only times we did not see him out of the whole time was once we went to Ale and Angus and once we went over to The Mission and we didn’t see him there.”

The juror told Judge Karalunas that Mr. Greenspan was in the elevator “at least half the time, if not three quarters of the time.” 

So there ya have it.  A new trial and I would guess that National Union/AIG would need to pick up the tab for this. Now, wouldn’t it have just been easier to write this child a check for all the hell he’s been put though?!  Just saying…

Small Smiles Dental Syracuse Bohn Malpractice New Trial Decision

Link to 29 reports on FORBA’s Small Smiles Dental Centers

Corporate dentistry criticized for unethical practices, unnecessary procedures

by Eddie Burkhalter
eburkhalter@annistonstar.com

Jul 28, 2013

When Quintoya Seawright’s 3-year-old daughter, Destiny, chipped a baby tooth in November 2010, the young mother took her to the Small Smiles clinic in Montgomery. Quintoya, 25, would end up taking her daughter to the clinic four times that month.

On the last visit on Nov. 9, her daughter was strapped to a board for an hour while the dentist struggled to place two stainless steel caps on baby teeth while her daughter screamed and struggled, saying she could still feel it, the family said.
But without much money, the young mother had to rely on Medicaid to pay for her daughter’s care. Small Smiles specializes in treating children eligible for Medicaid. The company operates another clinic in Dothan.

The large dental chain is owned by a private equity firm and is managed by Nashville-based CSHM LLC. A report released by the U.S. Senate Finance Committee last week claims Small Smiles and clinics like it are motivated by profit, often performing unnecessary procedures, and should be removed from the Medicaid program.

The report also says the clinics are operating in violation of laws in 22 states, including Alabama, that ban anyone other than a licensed dentist from owning a practice. The report states that CSHM actually owns and operates the clinics, and not the “owner” dentists the company enlists to skirt to get around those state laws.

Quintoya said she was never allowed to go back with her daughter to watch the procedures at Small Smiles, but the 3-year-old girl’s grandmother, Sophia, demanded she be allowed on the girl’s last trip.

Destiny began pulling at her mouth, so workers strapped her arms and legs to the board, then the dentist struggled for an hour to place the two caps on the tiny baby teeth while Destiny “kept saying she still felt it. He said, ‘No. She’s numb. It’s just the noise,’” said Sophia.

“Her heart was just beating so fast,” Sophia said. “The lady was holding her head down and was trying to get her to open her mouth by squeezing her nose.”
Destiny had a total of five stainless steel caps placed on baby teeth over four visits. One cap fell out along with the tooth a couple weeks later. Quintoya said she never heard the dentist say her daughter had cavities in those teeth, but he said the caps would help prevent them from forming.

“I’m not sure if it was a necessity to have all those silver things in her mouth,” Sophia said.

Read more: Anniston Star - Corporate dentistry criticized for unethical practices unnecessary procedures

Oh where, oh where has Small Smiles gone, oh where, oh where can it be…

February is “National Children’s Oral Health Month”. Normally Small Smiles Dental Centers lead dentists (or fake owner dentists) slither from under their rock and hit local morning TV talk shows, claiming they are having free services that very morning for a couple of hours. So far, I’ve not seen hide nor hair of them in 2013. Kool Smiles Dental centers at least announced they gave away toothbrushes this year. (Geez, I hope they weren’t those chemical-laden ones from China that leave blisters in your mouth.)

Small Smiles “free services day” were a sneaky ploy. The dentists would appear on local talk shows about 6 AM announcing they were having free services that morning; from 9AM-11AM for example. They would invite the public, telling them they needed to call for an appointment; failing to mentioning the schedule was already packed tight as sardines – as they were everyday.

It was last year about this time they were preparing documents to file bankruptcy in Nashville’s Federal Court and closing several clinics (updates on that coming soon). By June the OIG forced them to divest in at least one clinic; personally I think it was more than one, Manassas, Virginia clinic for sure. (Let’s just say, whoever took over Manassas, also took the Pueblo, Colorado clinic as well. See: Violations of Corporate Integrity Agreement Triggers Divestiture Action by HHS OIG.

“It is clear that the defendants’ actions constituted more than just malpractice.” –Judge John Cherundo, Onondaga County Superior Court

By August 2012, Small Smiles Dental Centers were taking serious hits in the malpractice cases file against them. In 2011, families of at least 75 children had filed lawsuits in New York against the Small Smiles Dental Centers. Judge John C. Cherundo denied the companies request to dismiss the cases saying, “This intentional misconduct was part of the of the alleged scheme to generate revenue as quickly as possible”. 

FORBA – Go Straight to... Haiti And Take Your Toothbrushes With You

EUREKA! 

FORBA Small Smiles has hit the Mother Load!

Oh wait, no, they aren't sending help, they are sending a few toothbrushes.  Hell, I could send 1,000 toothbrushes.  

FORBA's New Branding

There is a new definition for the word FORBA now. Used to be FOR Better Access, now it's all sugar coated as well;

FORBA "For Better Access, For A Better America"

What the heck ever! Nice try guys.

Since you've come up with a new slogan, wanna take the time to comment on EEHC, Inc, or should I?

Kansas TV Station Looks Into Small Smiles

Families Concerned About Small Smiles

Posted: March 17, 2009 03:40 PM

Updated: March 17, 2009 09:30 PM

Jason and Naomi Pinkston called FactFinder Investigators shortly after taking their four-year-old daughter, Aerial, to the dentist. They say they knew right away something wasn't right.

"I feel they took advantage of my daughter to make a profit," says Naomi.

Jason says the family did research shortly after their experience at the clinic.

"All you have to do is Google these guys to get page after page of horror stories. It felt like a nightmare we couldn't wake up from," says Jason.

That nightmare, as Jason describes it, is the work Small Smiles performed on Aerial. The family showed us before and after pictures of Aerial's teeth. Her baby teeth were showing signs of decay so Small Smiles ground them down and put crowns on them. But the Pinkstons say their problems began before any work was performed.

"She didn't explain anything to me about why it would be important to Aerial to have crowns-whether we didn't do it what would happen or what a crown was. Absolutely nothing," says Naomi.

We don't know if the work was necessary; it's too late to get a second opinion because her teeth are gone. We can tell you four of Aerials front teeth that were crowned by Small Smiles will have to be pulled by another dentist.

We wanted to talk to Small Smiles about Aerial's dental work, but instead were referred to a company in Washington, D.C. Spokesperson Don Meyer tells us the clinic thinks Aerial's treatment plan was appropriate, but the execution was less than ideal. He says because of what happened, dentists in the Wichita clinic will seek continuing education.

"What we're finding is that some of our dentists may require some extra training on what's called a ‘New Smile Crown'," says Meyer.

Although Small Smiles markets exclusively to children, we were told none of the dentists at the clinic have pediatric qualifications. They are trained only in general dentistry.

We talked to pediatric dentists in the Wichita area. All of them told us many of their patients come from Small Smiles. Patients like Shelbi Meisch's daughter Amaya.

"She's terrified to see the dentist, still. Every time we go she's scared to go in," says Shelbi.

Like the Pinkstons, Shelbi doesn't feel her options were explained and Small Smiles ended up pulling six of Amaya's teeth.

"No they didn't tell me they were going to be pulling all those teeth. I was under the impression they were going to crown two back teeth and pull the front teeth," says Amaya.

Another dentist had to perform corrective work Amaya's case.

Then there is Stacy Luthy and daughter Emma. Stacy contacted us after learning we were working on the story.

"They informed me that they had a harness they put the kids in that restrains them. They made it sound routine and no big deal."

Stacy wasn't allowed to be in the room with her daughter when they went to Small Smiles about two years ago.

"About 20 or 30 minutes later they came out and said she had been throwing up. They brought her to me. She had been screaming. She was horrified. She was in tears," says Stacy.

Like Aerial and Amaya, Emma has also had corrective work performed. The teeth Small Smiles crowned fell out, leaving her with nothing until her permanent teeth come in.

The parents say all three girls now have to be sedated to even visit the dentist.

"She'll never not be afraid of a dentist, which is alone is horrible because it's such an important thing to do," says Naomi Pinkston.

That's why the Pinkstons came to us. To encourage other parents to ask the questions they didn't ask.

More Company Response:

Forba, the company that manages Small Smiles, tells us many changes were made in late 2007. They include some of the following:

• Parents are now allowed back with their children during visits. Small Smiles made the change after receiving complaints from parents.
• It conducted about 12,000 surveys seeking parental feedback.
• Working to better communicate with parents.
• Dentists have been retrained on the use of protective restraint
• Created a toll-free number for parents to call with concerns or complaints (1-877-302-KIDS)
• Kansas law requires dentists' offices to be locally owned. This is the company's response to corporate ownership concerns.

It is not uncommon for doctors and dentists to hire or outsource various professional and specialized services, including advertising, computer technical support, legal advice, and even human resource specialists to assist them in managing their practices. For example, the Kansas Medical Society created a practice management firm to provide a broad range of office management services to physician practices around the state. Such services are provided under a management services agreement, include a variety of services and are done for a negotiated fee, much like our agreement with Dr. Reza.

Click here for the transcript of the live chat that took place after the segment aired.

________________________________________

This blogger's Comments:

I don't care what kind of crap they say, Dr. Mohammad Reza Akbar doesn't own this clinic. At the Kansas Secretary of State's Office it says the mailing address is:

Linda Zoller
618 Church Street, Suit 520
Nashville, TN 37219
(FORBA Holding and FORBA Services Address, Linda Zoller is just the VP of the legal department and does most of the state business filings.

I don't even think Dr. Reza Akbar lives in Kansas but I could be wrong, he didn't used to.

As you noticed no one at FORBA would speak on camera, heck they don't speak off camera. They only send their PR guy, Don Meyer to appear, or write responses or start a blog to defend and promote the company. You would think Dr. Reza would want to defend his own clinic wouldn't you?

Don Meyer says a lot of changes took place in 2007. Well, evidently not near enough since I didn't start this until early 2008 and I've heard these horror stories for well over a year now, and they still keep coming in. All of their talk is nothing but Hogwash and they think people are actually going to be gullible to believe it.

********************************************************************************

Here is just one comment from the KWCH TV Website: (go to the bottom of the page and click on 'see all comments')

Whistleblower:

Thursday, March 19, 2009

To Jason, you are welcome and yes I am employed at Small Smiles. The guest brought up some good points...why am I still there? Partly because I do know what goes on and even if I can only save a couple of kids from being traumatized by the procedures and roughness that and unnecessary work I have done a little to stop some of it.

I know I can't stop it all but anything helps. Yes I will be out of a job but there will be a lot of kids that won't be put through this there. As for the dentist in Colorado....yes it is a different state but Small Smiles is nationwide and all of the training is done in Pueblo, CO for the dentists so you see...they have one way of training and we have had a number of dentists that were just as bad, maybe not taking drugs but doing terrible work or pulling permanent teeth when it should have been the baby tooth, or numbing the right side and then working on the left side and ignoring the child's screams of pain.

I know they have the same sub standard type of dentists across the nation. Maybe not ALL of them but a good portion of them are very substandard. The good dentists that we have had didn't last long. They left because they refused to work like that and didn't want to jeopardize their licenses. Trust me...when I first started working there I couldn't believe this type of care was actually going on in America. Maybe I will loose this battle and they will continue to operate but at least I tried and I know I have saved a few kids from the horror and pain along with the parents.

********************************************************************************
UPDATE:

By Michael Schwanke (WICHITA, Kan)
investigators@kwch.com
316-831-6166

Update:

STATEMENT FROM SMALL SMILES DENTAL CLINIC OF WICHITA

Every year we see thousands of children who receive compassionate, high-quality dental care at our dental center. Through our parent surveys, comment line and direct interaction with caregivers, Wichita families regularly express high levels of satisfaction with our care.

However, based on the story aired by Channel 12, an internal review of standards, quality and compliance has been initiated at the Small Smiles Dental Clinic of Wichita.

We take seriously any parent who expresses concern with their child's care, and we are always looking for ways to improve. We strongly urge any parent who has concerns to contact our parent hotline at 1-877-302-KIDS.

Kansas Dental Board is asking that anyone with a complaint regarding Small Smiles contact their office.
You can file an offical complaint at http://www.kansas.gov/kdb/ or call 785-296-6400.

________________________________________________
This blogger's comment:

1. The key word in that statement is the word "our". If Dr. Akbar owned that clinic wouldn't the term be "my" but no, they once again FORBA admits to owning these clinics.

2. I've heard this same statement over and over for 2 years! Why do you think that hotline number was set up in the first place?

3. The Kansas Dental Board has been alerted on several occasions about Small Smiles and their tactics and haven't done a darn thing so far. But I highly suggest you give it a go anyway.

4. I like to hear from those patients who were actually treated by Dr. Mohommad Reza Akbar himself.

Forba Holding, LLC Sues Adventure Dental and Vision (Hero Management, Ron Montano)

I reported a month or so ago about Ron Montano, his dental management company, Hero Management and his string of clinics called Adventure Dental and Vision.  I reported that he used to work for Small Smiles.  His separation from the company is conflicting, I've heard he quit, I've heard he was fired...not that it really matters.

Well, in April 2007 Forba Holding file a lawsuit again Ron Montano and Hero Management and the cause in question is the "Economic Espionage Act of 1996, section 18:1831.  Forba was demanding $350,000 in damages according to the suit.  Cause Number 2007cv00675.  This particular case was dismissed on September 21, 2007 with both parties agreeing not to pursue this any further.  I suspect Forba really didn't want ALL their trade secrets being aired in open court don't you?

According to Wikipedia the Economic Espionage Act of 1996 is as follows:

The Economic Espionage Act of 1996 (see RFD 18 U.S.C. § 1831) makes the theft or misappropriation of a trade secret a federal crime.

This law contains two sections criminalizing two sorts of activity. The first, 18 U.S.C. § 1831(a), criminalizes the misappropriation of trade secrets (including conspiracy to misappropriate trade secrets and the subsequent acquisition of such misappropriated trade secrets) with the knowledge or intent that the theft will benefit a foreign power. Penalties for violation are fines of up to US$500,000 per offense and imprisonment of up to 15 years for individuals, and fines of up to US$10 million for organizations,

The second section, 18 U.S.C. § 1832, criminalizes the misappropriation of trade secrets related to or included in a product that is produced for or placed in interstate (including international) commerce, with the knowledge or intent that the misappropriation will injure the owner of the trade secret. Penalties for violation of section 1832 are imprisonment for up to 10 years for individuals (no fines) and fines of up to US$5 million for organizations.

In addition to these specific penalties, section 1834 of the EEA also requires criminal forfeiture of (1) any proceeds of the crime and property derived from proceeds of the crime and (2) any property used, or intended to be used, in commission of the crime.

The Act authorizes civil proceedings by the Department of Justice to enjoin violations of the Act, but does not create a private cause of action. Thus, victims or putative victims must work with the U.S. Attorney in order to obtain an injunction.

I don't really understand exactly why it was Forba vs Hero since this is a criminal act and Forba would have to file a criminal complaint with the US Attorney to get this suit filed and according to the filings this is a civil suit. 

Anyway, evidently Forba says Ron Montano took some 'trade' secrets with him when he left Small Smiles and is using them to profit from his Adventure Dental and Vision clinics.

The attorney for Forba was William T. Slamkowski of Hensley, Kim and Holzer in Denver.  The attorney for Ron Montano  was Brett Painter of Davis, Graham and & Stubbs in Denver.

Update:

Ok, I finally got my hands of the law suit and Forba was ticked off because two of their employees, besides Ron himself went over to Adventure Dental at the time it was called Captain Smiles.  The two others that jumped Forba's ship was Joseph Lee and Adam Ditto.  Lee and Ditto supposed took all this sensitive info over to Montano....

Forba To Participate In Study; Shouldn't They Be Doing Something Else With All Their Spare Time!

OH, Dear Lord Above, Please Protect Us From More Forba! Amen.

560 unlucky patients to be recruited for Forba experiment, I mean 'study'!
PEARL Network-Practitioners Engaged in Applied Research and Learning; Forba and the words 'applied research and learning' all in the same paragraph cause one to choke, does it not?

1. Who is funding this?
2. You would think a company needs to be of much higher quality than Forba/Small Smiles before they get into research. And Forba/Small Smiles going to 'study' 'treatment' of anything whatsoever is beyond me believing!
3. Let me 'examine' some 'treatment'!
4. What makes them think they are going to be in business long enough to complete any study!
5. Let me see, isn't Forba the one being 'studied' ...oh say by.... all kinds of State and Federal Agencies!!!!!!!!
6-100. What's wrong with people?
101. Shouldn't a company have qualified dentists to actually participate in a 'study'?!
103. If  PEARL ever had any credibility at all it's gone now!
104.-200. What's wrong with people!

FORBA-Managed Dental Centers to Participate in PEARL Network Study
Multi-year study will examine treatment of deep caries
July 22, 2008 - Nashville, TN – The lead dentists of three FORBA-managed dental centers have volunteered to recruit patients for a multi-year study conducted by The PEARL Network (Partners Engaged in Applied Learning and Research) that will examine treatment of deep caries nationwide.
Management of deep caries close to the dental pulp presents a challenge to both clinician and patient because the prognosis for recommended treatments is not well documented. The PEARL Network study, called Complete versus Partial Removal of Deep Caries: A Comparison Study of Treatment Outcomes (Deep Caries Study), will attempt to shed light on the most effective treatment options.
“The working relationship between FORBA and the PEARL Network will allow for a broader base of clinical studies to include a wider consideration of the population,” said Dr. Frederick Curro, New York University College of Dentistry’s Chief of Pharmacotherapeutic Investigations, who is conducting the PEARL study.
In a survey of PEARL Network members, 80 percent of dentist practitioner-investigators reported removing all caries from deep lesions and 20 percent reported that they only partially remove caries. Based upon this survey’s results and the recent publication of a report that found outcomes of both treatment approaches produced similar outcomes, the PEARL Network designed this effectiveness study to assess treatment outcomes for both procedures in PEARL Network practices.
The specific aims of this research are to:
• Compare the effectiveness between complete and partial caries removal in deep Class I lesions for maintaining tooth vitality at one year post-treatment.
• Assess the effects of deep caries treatment on patients' Post-Operative Hypersensitivity (POH) and Oral Health Related Quality of Life (OHRQoL)
• Evaluate cavity lining and bonding techniques for non-vitality outcome trends in order to design a follow-up prospective intervention study.
The study, currently in its early phases, will recruit 560 patients who will be monitored at 6 and 12-month intervals to examine treatment efficacy.
“FORBA provides dental care to a unique population which provides an opportunity for the PEARL Network to be more inclusive of its clinical studies,” said Dr. Curro. “The synergy between Forba and the PEARL Network will be manifested in the breadth of the patients considered for the clinical studies and in translating the clinical data to all socioeconomic levels.”
Contact: Don Meyer
(202) 898-0995
# # #

FORBA's Todd Cruse of Nashville, TN Donates To New Mexico Congressman

Call me stupid. Ok, wait, you would have to get in line to do that but anyway...

Wonder why Todd Cruse in Nashville would contribute a mere $250 to a congressman's campaign. Especially knowing how they work and all, surely he wouldn't expect much in return for that.

But the bigger question is:

Why would Mr. Cruse donate to Ben R. Lujan, a New Mexico Congressman.

You can see for yourself here.

Click

Oh wait! Here it is, straight from Ben's website:

Commissioner Luján has also fought for improved health care for New Mexico consumers by investigating the health-insurance industry's denial practices and spearheading development of legislation that expands access to insurance and closes loopholes. The industry had been using these loopholes to unfairly deny medical claims and void policies.

"Closes Loopholes" ROTF LMAO ROTF LMAO

Think about that a minute, the King of Loopholes, donating to a guy who boasts he 'closes them'. LMAO!

OMG, not a day passes I don't get some kind of 'pee' my pants hearty laugh with this group!

And get this Michael Lindley, FORBA's CEO donated to Ben as well. I guess Mikie makes more than Todd, because Mike donated $1, 000.

I guess Mike and Todd want to join the fight and help close all those 'loop holes'! LMAO!

Next thing ya know, Todd will be on the witness stand again.

But here is the REAL reason: A loan from the state of New Mexico to open a Small Smiles there.

Click Here for the story.

Related:

Mario Burgos: Bahrain Investors Collect New Mexico's Tax Dollars

Dr. Robert Andrus Does NOT Really Own Any Small Smiles Clinics In The Sense They Want To Project

This article had been reprinted here before but I felt it was worth reprinting it again along with the link to the original article.

Click here for original.

Anyway, it's important because it's talking about the Small Smiles opening in Roanoke, VA and how it's owned by Robert Andrus and FORBA only manages it for him.

Well, that simply isn't true. Robert Andrus works (or should I say worked, he's no longer with them according to recent reports). On an document that was sent to me listing all employees at FORBA, their phone numbers, email address and their job title Robert Andrus is listed as Senior VP West Region.

In fact he and Kenneth (Ken) Knott, SVP Central Region are listed as being owners as several Small Smiles clinics, especially in states where dental clinics have to be doctor owned. (I guess being doctor owned is subjective as to what percent of ownership isn't it, 1% or 100%?)

If you check phone books of various cities where Small Smiles is located you will see Dr. Robert (Bob) Andrus' name listed on several of them as being the owner and providing services to clients. He is (was) nothing more than a FORBA employee, it's just that simple.

Small Smiles defies traditional system - Low-income children haven't been welcome at most dental practices in the region, at least not without tight restrictions

Dentists suffer with a toothache of sorts over treating patients on government programs. The reimbursement is low, and the hassle is often high. Dentists prefer patients with private insurance or cash, on whom a stable, profitable practice can be built.

But a new Roanoke dental clinic has turned the standard business model on its head.

Four dentists courting the business of low-income children in Western Virginia have opened a practice at Crossroads Mall. Small Smiles caters to children age 20 and younger enrolled in any of the state's health insurance programs: Medicaid, FAMIS and FAMIS Plus. Low-income means people at or below 200 percent of the poverty level, which is $40,000 for a family of four.

It has drawn a huge response, with 2,100 patients booked for appointments before it opened July 31, drawn only by TV commercials and a postcard mailing.

"I think it's going to be successful," said dentist David Jones, who closed his private Roanoke practice to work at Small Smiles. There's so much work, "we could probably keep another clinic like this one afloat."

If the niche sounds unusual, it is: Low-income children haven't been welcome at most dental practices across the region -- at least not without restrictions that close access to new patients when the dentist feels he or she can no longer afford to treat any more.

But last year, Virginia lawmakers intervened. They increased reimbursement for dentists who treat Medicaid-insured children and chopped away red tape for both patient and dentist. Attention was directed at reducing missed appointments; people on Medicaid and related programs miss up to 50 percent of scheduled dental appointments.

National companies that cater to those on government programs have been setting up shop in Virginia. The Small Smiles group, from Pueblo, Colo., has opened 46 practices across the country, including in Roanoke and Richmond. A similar enterprise, Kool Smiles, based in Decatur, Ga., has 17 sites nationwide, including four in Virginia, its Web site said.

"We have a business model that works because this is all we do five days a week, 12 months of the year," said Todd Cruse, speaking for Small Smiles in Roanoke. "We typically average somewhere around 72 to 75 patients a day."

Cruse is chief development officer at FORBA LLC, a dental practice management company in Pueblo, Colorado.

FORBA manages the Roanoke practice for its owner, Colorado dentist Robert Andrus.

Terry Dickinson, executive director of the Virginia Dental Association, was wary when he first heard that a for-proft, corporate dental practice focused on the poor was preparing to operate in Richmond this past spring.

It appeared to be a low-margin business dependent on moving a high volume of patients through, Dickinson said. Might Small Smiles be a "mill" providing the least acceptable care, Dickinson wondered.

So he met with Small Smiles officials. "We made it clear if they chose to come into the state that we would have our eyes on their operation," Dickinson said. Company officials pledged to give quality care and invited state dental industry leaders to drop by unannounced.

Now that the Richmond practice has been up and running for several months, Dickinson is satisfied that Small Smiles is meeting the needs of Virginians, he said, adding there haven't been any patient complaints to his association.

"We are very pleased with what they're doing," Dickinson said.

Another Small Smiles Business Partner Settles Medicaid Fraud Charges

I hardly know where to begin on this entry. What a mess we have here. It might help if you read the entry about the "Tangled Web" before reading this one.

Well, earlier this month we had Doral Dental implicated in the bribery charges of former Tennessee State Senator John Ford. During the trial FORBA/Small Smiles top dogs, Todd Cruse and Dan DeRose even had to take the stand.

Doral Dental execs were so guilty they admitted if they took the stand they would plead the 5th as not to implicate themselves.

Now we have Amerigroup settling the largest ever false claims Medicaid Fraud case in American history at a whopping $225 Million dollars. (somehow no jail time has been imposed)

After WJLA TV's investigation aired about the horrible treatments of children at Small Smiles clinics and the medicaid fraud in and around Washington DC, Amerigroup announced it was requesting Doral Dental to do a thorough investigation of these allegations. (aren't you just about choking right about now?)

Amerigroup contracts with the state

Doral Dental contracts with Amerigroup

Small Smiles contracts with Doral Dental

...to provide dental care to children enrolled in medicaid in Maryland, District of Columbia, Ohio and Georgia.

Don't forget just a few short months ago Dr. Michael DeRose the co-founder of FORBA/Small Smiles paid a $10 million dollar settlement in North Carolina for medicaid fraud.

Something tells me that FORBA/Small Smiles was not exactly shaking in their boots when they were made aware Amerigroup was having Doral Dental look into their business practices, what do you think?

New Papoose Board Consent Tactics Surface

Today I've received two separate reports from concerned parents that indicate FORBA-Small Smiles have changed it's tactics in obtaining consent to strap children down in papoose boards.  There reports are from two separate states. 

(Boy, the Papoose board sure is an important tool for these places aren't they)

Evidently they aren't having the parent or guardian pre-consent to the use of these devices anymore.  (They are calling them "protective wraps", isn't that sweet!)

From the two reports I've gotten just this morning, they are still separating the parents from the children, taking the children back for fillings, sealants, crowns whatever, then returning to to the parents saying:

"because he was wiggling and screaming and said that he was a danger to himself and the doctors"

It makes it seem that they are in the middle of a procedure and it's imperative they sign this consent so that they can finish the procedure.

Whatever the real reason, it's clear they have changed their tactics but still pushing on tying up children at any cost.

Now, FORBA, you want to make another statement about how you are improving things?  That is just pure BS!

FORBA PR Machine At Work

After watching boards across the Internet for the last few days I can see FORBA-Small Smiles-DeRose have put the big PR firms to work but they are gaining little ground.

I swear I think they have actually hired people to spend their days getting out and making positive posts or try to find fault in what parents are finally speaking about.

The most common posts are:

1. We are trying to hire compassionate and quality staff. (How long does it take, they said that three years ago, two years ago, and last fall) They can't change a thing until they change to powers that be, and that hasn't even come close to happening. Those in power in 2000 are still there. It's clearly documented on this site with references that shows the same names of the same good ole boys at the same addresses.

2. It was an isolated incident. Whatever how many thousands of complaints for how long do they consider it to be a bit more than "isolated"

For Heavens Sake, the government set up a Hot Line to report abuse from these places!

Once again I can't stress enough that private dentists are doing this same crap. Be on alert!

3. Just a bad apple in the bunch. A bad APPLE!! Well, yeah! Lots of bad apples. When you set up shop in Pueblo Colorado and send out demon seeds across the country, to plant more diseased trees! Clearly some bad apples, from the bottom of the tree straight to the top!

FORBA Financially Stressed: Maybe A Papoose Board Is In Order

As I suspected, FORBA/Small Smiles is a bit financially challenged and unable to open any more clinics at the present time. According to reports no monies are being paid out during the Medicaid fraud investigation which is really putting a crunch on them financially.

How is this bad? Well that means they need to push their production on who they can when they can and that's spells trouble for the children being tied down in the papoose boards also known as pedo's in the biz, as in pediwraps, not Pedontists.

That means more children are going to have to use the combs, brushes and blow dryers the assistants keep in the back to clean the children up before they give them back to their parents.

Is FORBA FORba Sale or Just Needing Money?

Wonder why Draper, Fisher and Jurvestion, an early stage venture capital company would be checking this blog out? The "keyword" they used in the search engine was "FORBA". After checking out all the other people/companies/law firms that have been 'avisitin' lately I have to wonder if someone is not trying to:

1. Unload FORBA to anyone that will take it.
2. FORBA /Small Smiles/DeRose getting their butts sued
3. Are really hurting for cash since they have to be at the top of the "red flag" list in all their billings.
(In fact, I bet a whole army of "color guards" come strolling through the Medicaid billing center)
4. FORBA is gathering up some cash for all the "settlements" and legal fees they are going to make and need.
5. FORBA is robbing from Peter to pay Paul, and that only makes for a sore Peter.

Here is the list of just a few visitors and the "keyword" they used if I know it:

Honigman, Miller, Schwartz & Cohn - Health Law Practice- "Medicaid Dental Center Settlement"
Shearman & Sterling -Law Firm
CIT Financial - Financial advisers for Arcapita
King & Spalding- Law Firm

Navigant Consulting-International Consulting Firm
Houlihan, Lokey, Howard and Zukin-Investment Bank-"FORBA and Child Abuse"
Interlink Advertising-Ad firm-"Michael DeRose"
International Monetary Fund-"DeRose Pueblo"

First Southern National Bank
Omnicom Management Services-Texas Ad Agency-"Dan DeRose"
LA SALLE CAPITAL- Investment Bank-"Forba/Small Smiles MA"
Covington and Burlington Law-Law Firm-"Delta Dental"

Veroxity Technology Partners
FTN Financial Investment bank-Investment Bank
Stroock & Stroock & Lavan LLP-Law Firm-"Albany Small Smiles and Rochester"
RSM MCGLADREY-Accounting firm

CSC Holding-Holding Company-"Small Smiles Arcapita"
Cratos Capital Partners
Canon Capital Advisors-"Small Smiles Billing"
NCMIC-Insurance and Finance Group-"Medicaid Dental Center"

Forbin Group-"Papoose Board"
Peabody and Arnold, LLP-Law Firm-"Small Smiles"
Poyner & Spurill-Law Firm-"Child In Papoose Dental"
Vestar Capital Partners-Investment Group-"Rafael Rivera, DDS"
Lehman Brothers-Investment Bank-"Forba For Sale"

Wesley Capital
Draper, Fisher and Jurveston-Early Stage Investments-"FORBA"
Wells Fargo-Bank-"Tish Ballance"
Morgan Lucas & Bockius-International Law Firm-"FORBA"
Haynes and Boone, LLP-Internation Law Firm-"came to blog directly"
Deloitte & Touche

FORBA, LLC Formed 1-2002 then renamed to LIC SAC, LLC

About the exact same time the DeRose's sold the assets of FORBA, LLC they changed the name of FORBA, LLC (For Better Access) to LIC SAC, LLC. (Lick Sack, nothing but class those nasty scumbags...I mean scum sacks) 10-02-2006. Notice on the documents the address is that of DD Marketing in Pueblo.

To See the documents click here.

10-01-02
FORBA, LLC Articles Of Organization Here, see Dan DeRose's name right here!
Dan DeRose, Michael DeRose, Ed DeRose, William Mueller, and Adolph Padula.

According To The Colorado Secretary Of State Website, FORBA, LLC, named changed to LIC SAC, LLC, 10-02-2006 is listed as stated below:

5-5-2008: Entity name and any active trade names changed due to failure to file annual report

Dentists React To Small Smiles

These are posts from a Dental Message Board in reaction to Small Smiles/FORBA

1. There is a small smiles clinic close to us and we see a lot of children who have been put through the ringer there. Most times the work is sub-standard and we are re-doing what wasn't done correctly the first time around. Many of the children who are referred are great kids and just need some TSD and patience. Unfortunately, at that point they are pretty traumatized. The thing that worries us here in our clinic is the disregard for max local anesthetic dosages, etc. It's hard to believe you can papoose a 3 year old and do 4 quadrants of dentistry in one sitting, staying within the safety limits for local anesthetic. I'm all for providing needed treatment, but I'm doubtful as to how much training and supervision there are at these clinics.

2. small smiles opened in our town about six weeks ago. a good friend of mine was working as a hygienist there--she quit after two weeks. i don't know how anyone can justify treatment like that. i see kids with medicaid as does another large pedo practice in town, as do several other family dentists i know. access to care isn't an issue in my area for these kids so they can't use the "we're your child's last hope" approach.

look at the aapd guidelines. they (small smiles) aren't compliant and i don't believe they provide the standard of care offered in my area.

previous to this story, i was talking with a friend on the local peer review on how to approach this group because i was concerned about what i was hearing.

I personally LOVED This one!!!!

3. At our SSPD meeting in September AAPD president Keith Morley said to watch out for these FORBA clinics. He said they are on the way to any rural area in which they can treat low socioeconomic children for Profit.

I too see Medicaid children b/c I feel it is my way of giving back to society. The News took the absolute worst parts of the entire story and put that on TV for everyone to watch. I've been in situations in which i've had to use a papoose board while the child screamed away b/c there was no other choice. I would think any of us pedos understand exactly what was going on there. Most of what they do may not be morally right and is against the ethics of the ADA and AAPD however it doesn't break any laws. We need to all band together and keep these clinics from opening in our areas.

4. Just completed 30 years of dealing with Medicaid. It tooks it's toll on me financially (somewhat), but more emotionally and physically (which is why I stopped). The stories I have heard even for adults can be incredible, and then we get to the "access to care" issue. Who in their right mind would like to stand in line for that kind of access?

I know that there are also some incredible providers of care to this population, adults and children. But, at times, it seems that as long as the care is being "provided" by a provider, that the state powers will look the other way. An acquaintance of mine who previously worked at a one of these facilities stated that some of the dentists, at this particular facility, should not have licenses to practice.

5. If providers would treat mediciad patients as a requirement for renewal of our state granted license to make money in this limited area, access issues would greatly diminish.

6. There is one down the street from me called Vital Smiles, formally the Tooth Zone. I used to say "Who else is going to treat these kids" (I take medicaid by the way) From seeing some of the dentistry, and hearing from patients, former staff members, and a former Dr. there, a lot of those kids would be better off if they had not even gone.

7. If the Democrates get the s-chip legislation passed they will providing about 1 million more American kids with the kind of treatment that is getting blasted. S-Chip in most states is lumped into medicaid. I could care less about Dem vs Rep, but this is to make legislaotors (sp?) look good by providing insurance to these poor kids. What kind of care will be provided? Will they have access to care with this insurance?

8. small smiles clinics do not sedate or offer GA. What upsets me is not the use of the papoose per say, but it is how the clinics are run. There are several Kool Smiles clinics in the area where I practice, and they are run in a similar fashion to Small Smiles. they over treatment plan just to do pulp and crowns. I see at least 3-5 patients from their clinics , and the parent shows me the tx plans. many times it is crowns, where simple ONE surface restorations suffice. These clinics do not have a good reputation where I live.