Representative Lois Kolkhorst tips hat to those reporting on the dental Medicaid fraud in Texas

Dedicated to all those who are not deterred from speaking out

During a Texas Public Health committee meeting on October 15, 2012, committee Chair Rep. Lois Kolkhorst, tipped her hat to the public, for speaking out about the massive amount of dental Medicaid fraud taking place in Texas.

“…This wasn’t a huge issue on this committee or others would have maybe been a little more privy to it—it took a lot of news reporting for us to really, and thank goodness for the Bill of Rights, because that’s really what brought it to a head, “ s

“…I want to tip my hat to Channel 8 and WFAA in Dallas, certainly the Texas Tribune has given this a lot of coverage…”

Without the public and company insiders speaking out, without Mr. Harris at WFAA, listening, Representative Kolkhorst and the Public Health committee would still be in the dark.. And I suspect the Texas Inspector General and Attorney General’s office would still be turning a blind eye to the red flags they found in 2008.

However, since Richard Malouf -  under fraud investigation himself - filed a SLAPP lawsuit last week against WFAA TV; investigative reporter, Byron Harris; Mary C. Jones and his neighbor, Laura Wilson, I’m guessing he’s not as appreciative of the “reporting” and our “Bill of Rights.” 

Note, Rep. Kolkhorst said it took a “lot of news reporting” to get their attention. So don’t quit; keep blowing those whistles and beating your drums. Don’t be intimidated by even the sleaziest of those who may try to twist the truth.

On a side note: I don’t live in Texas and I don’t have a clue who Lois Kolkhorst is. But I would vote for her over the two loons we have running for President based on the October 15, 2012 hearing alone.

Go Lois!

Whistleblowers, we should all be one!

Whistleblowers Help Texas In Medicaid Fraud Cases

• by Becca Aaronson
• September 27, 2012

With the help of private whistleblowers, Texas has reaped more in Medicaid fraud settlements with pharmaceutical companies than any other state, according to a report released Thursday by Public Citizen, a nonpartisan consumer advocacy organization. 

“When I’ve spoken with a couple of other states, they definitely recognize Texas as a leader in enforcing pharmaceutical fraud,” said Dr. Sammy Almashat, one of the report's authors.

Texas has recovered at least $354 million in Medicaid fraud settlements from pharmaceutical companies since 1991 with the help of private whistleblowers, according to the report. Almashat said that’s because under Texas law, whistleblowers can receive between 15 to 25 percent of the financial penalties of a Medicaid fraud settlement for bringing the case forward.

Although 13 states have similar laws, “Texas is a unique case, because other states haven’t been nearly as active as Texas in taking advantage of whistleblower revelations in prosecuting,” civil Medicaid fraud, said Almashat.

“A whistleblower brings unique underlying knowledge about the fraud that was perpetrated by the defendant in the case,” said Daniel Hodge, first assistant attorney general. In all civil Medicaid fraud cases — including those against pharmaceutical companies and many others — in the last 10 years, Texas has recovered $880 million, said Hodge, and $373 million of that went to the state treasury. 

The whistleblower cases are entirely responsible for that $880 million, Hodge said, explaining that although the Inspector General at the Texas Health and Human Services Commission referred 12,000 criminal Medicaid fraud cases to the AG's office since 2002, during that same time, that agency only referred three civil Medicaid fraud cases.

Currently, a top priority at the AG’s Office is to pursue orthodontic and dental fraud in the Medicaid Program, said Hodge. The office has assembled the Orthodontic and Dental Fraud Task Force to combine resources at various agencies, including the Office of Inspector General at the HHSC. At least one case being pursued by the task force was referred by a whistleblower. 

Given the significant portion of the state budget that goes to Medicaid, “it’s more critical than ever for the taxpayers that we aggressively pursue any actors that defraud the taxpayers and recover those dollars,” Hodge said. “We’re thrilled that Texas has been recognized for [Attorney] General Abbott’s efforts to prioritize uncovering and recovering waste, fraud and abuse in the Medicaid program.”

Texas Attorney General, Greg Abbott, seeks to recover millions from Dr. Richard Malouf and All Smiles Dental Centers

In March Dr. Richard J. Malouf agreed to pay $1.2-million to settle fraud charges in Texas. That was just the beginning for Dr. Richard Malouf’s woes.

Dr. Richard J. Malouf and Valor Investment thought they could create enough shell companies to hide their flagrant fraud of the Medicaid system in Texas. They thought wrong.

Initial reviews of records seem to indicate 90% of the services for which Dr. Malouf and Valor billed Medicaid, did NOT meet standards and were unnecessary. In other words, 90% of Dr. Malouf’s income was stolen from taxpayers, not just Texas taxpayers but all taxpayers. (Medicaid is funded with both state and federal funds)

Laws in Texas, as in most states,  say that each defendant is liable for the amount of payment they obtained either directly or indirectly from unlawful acts-fraud. They are liable for:

• Two times the amount of the payment,
• Interest,
• Fees,
• Expenses,
• Cost incurred by the AG and the Whistleblower to investigation and recover the stolen funds.

In two Whistleblower suits recently unsealed the following corporations, professional corporations or limited liabilities are named:

All Smiles Dental Centers – ASDC Holdings, LLC owned by Valor Private Equity in Chicago, IL.
All Smiles Dental Center, Inc owned by ASDC Holdings, LLC
All Smiles Dental Professionals, PC – Dr. Adrian Codel
Dr. Richard J. Malouf, DDS
Lewisville Smiles, PLLC
St. Francis Smiles, PLLC
Garland Road Smiles, PLLC
Jacksboro Smiles, PLLC
Jacksoboro Smiles by Wire, PLLC
Valleyview Smiles, PLLC
Plano Minyards Smiles, PLLC
Haltom City Smiles, PLLC
Haltom City Smiles, PLLC
Haltom City Smiles, PLLC dba All Smiles Dental & Orthodontics
Northwest Highway Smiles, PLLC
Fort Worth Smiles by Wire, PLLC
Garland Road Smiles by Wire, PLLC
Garland Road Smiles, PLLC dba All Smiles Dental and Orthodontics
S. Hampton Smiles, PLLC
Park Plaza Smiles, PLLC
Park Plaza Smiles, PLLC dab All Smiles Dental and Orthodontics
Richard J. Malouf DDS P.A
Richard J. Malouf, DDS P.C.
2009 Strait Land Family, L.P.
Camelia Family Limited Partnership
RGS Dental Management Services, LLC
RMAL Holdings, LLC
Discount Dental Supply, LLC
As Property Holdings, LLC
M5 Holdings, LLC
Hypermart Lot 6, LLC
Dr. Raffy Kouyoumdjian

(the guys highlighted should go on a no fly list, they may try to skip the country)

The number of people and companies Greg Abbott has named blows the number entities the Connecticut AG filed suit against in May off the charts – Conn AG files suit against dental practice over billing – 28 named. This would make for a great reality TV series – “Battle of the Attorney General’s” or '”Operation Bring Back the Bacon”

Anyway, hats off to Texas AG Gregg Abbott for trying to bring the bacon back home. With any luck at all his office will be covered up with these suits.

 

April 2012 Ellis Whistleblower Lawsuit

---

June 25, 2012 Whistleblower suit

Castillo Whistleblower Lawsuit

Yes, Malouf is trying to escape these claims by filing bankruptcy. Let’s see how far that gets him in this case. Just remember, Salmon swim up stream.

Heartland Dental Management Dentists Accused Of DEA Number Sharing

From Federal Compliant File 4-2008

US vs Heartland Dental Care, Inc.

Heartland Dental Care, Inc. referred to as "Heartland" is a
Delaware corporation in good standing located at 1200 Network Centre Dr., Effingham, Illinois.

Heartland manages dental practices throughout the state of Illinois and elsewhere. Heartland
Dental Care, Inc., which was not incorporated until 2006, is the successor entity to Dental Health
Resources, LLC, Dental Health Resources, Inc. and Heartland Dental Development, Inc.
(collectively "DHR entities"). The DHR entities managed the dental practices, entities, dentists
and employees whose conduct is described below.

Richard E. Workman, D.M.D. is the President and Chief Executive Officer for Heartland.

In the Complaint dentists employees by Heartland at various locations used DEA numbers of other registered dentists to write prescriptions regulated medications.

DEA Inspector reviewed conduct between 2003 and 2007 and found numerous instances of misuse of DEA numbers.

Heartland employed newly graduated dentist who were not yet registered and issued a DEA number for dispensing prescription of controlled substances. Therefore in order to conduct business these dentists used DEA numbers of established dentists.

Heartland Dental was aware and facilitated in this procedure.

Wow, I wonder if this goes on at other Dental Management Companies as well, namely FORBA!

If any of you employees out there know of fraud and corruption at FORBA you could well end up like the woman in Illinois who reported them under the false claims act as a Whistle Blower entitling her to a portion of the fine/settlement. As well she won over $300K for wrongful termination.

I've put links on the side bar regarding the False Claims Act Laws and Whistle Blower Protection.