2015 Texas State Dental Board Continues Massive Failure to Protect Citizens

Aired WFAA July 20, 2015

National Association of Dental Plans is worried the Texas State Board of Dental Examiners might have too much power! OMG!

No, I’m not kidding. We know that is not going to happen and is utterly ridiculous to even think that could be possible.  The NADP and it’s illegal dental clinic owners they refer to as DSO’s are safer in Texas than any state in the union!

DALLAS, TX--(Marketwired - May 14, 2015) - The National Association of Dental Plans (NADP) has urged Texas lawmakers to take steps to prevent the Texas State Board of Dental Examiners (TSBDE) from passing rules that limit the effectiveness of dental support organizations (DSOs), as such action could jeopardize access to dental care for more than a million Texas Medicaid members.

Many of NADP's member dental networks in Texas include dentists in practices supported by DSOs. This includes carriers providing dental services through the state's Medicaid program.

Read more: http://www.digitaljournal.com/pr/2554531#ixzz3a9T5xFWi

I've had it with agencies and investigators who say that are going to take it to crooked dentists!

After 8 years of blogging and more than a few new stress related grey hairs, I have had it.  I've had it with dentists who hurt kids.  I've had it with politicians and regulators that say they are going to stop children from being hurt.  I've had it with agencies and investigators who say that are going to take it to crooked dentists.  I've had it with a government that doesn't want to protect children.  In the last few months 3!! investigators have told me that after years of hunting, gathering evidence and being sickened at what they found, they have hit brick walls WITHIN their own agency.  Two quit, one after telling me about recent DEATHS in their state that were swept under the rug.

So here is my question for all of you readers - when are you going to wake up and say you've had it, too?  Do you not realize that the mouth and bank account of you and every person you love, is at risk?  This crap started almost a decade ago.  Did you really think that a decade of DeRose trained dentists would simply put in their time and then go into humble private practice without retaining any of their bad habits?

Don't be foolish.

Just like a fart stinks up a whole room, the fraudster dental clinic alumni started a stink that goes DEEP into the dental biz.  Think I'm wrong?  Tell me if this sounds familiar?

Case in point number one:
 
Your friend has a 14 year old boy who has had braces on for 3 years.  The new pediatric dentist who recently bought the practice where this boy is seen announces right before his braces are removed that he has developed 5 new cavities.  Because his brushing was probably not so good with those braces.  And his orthodontist isn't really looking for decay so didn't mention it.  These aren't your run of the mill pit and fissure cavities - these are the multiple surface (expensive) kind.  Might as well get them fixed and give that kid a lecture about how his lousy toothbrushing just cost you $1700 ON TOP of the braces, which weren't cheap!

So the dentist "fills" 5 teeth with itty bitty wholly enamel contained occlusal surface only goop and sends the bill to the parents.  Oh, I forgot to mention that the parents are both corporate lawyers.  With no dental insurance.  But nice cars and kids in private school so odds are that bill is going to be paid.

If you think Medicaid has no oversight, guess how much you get when you pay cash?  ZERO.  That 14 year old boy is a real kid - his parents paid $1700 for Dentally (Medically) Unnecessary care.  But how the heck are they going to know that?  Right now they think their son is a lousy brusher who will probably need a few more cavities fixed in the near future.  They may be corporate lawyers but their son is a sitting duck.

Do you really think that none of the DeRose trained dentists who have since moved on to private practice would not sense an opportunity if presented with such a scenario?  Or the ones who did some time at Kool Smiles?  Or maybe All Smiles?  Perhaps Comfort Dental?  Or maybe Aspen dental?

Case in point number two:
 
Last week the state of Texas startled citizens when it settled a $16 million dollar fraud case for less than the cost of a kitchen remodel!

Last week (August 28, 2014) the Texas Health and Human Services Office of Inspector General (THHS-OIG) setting a $16 million dollar dental fraud case against one of their top stainless steel crown fraudsters for $39,000! That’s right! Just about one quarter of one percent!
Someone please tell me how that is possible!!

In an article by “The Austin American-Statesman” it says:

“The deal represents the latest underwhelming outcome for state regulators who say they have identified hundreds of millions of dollars in dental and orthodontic fraud between 2007-2012, yet have struggled to produce decisive legal victories.”

Rachel Trueblood says the reason for the lowball number is, “There was a complete lack of evidence.”

Texas State Board of Dental Examiners take swift action!

For those who think the Texas State Board of Dental Examiners can’t take swift action, you are dead wrong.

Bryan, Texas creepy dentist and dental board member, Dr. William Reagan Birdwell was arrested Wednesday, May 21, 2014 after caught filming an employee changing in his office bathroom.

At  lightening speed the board took harsh action by removing any mention of him on their board member page.

So there!

Birdwell was appointed by Governor Rick Perry in 2009 for a term ending in 2015. I guess his term ended early.

Wednesday May 21, 2014 TSBDE Board Members

 

 

 

 

 

 

 

 

 

 

 

 

Two days later, poof, he’s gone!

Dental Medicaid Fraud and Drug Cartels–The Connection In Texas

AUSTIN, TEXAS, May 26, 2013 - The vice chair of the homeland security committee in the Texas House says there is a direct connection between drug cartels and Medicaid fraud being perpetrated along the South Texas border region.

For this and other reasons, state Rep. Allen Fletcher said he offered an amendment to Senate Bill 8 that will allow the Office of Inspector General (OIG) to hire commissioned peace officers for their investigations into Medicaid fraud. Senate Bill 8 is a major piece of legislation dealing with fraud, waste, and abuse in the Medicaid program.

“There is Medicaid fraud all over the state, Dallas, Houston, you name it. The cartels are in Dallas and Houston. But way along the border, and all along the border, McAllen, Brownsville, Cameron County, Hidalgo County, Starr, all those areas, there is huge cartel influence and I assure you that these individuals that are involved in setting up these bogus clinics and hiring these dentists and doctors to file these fraudulent Medicaid claims, it’s cartels,” Fletcher said.

Fletcher is one of just a few retired police officer serving in the Texas House. He investigated white collar crime for Houston Police Department for many years. Fletcher said he spoke to Jack Stick, deputy inspector general for enforcement for the Office of Inspector General Texas Health and Human Services Commission, about carrying an amendment for Stick to allow OIG to have commissioned peace officers working as investigators.

Malpractice suit filed against Texas dentists, M. Jerome Holmes, DDS

On February 21, 2013, Cheryl Rye filed a lawsuit (Cause 201310522-7-in Harris County Texas District Court against Dr. M. Jerome Holmes, DDS.  Cheryl's daughter went to Dr. Jerome Holmes for a scheduled cleaning and received the standard dental abuse treatment – restraining, child abuse, mom in the waiting room hearing blood curdling screams from her daughter, bodily injury and lies to cover it all up.  They staff actually told the mom all the red marks on the child was an allergic reaction!

The treatment of this little girl sounds all too familiar.  Wonder if  Dr. Jerome Holmes worked somewhere else prior to his own practice?  As we’ve seen, there is never just one child, there are usually many children that have suffered at the hands of dentists like this. 

A huge round of applause for mom suing and a special thanks to the attorney who took the case - Tami Pierce of Kingwood

Checking Dr. Jerome Holmes Texas dental license shows no disciplinary actions, which means he could have murdered 10 patients – Texas State Board of Dental Examiners are not exactly known for their pro-action to protect public health.

Dr. Holmes picture from his website, speaks volumes as to his attitude doesn’t it?  Looks like a creepy marionette to me.  

                  

Dr. M. Jerome Holmes
9815 FM 1960 Rd. W.
Humble, TX 77338
Phone: (281)548-3384
Fax: (281)548-7336
info@jeromeholmesdds.com

 

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No Way to Treat a Child, Mom Tells Dentist

By CAMERON LANGFORD 

HOUSTON TX - In a horrifying trip to the dentist, a little girl "screamed frantically for her mother," but the dentist kept drilling, with his staff "grabbing her legs and restraining her head," and threatening to call police when the mom tried to check on her daughter, the mother claims in court.
     Cheryl Rye sued Miner Jerome Holmes DDS and his dental office on behalf of her daughter, Katie in Harris County Court.
     Rye claims took Katie to Holmes' office for what she thought was a routine cleaning.
     "Plaintiff was administered nitrous oxide and the dental procedure began," the complaint states. "Plaintiff began feeling intense pain and screamed frantically for her mother. Instead of stopping the procedure or administering any additional nitrous or allowing her mother to enter the room to calm her Dr. Holmes continued to drill into the minor child's tooth.
     "Dr. Holmes, and his agents and/or employees, physically restrained Katie in a prison like manner by holding her down, grabbing her legs, and restraining her head in such a reckless fashion that it caused bodily injury.
     "Plaintiff continued to scream for her mother so loudly that her mother, Cheryl, heard her scream while she was sitting in the waiting area. Cheryl pleaded with the office staff to go and check on her daughter.
     "Cheryl was instructed to sit down, was refused access to her minor child and told the police would be called if she attempted to go back.
     "After several minutes of nerve-racking screams of pain and fear, little Katy finally emerged from the back area sobbing with large red marks on her head.
     "Cheryl inquired as to what happened to her daughter and why she had the injuries that were not present prior to the procedure. Dr. Holme's staff tried to cover up the negligent acts and told Cheryl that it was an 'allergic reaction.'"
     But Rye says she took Katie to her pediatrician, who determined that the marks "were not any type of allergic reaction, but were in fact injuries she sustained by being forcibly restrained."
     An emergency room physician confirmed the pediatrician's diagnosis, Rye says.
     She says Katie is still scared to go to the dentist, months later, and will require sedation to go to the dentist from now on.
     She seeks medical expenses and punitive damages for negligence, gross negligence and breach of duty.

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If anyone gets a copy of the complaint, I’d appreciate a copy.  cckaddie@yahoo.com

Thanks

Texas tries to crack down on dental chains that put profits ahead of patients

 

By David Heathemail

January 8, 2013

A leading Republican in the Texas legislature, who says she’s outraged by allegations that corporate dental chains put profits ahead of patients, has introduced a bill that would allow the state to regulate chains and forbid them from forcing dentists to meet revenue quotas.

A joint investigation by the Center for Public Integrity and PBS Frontline last summer found that two of the largest dental chains owned by private-equity firms, Aspen Dental Management and Kool Smiles, put pressure on its dentists to meet production goals, prompting complaints of overbilling and unnecessary treatments.

Both companies deny this. And a coalition of dental chains in Texas contends that their dentists have total control over patient care. But the chief sponsor of the bill remains skeptical.

“Several reports, including the Frontline program, have uncovered outrageous activities involving the illegal enticement of patients, especially among our Medicaid providers and often involving dental service organizations,” said Republican Sen. Jane Nelson, who chairs the Senate’s Health & Human Services committee.

Nelson did not name a specific chain. Aspen Dental does not accept Medicaid and has no offices in Texas. But Kool Smiles has clinics throughout Texas, and public records show that the state Attorney General has been investigating Kool Smiles for Medicaid fraud.

Read the entire story at Center for Public Integrity

Who is Legally Liable in Texas’s Dental Drama?

Who's Legally Liable in State's Dental Drama?

• by Becca Aaronson
• August 17, 2012

The state's sweeping Medicaid fraud investigation into dentists and orthodontists accused of giving unnecessary treatments to poor children has left Texas attorneys with lots of questions.
Who’s accountable for the Texas orthodontic patients abandoned mid-treatment when the state pulled the plug on their doctors? Could the state be held legally liable for giving doctors permission to perform medically unnecessary dental procedures in the first place? And ultimately, does the state’s method of cracking down on providers — halting funding the moment an investigation is opened — grant sufficient due process to the accused, or could the government be counter-sued for destroying the businesses of providers later found innocent?

Looking for ways to curb the state's budget woes, lawmakers have directed health investigators to amp up their pursuit of fraud and to oust providers who purposefully filed medically unnecessary or fraudulent Medicaid claims. Many of the accused providers have their funding frozen, and can't treat Medicaid patients in the meantime. In the words of Sen. Jane Nelson, R-Flower Mound, “using patients to game the system – and then abandoning those patients when you get caught – is shameful abuse.”

Texas Stakeholder’s meeting cover a lot, offered no solutions.

In case anyone missed the Stakeholder’s webinar yesterday. Here is a link to it:  July 27, 2012 Texas Dental Stakeholder’s Meeting

They talked about patient recruiting. They talked about the criminal behavior and the $10k fines for each of the people who recruit each time they approach a person in one of their vans. But I didn’t hear anything about who was going to start stopping these vans and handing out those $10K “patient recruiting tickets”. They also mentioned how illegal it was to “hire” a company to recruit and it was illegal to work as a recruiter.

They talked about the horrors and trauma small children are experiencing at the massive number of low quality dental centers, like Kool Smiles, Small Smiles, All Smiles, The Smile Center. They even mentioned babies being tied down and traumatized by hundreds of Texas dentists who are committing Medicaid fraud. Needless to say they skimmed over that subject as fast as possible. Mentioned a couple of words about standards and tabled it for later discussion, as they have for the past 10 years! Hey guys, it’s still on the table, don’t you see it!

The attorney for the Texas Dental Board admitted they have the power to make the rules, but didn’t say a word about if they planned on enforcing the rules they already have in place or any news ones they might create.

They talked about the $63 thousand dollars the government is handing out to Medicaid providers, and stressed the dentists are in the category. Then they told how to apply, what criteria must be met and I believe someone gave a count of 461 dentists who have already signed up for their piece of the pie. I’m not sure but I thought I heard applause.

 

by BYRON HARRIS
Bio | Email
WFAA

Posted on July 27, 2012 at 7:42 PM

Updated yesterday at 7:42 PM

DALLAS - As Texas cracks down on questionable Medicaid dental payments, dentists' offices are going dark all over the state.

From 28th Street in Fort Worth, to Eureka Circle in Wichita Falls, to Amarillo, dentists who've already collected money from the state to treat Medicaid patients are now turning away those patients, because the dentists' Medicaid claims are being rejected. There are more than 4,300 Medicaid dentists in the state.

Tens of thousands of patients are affected. In 2010, Medicaid paid for braces on about 80,000 kids in Texas. Treatment commonly takes two years.

Since March, the Medicaid dental is managed by three Managed Care Organizations (MCO's)  which have stiffened standards. One MCO said 91 percent of new claims are being rejected.

Moms whose kids already have braces on their teeth are being told children's braces must come off halfway through treatment, that they must go to another clinic far from home, or that there will be no more treatment whatsoever.

Friday, Dr. John Roberts chaired his first stakeholder meeting as Texas HHS dental director. The old director left after News 8 discovered hundreds of millions of dollars of questionable payments under Medicaid orthodontics.

Dentists learned the three MCO's have different payment rates and differing standards. But the overall impression was that moving forward, the children with braces already on their teeth would receive treatment somehow.

"There are plans in place to continue treatment on patients, to re-evaluate patients, and to complete every patient's braces," said Dr. Robert Morgan of Children's Medical Center in Dallas, who attended the  meeting.
The meeting was also broadcast over the web for reporters and interested parties.

It was not clear how the process would exactly work.
If the state reassigns patients to new dentists, regardless of their original need for braces, it will cost millions for treatment which may have been unnecessary in the first place.

One example is All Smiles Dental Centers, which is being sued by the state for fraud. All Smiles told The Dallas Morning News it is eliminating orthodontic treatment at 13 clinics. One witness in the state's case against All Smiles said 95 percent of the dental chain's claims in a 300-patient sample were fraudulent.
All Smiles did not respond to News 8 efforts for clarification.

Related:

• Texas taxpayers pay big for straight teeth
• Questions surround lucrative Medicaid dental business
• Texas Medicaid problems may apply nationwide
• Crooked Teeth: Medicaid Millions
• Texas, feds take action on orthodontic fraud
• Outrage on Capitol Hill follows News 8 Medicaid probe
• Texas AG lawsuits spurred by WFAA dental investigation
• More stories about WFAA's Texas Medicaid orthodontics investigation

Texas Stakeholders meeting today at 1PM Central time: Orthodontics on the menu.

Click reserve my seat, fill out the form and they will send you a link to the meeting.

http://www.hhsc.state.tx.us/news/meetings/past/2012/072712-Dental-Stakeholders-Meeting.shtml

Medicaid Dental System an Ongoing Challenge

Texas Tribune July 27, 2012

While Texas works to fix a system that allowed dental clinics to charge the state millions of dollars in questionable Medicaid bills, dental providers say impoverished Texas children do not have adequate access to care and that the state’s rocky transition to Medicaid managed care is compounding the problem. 

Concerns over the system will be addressed Friday, when the state’s Health and Human Services Commission holds a "dental stakeholders" meeting in Austin. John Roberts, an official with HHSC, said the dental directors of managed care health plans, members of state government and other state officials will address 14 questions previously submitted by dental providers across the state. One topic on the agenda: "Discussion on orthodontic continuation of care for abandoned patients."

Shannon Ash of Lewisville says her three teenagers haven’t been able to get their braces checked by an orthodontist for two months and are using wax to hold off the pain from wires cutting into their cheeks. After the dental clinic that had gotten state approval to put braces on her children shut down, the children’s new orthodontist told Ash that the Medicaid managed care dental plan assigned to her children by the state didn’t think her children’s braces were medically necessary. Therefore, it wouldn’t reimburse the orthodontist for treatments.

“I don’t have money to take care of the issue, or else I would have had it done myself,” Ash said. “If I had known this [would happen], I would have just let my kids’ teeth be crooked.”

After news broke last fall that Texas was paying millions to dental clinics for fraudulent or unnecessary Medicaid activities, such as putting cosmetic braces on low-income children, the state cracked down. The Health and Human Services Department's Office of Inspector General has put 23 orthodontic clinics on payment holds since October while it investigates fraud allegations. And managed care organizations that began administering Medicaid dental plans in March are placing stricter requirements on dental providers to prevent fraud.

Byron Harris was in Washington for the hearing on Medicaid fraud. You don’t want to miss his report.

by BYRON HARRIS
Bio | Email

WFAA
Posted on April 25, 2012 at 10:11 PM
Updated today at 7:36 AM

WASHINGTON — "It took a reporter to unlock the mystery that Texas is spending more on braces than the rest of the country put together?"

That was the half-humorous question Rep. Trey Gowdy (R-South Carolina) asked his fellow members of the House Oversight and Government Reform subcommittee in Washington on Wednesday.

Looking at Medicaid fraud, the committee talked to whistle-blowers and lawyers from Minnesota and New York, all of whom discussed scandals in their home states.

But the witness at the heart of this hearing was from Texas.

Dr. Christine Ellis, a North Texas orthodontist, credited News 8 with revealing a "flagrancy of fraud that is truly unbelievable."

News 8 spent thousands of dollars to acquire Medicaid records from the State of Texas and discovered that the state paid out $424 million to put braces on poor kids' teeth from 2008 to 2010.

News 8 also obtained spending totals on orthodontics from other states individually, after the federal government said it did not compile them.

"As they say, everything is bigger in Texas," Dr. Ellis told the panel. "Thanks to the investigative reporting of WFAA's Byron Harris, we now know that orthodontic Medicaid fraud is no exception."

Just a wild guess, but I’m thinking the ADA and the DGPA are none too happy about the hearings on Corporate Dentistry in Texas

Yes, the ADA is a different group and as we know the ADA rules, since they have the gold. But honestly, they might as well be the one and the same.  If you dig deep enough everyone with the DGPA is with the ADA, right?

Just two short days before the Texas Hearings on April 11, 2012, the ADA issued this:

 

 

ADA explores growth of large group practices

By Karen Fox, ADA News staff
April 09, 2012

The ADA is taking steps to increase dialogue with large group practices and gather information regarding this rapidly expanding career option.

This sector of the dental workforce has experienced significant growth in a relatively short period of time. According to the ADA Health Policy Resources Center, in just two years the number of large dental group practices has risen 25 percent.

For now, it’s still a small piece of the overall dental delivery system pie. In a 2008 sampling frame, the Health Policy Resources Center concluded that solo dentist practices account for 92 percent of all dental practices, and very large group practices with 20 or more dentists make up only 3 percent.

However, in analyzing its data on individual dentists, the HPRC has concluded that the rate of solo practitioners is falling. In 2010, 69 percent of dentists were solo practitioners compared to 76 percent in 2006.

Texas Board of Dental Examiners–Drilled; the truth hurts

Well, it appears Wednesday-April 11, 2012-was an eventful day in Texas, at least when it comes to Corporate Dentistry practices that has invaded the state. The Texas state legislature is finally asking question why these places are in business and who is in charge of letting them do as much damage to the children as Mad Cow does to cattle.

The Texas State Board of Dental Examiners says it’s not them, just like the Georgia Dental Board. Below there are three articles from around the web on the happenings yesterday.

I just have so much to say about this, but I don’t have time today.

Wednesday April 11, 2012

Statesman. Com
Watchdog group, others doubt effectiveness of dental board
By Mary Ann Roser -AMERICAN-STATESMAN STAFF

Published: 9:19 p.m. Wednesday, April 11, 2012

Patients, dentists and lawyers told a Texas legislative committee Wednesday that the state agency that regulates dentists does a weak job of protecting the public from bad care.

But board officials said the Legislature hasn't provided enough money to better regulate 60,000 licensees in Texas.

The problems go beyond that, said members of Texans for Dental Reform, a Houston-based group that monitors the Texas State Board of Dental Examiners and has long sought to air its grievances before the House Public Health Committee.

The group, and other members of the public, came to the committee Wednesday with recommendations and complaints. Among them: The board protects dentists and lacks a standardized way of disciplining them; it defines standards of care on a case-by-case basis, rather than following established care guidelines when investigating dentists; and it allows dentists who have been in serious trouble to get a new license number, making it exceedingly difficult for the public to connect the dots to previous disciplinary actions.

They also said that board members should never act as expert witnesses in lawsuits involving dentists and asked for action against unregulated dental clinics that "overtreat" children to take advantage of increased payments from Medicaid, the state-federal program for the poor.

"Over the past three years, we have found the board resistant, abusive and arrogant towards the public and unwilling to make the changes needed to protect public safety and health," said Gwen Mitchell, president of Texans for Dental Reform.

Dr. Tammy Gough of McKinney, presiding officer of the 15-member dental board since December 2010, said the board has strengthened various rules and is developing a standard way to review complaints and discipline violators. She said she has no problems with a law banning board members from acting as expert witnesses because none do.

But the volunteer board is hamstrung in its work by too little staff, not enough money and a lack of authority over corporate-owned dental clinics accused of exploiting Medicaid, said Glenn Parker, acting executive director of the agency.

Medicaid fraud complaints are turned over to the attorney general, inspector general and law enforcement officials, Parker said.

"We understand there is room for improvement," said Gough, who won praise from various members of the public for her openness to change.

The board could do better if the Legislature allowed it to keep more of the $9.6 million it collects in license fees and other work, Parker said. Instead, its current budget is just $2.7 million, and although it is authorized to employ 36 people, it employs just 29 because it can't afford more, he said.

Board officials also said some changes Texans for Dental Reform and others are pressing for would require legislation.

Houston lawyer Jim Moriarty disagreed that the board lacks authority to go after the corporate-owned clinics that are abusing Medicaid. He has filed suits in New York and Colorado against a network of clinics with operations in Texas and said the board should discipline the dentists in those practices, he said.

Lawyer Charlie Gustin of Houston has sued the Smile Center in San Antonio and told the committee of one case involving a 5-year-old boy who received 20 "baby" root canals and 20 steel crowns in 48 minutes. The boy left the clinic with cement in his mouth, and 14 of the crowns have since popped off, Gustin said.

Smile Center spokeswoman Debbie Clarke said the owner of the practice was unavailable to comment Wednesday "due to his professional responsibilities."

At the hearing, committee Chairwoman Lois Kolkhorst, R-Brenham, said that she wasn't interested in revisiting past problems but that the panel recognizes that the board needs lawmakers' help to get the tools it needs to do a better job.

Dentist Douglas Terry, a Houston-area member of the reform group, said he was encouraged.

"Things are going to change," he said.

Contact Mary Ann Roser at 445-3619

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The Texas Tribune
Texas Dental Board is Accused of Ineptitude

by Becca Aaronson

April 12, 2012

Texas toddlers being held in restraints as dentists at corporate-run clinics performed unnecessary root canals were among the dental horror stories told Wednesday at a House Public Health Committee hearing at the state Capitol. 

The Texas State Board of Dental Examiners, which regulates dental licensing in Texas, was the subject of criticism by members of Texans for Dental Reform and unaffiliated residents, who called for legislative reform while levying accusations of ineptitude, a pattern of withholding or obscuring negative information about dentists, and failure to act against corporate-run dental clinics committing Medicaid fraud and harming patients.

But others came to the board’s defense, saying that the new leadership is trying to fix mistakes from the past and that the board lacks the resources to do its job well. 

“We have an underfunded and understaffed state board that is not able to accomplish all that we’d like them to accomplish,” said Richard Black, the legislative chairman for the Texas Dental Association and an El Paso dentist. Although it is taking time, the leadership of the board has made “substantial progress,” he said. 

Both Black and members of the dental board expressed concerns about the recent outcrop of corporate-run dental clinics — and the board’s limited ability to protect the public when unlicensed operators at such clinics interfere with patients’ treatment.

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The clinics in question often serve only Medicaid patients and pay one dentist to act as a prop by claiming ownership. The real owners of the clinics — usually private equity firms — are in the dental business for profit, and encourage overutilization of Medicaid services by dictating a “one-size-fits-all treatment plan” or setting quotas for the number of procedures that dentists should perform, said Black.

Dentists drilling for Medicaid gold is a national issue, as one Washington TV station documented, and more corporate-run dental clinics popped up in Texas after lawmakers raised reimbursement rates for dental procedures in 2009 to motivate dentists to accept Medicaid patients. Joyce Sparks, general counsel to the dental board, said the board has also seen an increase in complaints of dentists violating standards of care since then, which could be linked to the rise in reimbursement rates.

Jim Moriarty, a Houston lawyer, detailed reports of torturous procedures at corporate-run clinics, in which children as young as 2 are immobilized, sometimes with a restraining device called a papoose, while the dentist inserts multiple stainless steel caps or performs root canals rapidly.

“They won’t let the parents be present because the parents would be tempted in Texas to pistol-whip them if they knew what they were going to do,” Moriarty said. He’s currently suing one company that operates six dental clinics under various names in Texas and said the dentist who claims to operate those clinics — but actually works and treats patients in Oklahoma — bills Texas $12 million a year to treat Medicaid patients.

“We want to be part of the solution, but right now we have no tools with which to combat this,” said Glenn Parker, the dental board’s acting executive director. The board only has the authority to license and sanction individual practitioners, which inhibits its ability to monitor or regulate clinics owned by private equity firms or corporations. The only recourse for the dental board is to notify the Office of the Inspector General and other state and law enforcement agencies when they’ve received an accusation of Medicaid fraud.  

Unless someone comes forward “willing to testify they’re a cover for the private equity fund, so sanction me because I’ve been defrauding you,” the board can’t do anything, Sparks said. “It just doesn’t happen.”

The board has identified the corporate practice of dentistry as an issue for lawmakers to address in the next legislative session, Parker said, adding that the board wants to get legal authority to regulate those clinics. The board also wants adequate funding to resolve the complaints it receives.

Unlike the Texas Medical Board, which pays consultants and doctors to investigate allegations of medical misconduct, the dental board relies on volunteers to investigate complaints. There are usually 15 to 20 active consultants — dentists who apply to the board, undergo background checks and training, and then receive approval from at least two board members — to review complaints about standard of care. 

Parker estimates the dental board receives 500 to 600 standard-of-care complaints a year. At least two of the volunteer dentists must review a complaint and agree on whether a standard of care violation occurred before the case is closed. 

Board members said they've opened communication with Texans for Dental Reform to address their complaints, but ultimately, the agency needs more investigators and staff. Parker admitted the volunteers often "cherry pick" the easier complaints. “When you have staff turning over, some people do what’s easiest to do, not what’s best to do." 

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The Dallas Morning News

Texas board says it’s falling short in regulating bad dentists

SOMMER INGRAM
Austin Bureau
singram@dallasnews.com
Published: 11 April 2012 11:19 PM

AUSTIN — The agency that polices Texas dentists told lawmakers Wednesday that it doesn’t have enough resources or legal authority to crack down on careless and abusive dentists.

An advocacy group led the charge against the Texas State Board of Dental Examiners, telling a legislative panel that the regulatory board doesn’t do enough to discipline bad dentists or alert the public which dentists have been sanctioned.

“We’ve found [the] board to be resistant, abusive, arrogant toward the public and unwilling to make changes needed to protect public safety and health,” said Gwen

Mitchell, president of Houston-based Texans for Dental Reform. “The consensus is that it only has one agenda, and that is to protect its own.”

The board, which oversees 15,000 dentists, 32,000 dental assistants and 12,000 hygienists, has long been dogged by complaints of shoddy oversight that leaves patients suffering and dentists unaccountable.

In response at the House Public Health Committee hearing, board leaders said the agency needs more funding and staff to keep up with the demands of approving licenses and reviewing the 500 to 600 cases it gets each year.

They can range from pulling the wrong teeth to injuring a patient, from abusing drugs to sexually assaulting a patient.

Mitchell’s group and others want the board to disclose all complaints filed against dentists and to get rid of those providing dental care without a license.

But board officials said the Legislature wrote the law so that it can’t disclose complaints lodged against dentists if they are dismissed.
They said they’ve been limited in enforcement tools and largely depend on the attorney general’s or inspector general’s office to pursue and remedy cases of fraud, especially in Medicaid.

“It’s not the charge of the board itself to be the lead agency in investigating Medicaid fraud,” said Glenn Parker, the acting executive director. He said that if disciplinary action is taken by the attorney general’s or inspector general’s office, the board takes action.

He said the dental board collects $9 million annually in fees, but the Legislature allots it about $2 million for its total budget. “We could use a lot more funding,” he said, although he did not give a specific figure.

Licensing actions The board’s sanctioning method is to revoke or suspend dentist licenses, so board leaders say that leaves them without a way to punish those practicing without a license to begin with.

Dr. Tamela Gough, presiding officer of the board, said the board regulates individual practitioners but has no authority over clinics or owners of clinics. “We regulate the licensed dentist who is performing dentistry in these clinics — they’re not running willy-nilly as far as patient care,” Gough said. “But in order for us to regulate the actual corporate entity, it would require legislation.”

Jim Moriarty, a Houston lawyer who prosecutes Medicaid fraud cases, argued that the board is taking the easy way out by saying it doesn’t have the power to punish private entities and those practicing without a license.

“I’m appalled when I hear the board say they have no control over these people. Texas has some of the best regulations in the country, but the law is just not being enforced,” Moriarty said. “The board sits like an ostrich with its head in the sand saying, ‘If they don’t have a license, we can’t do anything.’”

Charlie Gustin, a San Antonio lawyer who works with children on Medicaid, told lawmakers about a boy he represented who went in for dental work and ended up worse off than he started.

He was given double the amount of local anesthetic required for a child his body weight and received 20 baby root canals and 20 stainless steel crowns in less than
an hour.

When he went to another dentist for remedial work, 14 of the 20 crowns popped out and the dentist noticed excess cement left in his mouth that can cause infection.

The dentist filed a complaint with the board and found that the first dentist’s license had been suspended in New York before he came to Texas.

“But the state board online lists no disciplinary actions,” Gustin said. “We need more disclosure to the public when you have a dentist that’s been kicked out of another state. But according to our state board of dental examiners, he’s clean. And that’s a problem.”

More fraud complaints
Joy Sparks, the board’s general counsel, said that over the last two years, Medicaid fraud complaints have increased, probably because reimbursement rates have gone up.

“The state increased the reimbursement rate to make it more lucrative for dentists to take Medicaid patients. … Once that occurred, there were those who took advantage of the system because it became more profitable to participate in Medicaid.”The House panel said it would consider efforts in the next legislative session to overhaul the dental regulations.

FINALLY!! Texas State Dental Board Director resigns before big hearing. Come One, Come All to the April 11, 2012 10:30 Texas State Dental Board Meeting!

By Mary Ann Roser
AMERICAN-STATESMAN STAFF

Statesman.com Article

Published: 8:47 p.m. Wednesday, March 28, 2012

Sherri Meek, executive director of the Texas State Board of Dental Examiners, resigned earlier this month and will not be present at an April legislative hearing where board critics plan to testify.

Meek, who cited personal reasons for her resignation, is using up personal leave time before her resignation takes effect Aug. 31, said the board’s general counsel, Joy Sparks. Glenn Parker, former executive director of the Texas Board of Chiropractic Examiners, has been the dental board’s director of administration for the past several months and has taken over as acting executive director with a salary of $75,000, a $5,000 increase to compensate him for his additional duties, according to a letter from Meek to Parker.

Parker will be at the hearing of the House Public Health Committee at 10:30 a.m. April 11 in the Capitol Annex, E2.012.

At the hearing, lawmakers will hear public testimony about various health registries maintained by the state and concerns about the operations of the dental board, including its enforcement practices and a law that allows board members to act as expert witnesses in cases involving dentists, as long as the board does not object.

“No board member has ever asked for permission to serve as an expert,” Sparks said, adding that she “would have absolutely no problem” with an outright ban on it.

Members of the Houston-based Texans for Dental Reform say they plan to speak at the hearing and voice their ongoing concerns about the dental board, including uneven and unfair enforcement of the law; “overemphasis on protection of dentists;” and conflicts of interest.

The hearing is open to the public.

Sherri Meeks has been there since 2007, that’s when it all went to hell in a hand basket in Texas. I’m sure there were initially good intentions with the Frew v Texas lawsuit, but damn!! If I were a conspiracy theorist, I’d think that Private Equity firms and corporate practice of dentistry bandits (DGPA) were at artful play here.

I’m not really a betting person either, but I’d wager the Texas State Board of Dental Examiners are going to need a larger venue come April 11 at their 10:30 AM hearing!!  I also think, Sherri Meeks should be dragged to that hearing, hog tied! What a chicken shit, she is!

What do you think?

Feds link orthodontist to Medicaid fraud scheme

By BOBBY CERVANTES amarillo.com Copyright 2012 Amarillo Globe-News. All rights reserved.

February 29, 2012 - 12:18am

Feds link orthodontist to Medicaid fraud scheme

bobby.cervantes@amarillo.com

Patients and former employees likened the Amarillo Medicaid fraud scheme to “herding cattle.”

Amarillo orthodontist Dr. Michael Goodwin scheduled up to 400 Medicaid patients a day and frequently billed the government for work he never performed, according to court records.

In late May and early July, authorities seized $244,235.67 from five JP Morgan Chase commercial and personal bank accounts associated with Goodwin, his wife and his business.

Goodwin billed the government a total of $1.67 million in fraudulent claims from April 2008 to April 2011, according to a federal forfeiture complaint the government filed Monday seeking to keep the seized money.

Goodwin, who also has an office in Indiana, has not been charged with a crime. His Amarillo office at 3629 Wolfin Ave. was closed Tuesday and messages were not immediately returned.

Goodwin and his wife, Patricia, did not file a claim to the seized money, according to the complaint.

New Medicaid Dental Rules in Texas is Potential Windfall for Wall Street–Anyone Surprised? Not me!

I made an entry here a few weeks ago about Kool Smiles telling their patients they have to choose a doctor, not their clinic under the new rules. I wondered how that would work, since the dentist’s don’t stay too long at the dental mills. Chances of seeing the same dentist twice (unless it’s the next day) slim to none. 

Here’s a comment on that from a Texas dentist I thought deserved being front and center.

UPDATED: TX Medicaid combats overuse of kids' braces -- 22 visits a year! | Trail Blazers Blog | dallasnews.com

 

UPDATE, 3:30 p.m.: The attorney general's office has 31 orthodontists under investigation for possible Medicaid fraud, David Maxwell, the office's deputy director of law enforcement, testified to the House panel. According to Rep. Lois Kolkhorst, R-Brenham, the panel's chairwoman, 24 percent of the nearly 80,000 children who last year received orthodontic services from Medicaid were under the age of 12. State social services czar Tom Suehs testified that, starting in March, the minimum age for treatment of severe misalignment of upper and lower teeth will be 13. "Some of our providers out there gamed and manipulated the system," Suehs testified. "I won't use the word fraud. ... Clearly, we didn't have some of the controls we should've had."

ORIGINAL POST: Poor youngsters in Texas who were put into braces courtesy of taxpayers saw their orthodontist an average of 22 times in fiscal 2010, state Medicaid chiefs said in testimony they were to give to a legislative panel Tuesday.

"Typically, 12 visits per year is expected," said the written testimony by Medicaid chiefs Tom Suehs (right) and Billy Millwee to the House Public Health Committee.

Read the rest – click below

UPDATED: TX Medicaid combats overuse of kids' braces -- 22 visits a year! | Trail Blazers Blog | dallasnews.com

Feds to investigate Medicaid orthodontics fraud in Texas

 by BYRON HARRIS
Bio | Email
WFAA
Posted on August 25, 2011 at 10:37 PM
Updated Thursday, Aug 25 at 10:37 PM

NEWS 8 INVESTIGATES

For the past six months, News 8 investigations have revealed hundreds of millions of dollars of questionable Medicaid spending on braces for children in Texas.

Now federal investigators are auditing the Texas Health and Human Services Commission, which controls those funds. Taking the lead in the audit is the Office of Inspector General of the U.S. Department of Health and Human Services.

In a letter to the state, the inspector general says it will examine the "authorization process for orthodontic treatment" under Texas Medicaid. "The objective of our audit," the letter continues, "is to review the State's controls to ensure that only medically necessary orthodontic cases are paid." The time period covered by the audit is September 1, 2008 through May 28, 2011.

Texas State Dental Board says it can’t stop the dental abuse and Medicaid fraud until someone complains, well someone complain already! Here’s help.

Texas State Board of Dental Examiners
Texas Dental Board Complaint Process
Texas Dental Laws, Rules and Regulations

Complaints:   complaints@tsbde.texas.gov
E-mailing the Board:
Indicate the intent of your communication in the subject and body of your email. This will help prevent our Security System from flagging your email as possible spam and deleting it.

Ms. Abigail Gutierrez, Administrative Assistant
Phone: (512) 475-2019
Fax: (512) 463-7452
Ms. Erica Bommarito, Administrative Assistant Phone: (512) 475-1996
Fax: (512) 463-7452
Ms. Jennifer Carriker, Compliance Officer, Administrative Assistant Phone: (512) 305-8991
Fax: (512) 463-7452
Ms. Gutierrez, Ms. Bommarito and Ms. Carriker can assist with:
          Contacting the Director of Enforcement
         How to file a compliant or check on the status of an on-going complaint           Information about a Closed or Dismissed Case
          Board Order Compliance
              (For Conditional Dismissal Compliance - Ms. Debbie Powell, Legal Assistant - (512) 475-0982)
Other Agency divisions and contact information

Texas State Dental Board Information:
Phone:  (512) 463-6400      (8am - 5pm, Monday - Friday, Except Holidays)Main Fax:  (512) 463-7452
Open Records Fax:  (512) 532-0637Open Records Requests: openrecords@tsbde.texas.gov

Mailing Address:

Texas State Board of Dental Examiners
333 Guadalupe, Tower 3, Suite 800
Austin, Texas 78701-3942

File a Consumer Complaint with Texas Attorney General here

File a Medicaid fraud complaint with Texas here
Report the fraud, reap the benefits-share in a portion of the recovery here.
Write your state lawmaker here
File a complaint with your local District Attorney or County Attorney, you can find them in the phone book.
Don’t forget to follow up all complaints with further letters and phone calls. 

Texas Board Dental of Examiners allows non US residents to scam taxpayers out of $22 million dollars. Cheap labor from across the boarder helps make the Navarro brothers two of the wealthiest Orthodontists in the US. Texas Dental Board refused to answer these questionable practices.

by BYRON HARRIS
Bio | Email

WFAA
Posted on August 18, 2011 at 10:00 PM
Updated today at 3:16 PM

DALLAS - Many parents know it can cost as much as $5,000 to put braces on a child's teeth. Despite the high cost, it's a financial sacrifice some families make for a child's appearance.

Rarely are braces a health issue. But, while some families struggle to pay for braces, under Medicaid in Texas, tens of thousands of children get braces for free.

Last year, Texas spent $184 million on braces under Medicaid. And while Texas spent as much as the rest of the nation combined, some states, like Michigan and Kansas, spent zero.