Showing posts with label Inc. Show all posts
Showing posts with label Inc. Show all posts

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.

Tuesday, January 03, 2012

So you want to work for a corporate dental chain? What should Dr. Beth do? 2012-1-3 14-7-20



Beth A. Dorain, DMD
Lafayette, Colorado

Employer: Perfect Teeth
Management Company: Birner Dental Management Service, Inc – Mark Birner, DDS-President

I am working for a corporate chain.  I do not like it, and I thought they were jerks.  The CEO called to yell at me about October's low production.  (FWIW, there were many legitimate reasons for the low production in October.)  Not worth listing here.  Production more than doubled in November.  The next day, he called to say he was going to change my compensation to purely a percentage of production.  After the first phone call,  I was 100% certain that I was going to quit in short order.  So, I went ahead and signed it.

Now, I've come to realize that I make 30% of insurance reimbursements and patient's co-pay.  The problem is that they take a lot of DMOs with capitation checks.  I spend a lot of time doing exams, fillings, etc. and discovered that there is no re-imbursement for those procedures.  The compensation for the work comes in the cap check.    But, they will not give me ANY percentage of that cap check.  I did not realize that I was doing exams, fillings, etc. FOR FREE.  In many cases, the fillings are $0.00 or the co-pays are ridiculously low. 

For example, I did three anterior root canals on one patient.  The total reimbursement for it was $120.00.  So, I made $36.00 for the three root canals. 
Is it even legal for this organization to expect me to work for FREE.
My contract does say (excludes capitation check)
I'm getting a lawyer!!!!!!!!

I did forget to mention one very important detail, one month after I signed the Addendum, I did get another offer which I accepted.  However, I am supposed to give my current employer 90 days notice (which I did on December 15.  That keeps me in "jail" until mid March.  I am hoping to not honor those 90 days due to the language of the original agreement. 


Tuesday, October 25, 2011

“Owner Dentists” banded together and won $130 million

Had I read this in 2007 or even 2008 I might have believed the whole scenario laid out in the lawsuit between Park Dental Group and American Dental Partners. But knowing what I know today I think it’s a case of “owner dentists” going rogue, but I could be completely wrong. 
In 2007 a Minnesota jury awarded a group of dentist $130 million dollars.  The group alleged American Dental Partners, Inc. had overstepped its bounds when it came to the treatment of their patients.  Disappointingly, the jury failed to address the claims of a corporation/non-dentist practicing dentistry without a license.  However I suspect one could say the monetary award spoke volumes.

I guess it could be a case of the smaller dental group decided to become their own “management” company and screw the Wall Street folks. But as long as dentists own the clinics, are making the decisions and delivering the treatment I don’t see a need for real concern, do you?

Star Tribune
December 13, 2007

In a landmark verdict likely to draw praise from those opposed to the growing corporate presence in medicine, a jury ordered a Massachusetts company to pay $130.6 million to a group of Twin Cities dentists who claim the company interfered with their delivery of care to patients.

A Hennepin County jury ruled Wednesday in favor of PDG PA, a professional association of 115 dentists who operate the Park Dental and Dental Specialist clinics. The dentists had accused American Dental Partners Inc., a public company to which they had outsourced most of the administrative side of the business, of overstepping its legal authority and granting itself grossly excessive fees.

[I’m wondering exactly what that grossly amount was, 100% as with CSHM]

The ruling and the mammoth award will have far-reaching implications for thousands of clinics and hospitals nationwide that in recent years have outsourced the management of their business operations to corporations that aren't owned by medical professionals, industry analysts said.

"It puts in sharp relief the tension that exists in the health care industry over who controls the practice of medicine and dentistry," said Joseph Anthony, an attorney with Anthony, Ostlund & Baer, which represented the dentists. "Will it be the doctors or will it be non-doctor-trained service providers?"

After a month long trial, American Dental and a subsidiary were found liable for, among other charges, breach of contract, breach of good faith and defamation. Late Wednesday, the jury ordered the company to pay $88.3 million in damages, then added $42.3 million in punitive damages on Thursday.

American Dental, based in Wakefield, Mass., said in a written statement that it is evaluating the verdict. Officials did not return repeated telephone calls. Shares of the company tumbled Thursday to $4.62 a share from $14.34 a share a day earlier.

The verdict stems from a dispute over a 1996 agreement in which an American Dental subsidiary, PDHC Ltd., agreed to provide the dentists with money for expansion as well as "non-dental administrative services," such as accounting, lab services and equipment maintenance. In return, the dentists agreed to pay a portion of their billing revenue to American Dental in the form of a "service fee."

[Honestly, I’ve got to give a huge thumbs up to whom ever “spun” this one.  There are lessons to be learned here, I’m sure]