Smiles Starters Dental Centers Under Fire AGAIN!

Smile Starters, formerly known as Medicaid Dental Centers, first made the news in North Carolina in 2003.  10 years later, little that has changed, other than its name and signage.

Reporter, Diane Wilson, with the ABC affiliate in Raleigh-Durham, NC reports on continued fraudulent diagnosing practices Smile Starters Dental Centers in North Carolina.  You can contact ABC’s “Troubleshooters” at troubleshooter@abc11mail.com

Listen for the usual Medicaid dental mill “buzz” words and phrases, such as: “Corporate”,“Chief Dental Officer”, “Do Not Allow Parents Back with the Child” and “Lead Dentist”.

 

End of EyeWittness ABC Channel 11 Report

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However unlikely it is for the North Carolina Dental Board to take action, it is still extremely important a complaint is filed and on record, so to speak. To file a complaint with the North Carolina Dental Board click here.

What they couldn’t tell you in the report:

Smile Starters and the dentists who work there, are very much familiar with the North Carolina Dental Board and visa-versa.  With the new regulations in North Carolina on how dentists and management companies operate, maybe the dental board could take a look at Smile Starters and Root Dental Management and expose the truth behind the true ownership of Smile Starters Dental Centers.

Smile Starters Dental Centers have operated under Medicaid Dental Centers (MDC), North Carolina Dental Centers and Smile Starters.  As reported above, Dr. Ralph Rivera was Smile Starters Chief Dental Officer under the prior ownership of Dr. Michael A. DeRose and Dr.  Letitia L. (Tish) Ballance.  Although it would be hard to prove outside a legal setting — where documents would have to be produced — I whole heartedly believe Michael A. DeRose sill owns and controls these dental clinics. Being that Michael A. DeRose has had his license revoked and is also listed on the governments LEIE (List of Excluded Individuals and Entities) list, it would be highly illegal for him to own a dental clinic or received monies from Medicaid or Medicare, directly or indirectly.  If he maintains any ownership, it would have to be masked by a few layers of corporations, and the DeRose’s are good at that game, or at least think they are.

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 Starters Still Abusing Children and Keeping Parents From Going Back With Their Child; After The First Two Visits Of Course.

Here is the story of a child who went to Smile Starters in North Carolina.  Her name is Kathy and she's 3 years old.  This is a sad story.  They make the mother feel as though she's a bad parent, they use the usual scare tactics and they've even blamed the child for not behaving properly.
Smiles Starters is part of the DeRose family of clinics, with Dr. Raf Rivera listed as being the owner.  Dr. Raf was a long time employee of Dr. DeRose and Dr. Ballance. 
When they got into trouble in North Carolina, Dr. Raf came to the rescue, offered up his name and they never missed a beat.  Wonder if DeRose and Ballance have paid the $10 million settlement yet?  If you have a child you has suffered at the hands of these ruthless creatures disguised as a dentist, contact Moriarty-Leyendecker.

The place I take my DD (dear daughter)is called smile starters and they pulled my DD's top 4 out . Caps on all but 1 tooth which was sealed and the bottom 4 has porcelain crowns in the back of them. And now her bottom 4 is going bad . And I cut out almost all sugar brush 3 times or more a day and she only has water or milk nothing else.
This place is the only one that takes Medicaid. And this next appointment I was told I can't go back with her that only 2 appointments the parents are allowed. They had to use a papoose each time cause she kicks.
But now I dread the appointment that is coming up this Friday (July 30, 2010) because they talk very stern to me the other times acted as if I was the worst parent in the world.
If I could find another place I would but there isn't a place that will accept Medicaid And I know they would want to put her through another oral surgery to pull those 4 bottom teeth and she had her first surgery last Dec.
I know her teeth are bad from genetics and they looked rough and I am caught in a hard spot cause I don't want them to report me for neglect and it states that they can if I miss a certain amount of appointments and I already rescheduled it .
And the health departments dental clinic is not equipped to  handle my DD's tantrums she has ( she kicks , scratches, cries, and pukes). She even has these when I brush her teeth.
I wish they was more equipped because they are nice to me about everything and didn't talk harsh to me . As soon as she grows out of these tantrums she has she is going to them.

Before

After

After

Now what is it they say about needing to put crowns on teeth to hold the place for the permanent teeth?

I've also seen reports lately where parents are being asked to sign a waiver to let their child go back alone!

Report of Fayetteville Smile Starters Abusing Another Child

Yesterday, another child was abused and traumatized at Smile Starters in Fayetteville, North Carolina.  This child's father is a member of our military serving our country with pride.

The abusers were dental assistants Sonya and Christy and the dentist Dr. Rafael (Raf) Rivera, Michael DeRose and Tish Ballance's hand picked successor to run their Smile Starter clinics.
Until yesterday this was a bright and energetic 29 month old  little boy, today he's bruised, scratched, withdrawn, not eating and having other intestinal track issues.

I called the Fayetteville office – 910-864-9884 to see if they had any comment, Debbie at the office, said they did not.

Tricare contracts with this house of horrors to provide dental services to our military families.  SHAME on TriCare, SHAME of The Department Of Defense, but most of all SHAME on The North Carolina Dental Board for not closing the doors on these places.  The board knows full well what happens to children here.

North Carolina Board of Dentistry Wants To Hear From You.... really?

The North Carolina State Board of Dental Examiners is holding a public hearing at it's office at 507 Airport Blvd, Ste 105, Morrisville, North Carolina.  The meeting will take place this Thursday, June 17, at 7 PM.  

Written comment from the public will be accepted through August 8, 2010 and can be sent to the board at the address above.  They don't seem to offer an email address.

The meeting  is to consider the following amendment to rule:
 

21 NCAC 16F.0103 CORPORATE OR LIMITED LIABILITY COMPANY NAME(the strikethrough is to be deleted and the underlined to be added to the rule)

Corporation or limited liability company designations shall consist only of the use of the words "Professional
Association," "P.A.", "Professional Corporation," or "P.C." for professional corporations and "Professional Limited Liability Company", or "P.L.L.C." for professional limited liability companies. All names shall also contain only the name or surname of one or more of the shareholders or members and may include the word "Associate(s)." the words “Associate(s)”, “D.D.S,.” “D.M.D.” and the geographic location of the company, provided that the company name may not be false, deceptive or misleading.
History Note: Authority G.S. 55B-5; 57C-2-01; 57C-2-30; 90-48;E
Eff. September 3, 1976;
Readopted Eff. September 26, 1977;
Amended Eff. August 1, 2010; August 1, 2009; August 1, 2002; April 1, 1994; May 1, 1989.

It can be seen here.

Seems to me the only people who would object to the, still very liberal verbiage, would be the crooks.  However I believe the language could be much tighter.  Adding some name of a North Carolina licensed dentist, the last name of a shareholder or member of the PLLC and a location clears nothing up.  Am I wrong?  For example, FORBA's Small Smiles clinics in Ohio alone are listed as follows: 

SMALL SMILES DENTAL CENTER OF COLUMBUS, LLC - JODI KUHN, DDS AND OLIVIA CROOM, DDS  with a Trade Name of Small Smiles Dental Centers of Columbus.  You pick the city then add the two names and file a DBA (doing business as) or a Trade Name, as it's called in some states and you still don't have a clue who your dentist is, who is going to treat you, or whose name will end up on the billing.

This is EXTREMELY misleading.  Why, well because Olivia Croom, DDS is listed on various dental plan sites as working in Farmington, MI, Mishawak, IN, and Dayton, OH.  In fact her name didn't even show up of state corporate filings until February, 2010, just four months ago.  Until then it was Jodi Kuhn and Patricia Nicklas, DDS and before that it was Kenneth Knott and Robert Andrus, and they NEVER treated one patient in OHIO.  

Here you can see when it was SSDC of C, LLC Kenneth Knott and Robert Andrus the phone book ad looked as though you would be making an appointment with either of the above dentists, but you would be dead wrong!   By the way, these clinics have changed their legal name 4 times in 6 years. 

 Let's look at the clinics in North Carolina that Michael DeRose and Tish Ballance owned and operated under the name Medicaid Dental Centers then changed it's name to Smile Starters.

Everyone thinks good ole Michael Anthony DeRose was ran out of North Carolina on a rail, well they too would be wrong.  He's alive and active in North Carolina.  As recently as September last year (2009) he changed the name of one of the companies.  (yes, I said one)  He changed Michael Anthony DeRose, DDS, PA to Michael Anthony DeRose, Inc.  (I suppose the DDS had to go after Colorado finally got off their asses and revoked his licenses).  

When Michael changed the name to Michael Anthony DeRose, INC he also amended the Articles of Incorporation to read to a Chapter 55B General Status and the nature of the Michael Anthony DeRose, Inc to: GENERAL BUSINESS MARKETING & CONSULTING.  (yes, his marketing ideas and advice is exactly what the dentists ordered!)

  

 HOWEVER, on October 6, 2009, the North Carolina Department of Revenue had other ideas for Michael Anthony DeRose, INC. and put the business was on suspension for violating N.C.G.S. 105-230 (a).  (he owes them money).  The suspension notices mentioned that once this was corrected they would remove the suspension.  It's hard to tell, but I believe everything was set straight with the Department of Revenue since it's status is Current-Active-Multiple.

 

But wait!  There's more!  Yes!  Ballance & DeRose, DDS, PA is Current-Active as well.  That's right, these two are still hooked up it appears.   Wanna take a guess where the current address is...  awe...c'mon...  YES!  2211 Executive Drive, Charlotte, NC  28201.  Not sure why, but one Incorporators name was left off the name of the company, his name- Robert D. Hinshaw, 185 Kimel Park Drive, Ste 200, Winston-Salem, NC  27103, he's an attorney.  But shouldn't he have been held as responsible for the actions of Ballance & DeRose, DDS, PA?   Just saying....

Ballance & DeRose, DDS, PA's Professional Service is -Dental Services.  So under the proposed change to North Carolina's rules, what would Mike, Tish and Robert do?

Well, the name contains the name or surname of one or more of the shareholders or members, it's a PA (professional association), so they are good there.  Since they are allowed to use "Associates" or "DDS" or DMD" in the name, that would be ok too, Tish Ballance is still licensed but they could always drop that and use Associates.  The only issue then is the location.   Well, all they have to do is add "of Charlotte" or "of Asheville" or "of Fayetteville" or "of Winston-Salem" or "of Greensboro" or "of Raleigh".  Then file the DBA as they do in Ohio and you still get Smile Starters and it clears nothing up and is still misleading.

If they are worried about something being 'misleading' they should look at the decor and advertising these places do that makes parents feel they are seeing pediatric dentists when they are in fact seeing someone who doesn't deserve to be called a dentist at all!

I know some are going to scream, oh no, Dr. Rafael Rivera, Jr. owns these clinics, and I say Bull!  He's just started his own PLLC (Professional Limited Liability Company) and contacts his services to these clinics...or something close to that.  

Root Dental Management is also alive, current and active in North Carolina, address is still the Executive St address in Charlotte.   Ryan P. Root filed his annual report in March 2010, wonder if Roger Walters is still on board there?  Ryan P. Root's address on the annual report is PO Box 816, PUEBLO, COLORADO.

So after looking at this, the only thing I see that improves the 'rule' is for the State of North Carolina Department of Revenue.  More filing fees for each location of each of the 'clinics', tax returns for each individual clinic as a separate business...

I don't see what the point is to add the geographic location of each clinic, if it doesn't matter whether the dentist who provide the services there are not necessarily on the ones on the state corporate filings, heck they may well not even live in the state!  

C'mon North Carolina Board of Dentistry, you can do better, children are being abused, medicaid is being defrauded and children are dying.

Where am I wrong here?

Smile Starters Dental Clinics in North Carolina