Did Levine Leichtman unload a sinking ship in InterDent?

I can only hope so. Not that I’m all tore up and concerned about Levine Leichtman. I just find it lip smackin’ good to see another private equity firm that may well get burned over the illegal practice of “Corporate  Dentistry”. Levine Leichtman operated dental clinics under the following names:
Gentle Dental
Smile Keepers
Capital Dental
Blue Oak Dental Group
Mountain View Dental
Affordable Dental Care
Dedicated Dental Systems Incorporated
Also associated with InterDent is Northwest Management Services.
Levine Leichtman Capital Press Release:

LOS ANGELES, Aug. 8, 2012 -- /PRNewswire/ -- Levine Leichtman Capital Partners (LLCP) announced today the closing of the sale of InterDent, Inc. to H.I.G. Middle Market, LLC. 
InterDent, Inc. is a leading dental practice support organization ("DSO") in the United States. The Company  provides support services to over 145 affiliated dental offices in eight western states including California, Oregon, and Washington. InterDent's affiliated offices benefit from professional management, economies of scale, superior information systems, and specialization of functions. Its network delivers comprehensive dentistry to over one million patients annually, including general, orthodontics, periodontics, endodontics, pedodontics, prosthodontics, and oral surgery.
"The InterDent investment has been very successful for our partners, our management team and all of the Company's stakeholders.  We are proud of the successes the company has achieved over the past years and believe the growth will continue with HIG's support," said Lauren Leichtman, CEO of LLCP.  "We are also pleased to provide a very attractive return to LLCP's investors through an exit that underscores our commitment to investing in the middle market."

Seriously?!  According to the WSJ, Levine Leichtman Capital Partners invested in 2000.  They filed for bankruptcy in 2003. Prior to the bankruptcy they owned and operated 226 dental offices in 14 states and now operate 145 dental offices in 8 states.
In 2008. InterDent entered into a 5 year Corporate Integrity Agreement with the Office of Inspector General due to fraudulent billing by at least two of it’s Dedicated Dental clinics in California.  They also agreed to pay $364,500 in restitution and pay $364,500 in damages. The 5 year Corporate Integrity Agreement expires on June 20, 2013.
John Steinbrun signed the Corporate Integrity Agreement as President and CEO of InterDent, Inc and InterDent Service Corporation and Scott Breman signed as President and CEO of Dedicated Dental Systems Incorporated.
I’m sorry, but bankruptcy, a corporate integrity agreement with the OIG, downsizing by 1/3, and numerous lawsuits is considered “very successful” for partners, management or stakeholders.

CSHM, LLC (Small Smiles Dental Centers) Files for Chapter 7 Bankruptcy

February 17, 2015
Just 4 months after CSHM, LLC (Small Smiles Dental Centers) were Excluded from the Medicaid program, Michael F. Gries, the installed Chief Restructuring Officer, filed Chapter 7 Bankruptcy in Delaware Bankruptcy Court on February 5, 2015. (Case No. 15-bk-10206)

CSHM, LLC is the restructured company that emerged in June 2012 when Church Street Health Management (f/k/a FORBA) filed for Chapter 11 Bankruptcy February 20, 2012. (Case No. 12-bk-01573)

Church Street Health Management signed a 5 years Quality of Care Corporate Integrity Agreement in January 2010 (CIA) after a 3 year investigation by the feds that found billing fraud and gross mistreatment, overtreatment and failure to come close to meeting an acceptable standard of care treating the dental needs of children on Medicaid. They also agreed to pay $24 Million for their misdeeds; the Department of Justice was to received $14.2 Million and 21 states were to share $9.7 million and explained here on page 6.

In addition Church Street Health Management (f/k/a FORBA) signed a Corporate Integrity Agreement with the New York Office of Medicaid Inspector General. Agreeing to paying New York and additional $2.3 million.

After continued blatant disregard for the Quality of Care Corporate Integrity, consistent failures of inspections, a 1500 page bi-partisan 2012 Congressional Report  and various warnings by HHS-OIG, CSHM, LLC received notice they were Excluded from the Medicaid program in March 2014. However the government saw fit to allow CSHM, LLC to pilfer and plunder the Medicaid slush fund for an additional 6 months under an Exclusion Agreement.

“This exclusion marks the culmination of a series of alleged failures by CSHM and its corporate predecessors to comply with its CIA. Under the CIA, an independent quality monitor conducted more than 90 site visits and reviews to monitor CSHM's compliance. Since the 2010 settlement, OIG repeatedly cited CSHM and took actions to address those violations, promote improved compliance, and maintain access to care for an underserved population. These actions included imposing financial penalties and forcing the divestiture of one of the company's clinics.

Despite these actions, CSHM remained in material breach of its CIA and OIG issued Notices of Intent to Exclude to the company in December 2013 and January 2014. In such cases, providers have the opportunity to demonstrate to OIG that they have cured, or are in the process of curing, the material breaches. CSHM represented to OIG that it would cure the material breaches. However, through meetings with CSHM and its Board of Directors and review of its written submissions, OIG determined that CSHM had failed to cure the material breaches and proceeded with the exclusion.

Until the exclusion goes into effect on September 30, 2014, an independent monitor will continue to monitor the quality of care being provided to patients at CSHM clinics. CSHM is required to inform patients at least 30 days before closing a clinic. CSHM is also required to keep State Medicaid agencies abreast of developments and provide monthly status reports to OIG. Any divestiture of assets by CSHM must be through bona fide, arms-length transactions to an entity that is not related to or affiliated with CSHM.”

Despite the “Quality of Care” issues as indicated by the classification of the type of Corporate Integrity Agreement they were under, and results of the Monitor’s monitoring, when CSHM received their Exclusion letter they claimed none of the clinics they own were effected it was just the management division of the company and issued a press release stating the centers different entities therefore not effected. HUH?

Here we are in 2015, 8 years since Small Smiles dental centers and their so called management company, CSHM were first investigated—it started in mid 2007— and it just past the anniversary of the 5 year CIA. Heck it expired two weeks ago—January 15, 2015.
According to the 31 page, 3 columns, list of Creditors filed February 5, 2015 they still owe various states their portion of the $24 million dollars. (a breakdown is below)  

They owe several “owner dentists”, support staff, and other dentists, as well as whistleblowers, dental boards, ad agencies, law firms, TV stations, court reporters, (for the numerous lawsuits in which they are involved), storage facilities,(wonder what’s hidden there), utility bills for their clinics, dental labs and insurance companies (hope they kept the Malpractice premiums up for all those dentists!), and every dental supply company in the country, and various management companies. (yep, the management company hires management companies)

Other notables were, Garrison Loan Agency who ponied up the dough to keep this scumbag company alive and kicking from 2012-2015 and the IRS.

Those missing for the list are David R. Wilson, CEO and other top executives, and Waller Landsden Law Group.  Hmmm… Pleadings indicate Wilson was paid $1,194,432.85 the year preceding the filing of the bankruptcy.

Other points of Interest in the initial documents:
Doc 2 Schedules of Assets and Liabilities,
Page 2, Item 3
—In accordance with the Exclusion Agreement, the Company divested itself of substantially all of the CSHM Assets through a series of sales between April and September 2014.  Included among the sale of the CSHM Assets, the Company sold certain assets to First Quality Management, Inc. (FQMI), pursuant that certain Asset Purchase Agreement, dated as of September 30, 2014.  Separately, the Company also entered into that certain Assignment and Assumption Agreement with FQMI, dated September 30, 2014, in connection with the assumption of six (six) MSA’s.  A breakdown of the other clinics can be found here, beginning on page 9.  Missing from that list is all the Colorado clinics except the Colorado Springs clinic.  Interesting, indeed.

So I was right when I posted about FQMI and the continued operations of Small Smiles Dental Centers. Current pleadings say they paid Dr. Paul Elkin $401,574.00 in the year proceeding this bankruptcy filing.  He’s the new head at FQMI according to his LinkedIn page.

Page 2, Item 4
—Additional assets were sold to employees of the Debtor in September 2014…

Wait, I thought the “owner dentists” were already “owners”, not employees!” (sarcasm)

Page 11 & 12
—1st. Lien Holder: Garrison Loan Agency Services, LLC – $37,500,000.00 initial loan, still owed $28,764,918.60;
—2nd Lien Holder: Garrison Loan Agency Services, LLC – $17,500,000.00 initial loan, still owed $17,786,714.00.
——Grand Total for Secured Creditor Garrison Loan Agency $46,551,633.00
Under Creditors Holding Unsecured Nonpiority Claims (Schedule F, page 15, of Doc 2) are all Medicaid Fraud Control Units Creditors and the amount:

	State	Known 2010 Settlement Amounts	Due as of January 2015
1	MFCU of Alabama	$463,028.00	$79,595.63
2	MFCU of Arizona		$127,853.41
3	MFCU of Colorado	$1,200,00.00	$616,099.66
4	MFCU of  Georgia		$288,910.84
5	MFCU of Idaho		$46,687.18
6	MFCU of Indiana		$348,534.90
7	MFCU of Kansas	$517,959.60	$260,969.66
8	MFCU of Kentucky	$123,693.14	$22,484.43
9	MFCU of Maryland		$275,814.83
10	MFCU of Massachusetts		$726,035.97
11	MFCU of Nebraska	$270,000.00	$61,717.55
12	MFCU of Nevada		$83,402.83
13	MFCU of New Hampshire		$48,090.36
14	MFCU of New Mexico		$182,376.06
15	MFCU of New York $1.15M+ $2.3M	$3,450,000.00	$315,849.66
16	MFCU of DC		$78,057.19
17	MFCU of Ohio	$2,392,926.50	$502,185.04
18	MFCU of Oklahoma	$700,00.00	$355,411.82
19	MFCU of South Carolina		$471,779.92
20	MFCU of Texas	$546,000.00	$117,851.57
21	MFCU of Virginia		$228,616.76
22	Department of Justice	$14,200,000.00	$12,966,496.00
23	Department of Justice		$7,844,455.34
	Grand Total	$26,300,000.00	$26,049,276.61

According to the pleadings (Doc 8-1) Amended Schedule B Personal Property they have:
Assets:            $136,369.67
Liabilities:  $73,314,905.16

The 2010 Corporate Integrity Agreement
The DOJ said in 2010 “"We have zero tolerance for those who break the law to exploit needy children," said Tony West, Assistant Attorney General for the Civil Division of the Department of Justice. "Illegal conduct like this endangers a child’s well-being, distorts the judgments of health care professionals, and puts corporate profits ahead of patient safety."

(cough, choke and puke, they have complete tolerance, encourage it, and are accomplices to it!)

Church Street Health Management-Small Smiles Dental burned through another Compliance Officer? Seriously doubt they are going to need one anyway.

Job Posting

If the company isn’t willing to “comply” it doesn’t matter how many “compliance officers” you hire.

Who would want to go to work for a company:

1. on the chopping block
2. has been in serious financial difficulty for 3 or more years!
3. blows through compliance officers like kids thru bubble gum
4. who has failed to even want to comply with the Corporate Integrity Agreement they are under. (see the Auditors Report for 2009 and 2010 in the below Sales Agreement link.
 

Here is a Sales Agreement between the entities to the new CSHM,LLC in 2011. That not would be, old FORBA, not new FORBA, but FORBA III. It’s a real page turner.

Anyway here is the job description.. lol

Church Street Health Management LLC (CSHM) is one of the largest (bankrupt)dental practice management companies in the nation, and focuses exclusively on supporting dental centers caring for pediatric Medicaid beneficiaries and their families. CSHM seeks an SVP, Chief Compliance Officer, who will be based in the company’s Nashville office (that we owe a ton of back rent to) and responsible for overseeing the compliance efforts of the company nationwide (that we have no intention of following”.  Reporting to the CEO, (who we aren’t clear will be)  the selected individual will be responsible for implementing and maintaining policies, procedures and practices designed to ensure compliance with the requirements of all Federal health care programs as well as its Corporate Integrity Agreement with the Department of Health and Human Services’ Office of Inspector General. (that up to this point we’ve basically disregarded because we can’t make moola if we comply)This position is a high profile (it will be when you are jailed) and fast paced (looking for places to hide) position with visibility (too visible) to Executive management, the Board of Directors and (very) significant governmental constituents. Attention to detail, organization skills, ability to see the big picture and accuracy are critically important skill sets.

Small Smiles Dental Centers: Countdown to Exclusion is Business as Usual

As the days count down to CSHM Exclusion from Medicaid becomes effective on September 30, 2014 I’m getting more and more reports that “lead” dentists of the individual Small Smiles clinics are “purchasing” their respective clinics. (Colorado clinics, New Mexico clinics and Indiana clinics just to name a few that have been reported.)

Since January 2010 the clinics have been visited by monitors and care continued decline to the point they were Excluded from Medicaid participation as of September 30.  Several reports from monitors found care unacceptable as dentists and staff continued to deliver substandard care as reported in the bipartisan Senate Report.

How can leaving same dentists in place improve the situation?

It is more than highly likely dentists who have been delivering the unacceptable care and treatment for years will continue with business as usual and children are still at great risk and taxpayers will continue to be fleeced.

The risk may be greater than ever.

Anyone think care will be better?

The dentists and clinic operations may not have the watchful eye of the government monitors or be bound by any Corporate Integrity Agreement with HHS-OIG.  That Agreement was made with CSHM, the management company of the Small Smiles dental centers. (another pitfall of corporate owned dentistry)

Top 5 Ways Small Smiles Dental Centers has violated their Corporate Integrity Agreement

I knew they would disregard each and every word of the Corporate Integrity Agreement.  I said so right here, the very day it was announced.  As for the $24 million paid to the Federal government, and just over $2 million to the state of New York, to them it was going to be nothing more than the cost of doing business.  Pay to play-simply another business expense.  Hey, do they get to deduct that from their income tax return?

The current CSHM crew took over the operation of the Small Smiles dental clinics after they purchased all of them in the fall of 2006-actually they hired the old bunch to do it for a while. 

The arrogance shined like a beacon from the start. The investigation by the Justice Department started in the fall of 2007, just about the time Alberto Gonzales resigned.  All the while, thumbing their very long-and continually growing-nose directly at the entire United States Department of Justice, the US Attorney General and about 23 state Attorneys General and the public at large. No settlement was announced and signed until January 2010.   During which time, they didn’t slow down, skip a beat, miss a step-or any other idiom you want to use.  The child abuse and Medicaid fraud continued-business as usual. 
I originally planned to take all 65+ of the Corporate Integrity Agreement (CIA) that Church Street Health Management (CSHM)- formerly FORBA – signed in January 2010 and mark all the ways, I knew for sure, CSHM had violated said agreement.
I had not got past Section III before I was overwhelmed. No, that’s not right, I was pissed off! Why? Because of the continued arrogance.
So I decided to pick out my top five
1.  Continue with bonus program that is based on “production” or in CSHM speak, “Collections”  To this day, everyone gets bonus if they meet “collections” goals, and it gets bigger if they meet set intervals, no max they can make.  See below.  BTW the Lead Dentist gets 12.5 times the said amount.  Lead Dental Assistant gets 1.5 times set amount.

2.  They are not supposed to base any compensation that would create an atmosphere for overtreatment and fraud, i.e. no % based pay.  Well, continuing with the bonus program didn’t thumb their nose to the CIA enough, no, they created a whole new contract for new and current dentists called “Collection Based Compensation”.   It’s all set out in a 30+ page contract that most CPA’s can’t figure out.
3.  Compliance Officer is not supposed to be the Chief Financial Officer – so they put the SVP of Financial Operations, Lorri Steiner in that position.  No, she’s not the CFO, but c’mon!
4. Appoint Compliance Liaisons at each center who are not afraid to report compliance breach to the board of directors, the compliance officer or anyone else.  So, what dose CSHM do, they make the Compliance Liaison the Office Manager!  Guess who gets a nice size bonus if all things go well at the center and they make their production goals, yep, the Office Manager!!!

5.  Hire an Independent Monitor to “monitor” their misbehaving.  So what does CSHM do, they have amazing made sure that N. Sue Seale, DDS, a great buddy and colleague of their Chief Financial Officer, Steven Adair, is the “pediatric dental professional” to check in on things with the Independent Monitor.   Reports to me are Sue and Steven come to some of the centers together and are quite cozy!
There you have it, my top five.  Well, the top five I picked out in the first few pages of the CIA anyway. 

Another Squabble with CSHM, Small Smiles Dental Centers and Owner Dentists—Small Smiles Reno—Who is extorting who?

I seldom tire of the spin found in legal pleading between owner dentists the illegal dental management companies such as CSHM but honestly it’s getting old.

Now that Dr. Jodi Kuhn purchased her clinics again and seems to have continued with business as usual in Colorado. Another turd has been thrown in the CSHM punchbowl by “owner dentist” Dr. James Mann in Reno, Nevada.  Dr. Mann was hired in October 2, 2006 and I’m positive he can be located as an employee of one of CSHM entities if someone looked.

 Dr. Mann filed suit against CSHM in May 2014.  The case was filed in Second Judicial District Court of the State of Nevada-Washoe County.  In like fashion, CSHM has filed a Complaint against Dr. Mann and Small Smiles Reno and asked for a Temporary Restraining Order. This was filed filed in Davidson County Tennessee Court on July 22, 2014.

In Dr. Mann’s lawsuit he claims he owns the Small Smiles clinic and is suddenly—after just shy of 8 years of employment—”concerned that CSHM’s heavy-handed control of Small Smiles is violating Nevada’s laws and regulations.”

I find It laughable that Dr. Mann is just now  “concerned”.  The public and government agencies have been concerned since 2004! How does Dr. Mann explain this?

Mann claims despite all the name changes—FORBA, Church Street Health Management, CSHM, etc.— many of the same key employees have remained as has their illegal business practices.  (Well, of course, thorn is a thorn by any other name.)

Mann says, “CHSM has continued Church Street’s practices” and “Indeed, many of the personnel associated with Church Street continued to work for CSHM”

He claims:

• Dictated the hours that Dr. Mann and Small Smiles should be open for business.
• Imposed pressure on Dr. Mann and Small Smiles to schedule more patients.
• Decided which equipment Dr. Mann could purchase for Small Smiles
• Insisted on certain dental procedures over others
• Set. Dr. Mann’s compensation.

Here is a statement that raises HUGE red flags and give me great concern:

Bileca sells to Matzkin or Towncare affiliates with Dental Care Alliance, it’s the same either way.

So it was announced last week that Florida State Representative Michael Bileca’s Towncare Dental Partners d/b/a Towncare Dental and Main Street’s Children Dentistry and Orthodontics is now “affiliated” with Dental Care Alliance based in Sarasota, Florida.  Of course that means he unloaded the clinics. Who knows he may stay on as CEO, President or whatever he claims to be.  Wonder if Mr. Bileca has bigger political ambitions and needs to rid himself of the DSO?

So, who is Dental Care Alliance?  Beats the hell outta me!  There’s a timeline after the press release.  You figure it out. 

What I do know is Steven Matzkin and Michael Bileca , their respective CEO’s are founders of that nasty group the Dental Group Practice Association (DGPA). So swapping control of dental clinics they illegally operate among themselves is akin to one of those underground “swingers” clubs.

Dental Care Alliance Press Release

Dental Care Alliance Acquires Towncare Dental Partners

Posted on January 16, 2013 by dca

Sarasota, FL – Dental Care Alliance (DCA) announces the affiliation of Towncare Dental Partners (TDP).

“Towncare is an outstanding, well regarded company, and we are excited to have their team join DCA and expand our administrative resources to better support the needs of our affiliated dental professionals,” says Mitch Olan Co-CEO/COO of Dental Care Alliance. “Both DCA and Towncare place the same emphasis on quality care, provider support and patient satisfaction.”

The Florida-based companies have similar operating philosophies and more than 40 years of combined experience supporting the dental profession. The combined company will now manage the administrative services of 145 dental practices in 8 states.

TEXAS: Chris Villanueva, DDS and others finally NAILED! Sadly they are not JAILED

FOR IMMEDIATE RELEASE

Monday, January 9, 2017

Texas Dental Management Firm, 21 Affiliated Dental Practices, and Their Owners and Marketing Chief Agree to Pay $8.45 Million to Resolve Allegations of False Medicaid Claims for Pediatric Dental Services

DALLAS – Texas-based MB2 Dental Solutions (MB2) and 21 pediatric dental practices affiliated with MB2, along with their owners and marketing chief, have agreed to pay the United States and the State of Texas Medicaid program $8.45 million to resolve allegations that they violated the False Claims Act by knowingly submitting, or causing the submission of, claims for pediatric dental services that were not rendered, were tainted by kickbacks, or falsely identified the person who performed the service, announced U.S. Attorney John Parker of the Northern District of Texas.

“Today's settlement demonstrates our unwavering commitment to protect the Medicaid program and the patients it serves from unscrupulous providers,” said U.S. Attorney Parker. “Providers who waste taxpayer dollars by billing for services that were not provided, or were otherwise improper, will be held accountable.” U.S. Attorney Parker commended the Texas Medicaid Fraud Control Unit, the Civil Division of the Texas Attorney General’s Office, the FBI and the Health and Human Services Office of the Inspector General for their coordinated efforts to investigate and resolve these allegations.

This settlement resolves allegations that between Jan. 1, 2009, and Dec. 31, 2014, MB2 and affiliated dental practices submitted claims to the Texas Medicaid Fee for Service Program for single-surface fillings in children that were not provided. The settlement also resolves allegations that MB2 paid kickbacks to Medicaid beneficiaries and their families, marketers, and marketing entities, in violation of the Anti-Kickback Statute, and that MB2 and affiliated dental practices used erroneous Medicaid provider numbers misrepresenting the dentists performing the pediatric procedures.

Medicaid is funded jointly by the states and the federal government. The State of Texas paid for part of the Medicaid claims at issue and will receive approximately half of the settlement amount.

MB2 is a dental management firm based in Carrollton, Texas, that provides management services to affiliated dental offices. The dental practices included in the settlement are Dental Professionals of Texas PLLC; Archstone Dental PLLC; Bliss Dental PLLC; Crescent Dental PLLC; Dental Central PLLC; Dental Family Circle PLLC d/b/a Forney Wellness Dental; DFW Family Dental Centers PLLC; Element Dental PLLC; Fresh Dental PLLC; Galaxy Dental PLLC; Legend Dental PLLC; Peppermint Dental PLLC; Picasso Dental PLLC; Sage Dental PLLC; Spearmint Dental PLLC; Tide Dental PLLC; Vida Dental PLLC; Viva Orthodontics PLLC and Wow Dental PLLC.

As part of the settlement agreement today, Drs. Christopher Steven Villanueva, Trung Minh Tang, Mauricio Dardano, Gabriel Shahwan and Akhil Reddy agreed to pay $250,000 each to resolve the governments’ claims against them individually. They are owners or part owners of MB2 and the dental practices included in this settlement, and practice dentistry in Texas. Frank Villanueva, MB2’s head of marketing, also will pay $100,000 to resolve his alleged personal liability.

As part of this settlement, MB2, Drs. Villanueva, Tang, Dardano, Shahwan, and Reddy have entered into a five-year Corporate Integrity Agreement (CIA) with the Department of Health and Human Services Office of Inspector General (HHS-OIG). The CIA requires an independent review organization to annually assess whether claims reimbursed by a federal health care program were correctly coded, medically necessary and appropriately documented.

“HHS-OIG is particularly vigilant about potential abuses in Medicaid pediatric dental offices where patients and their families are especially vulnerable to questionable practices,” said Special Agent in Charge CJ Porter for the HHS-OIG in Dallas. “Today’s settlement should ensure other dental clinics are aware that we are watching how they operate and will pursue appropriate resolutions when profits are put before patient care.”

Part of the allegations resolved by this settlement were originally filed under the qui tam, or whistleblower, provisions of the False Claims Act by Veronica Garcia, a former MB2 employee. The act permits private parties to sue on behalf of the government for false claims for government funds and to receive a share of any recovery. It also permits the government to intervene in such lawsuits, as it did in this case. Ms. Garcia will receive $1.521 million from the United States and the State of Texas.

This settlement illustrates the government’s emphasis on combating health care fraud and marks another achievement for the Health Care Fraud Prevention and Enforcement Action Team (HEAT) initiative, which was announced in May 2009 by the Attorney General and the Secretary of Health and Human Services. The partnership between the two departments has focused efforts to reduce and prevent Medicare and Medicaid financial fraud through enhanced cooperation. One of the most powerful tools in this effort is the False Claims Act. Since January 2009, the Justice Department has recovered a total of more than $31.8 billion through False Claims Act cases, with more than $19.3 billion of that amount recovered in cases involving fraud against federal health care programs.

The matter was handled by Assistant U.S. Attorneys Kenneth G. Coffin and Scott Hogan. The claims resolved by the settlement are allegations only and there has been no determination of liability.

MB2 Corporate Integrity Agreement

All current companies under Corporate Integrity Agreement

CSHM–Small Smiles Dental Centers are among exclusive group of 19 under a “Quality of Care” Corporate Integrity Agreement with US government

There are 346 Corporate Integrity Agreements individuals and corporations have signed with the Office of Inspector General (OIG).  Out of those 346 only 19 have the distinguished designation as being “Quality of Care Corporate Integrity Agreements”.  Church Street Health Management (f/k/a FORBA)  is among the exclusive bunch.

According to the OIG Quality of Care CIA’s:

Health and Human Services or Health and Hedge-fund Services? When it comes to Medicaid dental mills, it’s the latter.

December 11, 2012
On Tuesday, December 11, 2012, The Today Show aired an investigative report about the on going troubles at the Small Smiles Dental Centers. Interviews included one with Health and Human Services (HHS) officials in charge of overseeing the compliance of the notoriously troubled clinics.

If you’ve not seen the report, please take time to do that here.

The segment included an interview with a HHS-OIG Branch spokesperson. However, if not for the HHS-OIG seal displayed one would presume it came out of the the PR department at CSHM headquarters.

NBS News Senior Investigative Correspondent, Lisa Myers asks HHS-OIG spokesperson, “They’ve had 4 bites at the apple, when is enough, enough?”  

HHS-OIG responded with this check list:

1. “Dentists have been fired” – Well, dentists are fired there every day!! They are fired every day because they don’t meet the production numbers set by the corporate office. Their turn over had been setting at 48% since the beginning!

What about the Chief Dental Officer – Steven Adair, DDS?  He actually got a promotion. Dr. Adair is the author of the news letter for CSHM in which he suggests instead of the papoose board, try the “superman cape” method.

What is the Superman Cape Technique? Here, read this!

Compliance officers? – Yes, a few. They have burned through 3 in 2.5 years. CSHM will not hesitate to been throw one under the bus, blaming them for falsified reports to the OIG.

2. “Clinics have been closed” – Yes, they have filed bankruptcy! The started closing clinics in early 2011! HHS only forced 1 clinic in actually close – Manassas Virginia.

3. “This is not the same company” – True, it simply filed for bankruptcy, reorganized with some of the same investors in the background, and changed it’s name, replaced the CEO and President. But that was in 2011!

3. “The Independent Monitor is telling us that Quality of Care is consistently improving” – The same independent monitor in place for 3 years! The one CSHM pays. The one whose head dental investigator is buddies with the company’s Chief Dental Officer. So exactly when did that “improvement” begin? June of 2012? Certainly not in April 2012? The new people in charge actually  stepped in October 2011. It just wasn’t on paper with the bankruptcy court until June 2012.

The company has been in the news, how many times since 2007?
Countless!!!

CSHM and Small Smiles Dental Centers sign Exclusion Agreement

OIG Excludes Pediatric Dental Management Chain From Participation in Federal Health Care Programs

April 3, 2014

Related Information

CSHM, LLC Exclusion Agreement

CSHM, LLC, formerly known as FORBA Holdings and Church Street Health Management (CSHM), signed an Exclusion Agreement that bars CSHM from participating in Medicare, Medicaid, and all other Federal health care programs for a period of 5 years, Daniel R. Levinson, Inspector General of the U.S. Department of Health and Human Services, announced today. The exclusion is based on CSHM's alleged material breaches of its Corporate Integrity Agreement (CIA) with the Office of Inspector General (OIG). CSHM manages and operates the national chain of Small Smiles Dental Centers, which provides services primarily to children on Medicaid. CSHM's corporate predecessor entered into the CIA in 2010, as part of the resolution of a False Claims Act case involving allegations that the company had provided dental services to children on Medicaid that were medically unnecessary or failed to meet professionally recognized standards of care.

To minimize immediate disruption of care to the hundreds of thousands of children treated at CSHM clinics and to enable an orderly, controlled shutdown of the company or divestiture of its assets, the exclusion will be effective on September 30, 2014. CSHM waived its right to appeal this exclusion in any judicial forum.

"CSHM has committed repeated and flagrant violations of its obligations under the CIA—violations that put quality of care and young patients' health and safety at risk," said Inspector General Levinson. "This exclusion underscores our commitment to enforcing our integrity agreements designed to promote quality of care and protect patients in Federal health care programs." Mr. Levinson said that this exclusion "makes clear to the provider community that OIG closely monitors our CIAs, critically evaluates providers' representations and certifications, and will pursue exclusion actions against providers that fail to abide by their integrity agreement obligations."

On March 7, 2014, OIG issued a Notice of Exclusion to CSHM based upon numerous material breaches of its obligations under the CIA. CSHM failed to report serious quality-of-care reportable events, take corrective action, or make appropriate notifications of those events to the State dental boards as required by the CIA, OIG found. CSHM also failed to implement and maintain key quality-related policies and procedures, comply with internal quality and compliance review requirements, properly maintain a log of compliance disclosures, and perform training as required by the CIA. Finally, CSHM submitted a false certification from its Compliance Officer regarding its compliance with CIA obligations.

This exclusion marks the culmination of a series of alleged failures by CSHM and its corporate predecessors to comply with its CIA. Under the CIA, an independent quality monitor conducted more than 90 site visits and reviews to monitor CSHM's compliance. Since the 2010 settlement, OIG repeatedly cited CSHM and took actions to address those violations, promote improved compliance, and maintain access to care for an underserved population. These actions included imposing financial penalties and forcing the divestiture of one of the company's clinics.

Despite these actions, CSHM remained in material breach of its CIA and OIG issued Notices of Intent to Exclude to the company in December 2013 and January 2014. In such cases, providers have the opportunity to demonstrate to OIG that they have cured, or are in the process of curing, the material breaches. CSHM represented to OIG that it would cure the material breaches. However, through meetings with CSHM and its Board of Directors and review of its written submissions, OIG determined that CSHM had failed to cure the material breaches and proceeded with the exclusion.

Until the exclusion goes into effect on September 30, 2014, an independent monitor will continue to monitor the quality of care being provided to patients at CSHM clinics. CSHM is required to inform patients at least 30 days before closing a clinic. CSHM is also required to keep State Medicaid agencies abreast of developments and provide monthly status reports to OIG. Any divestiture of assets by CSHM must be through bona fide, arms-length transactions to an entity that is not related to or affiliated with CSHM.

The Inspector General credited Special Agents from OIG's Office of Investigations, Miami Regional and Nashville Field Offices, with assisting in this investigation. OIG was represented in the investigation and litigation of this matter by Senior Counsel Felicia E. Heimer, Maame A. Gyamfi, Robert M. Penezic, and Tamara T. Forys, with assistance from Paralegal Mariel Filtz.

CSHM disputed OIG's determination that it was in material breach of the CIA.

No one has stopped the “Child Abuse for Medicaid Fraud” scheme; not yet anyway.

1997 – Drs. Michael and Eddie DeRose along with Dan “put coke machines in schools” DeRose started opening dental centers to abuse children so they could defraud Medicaid, then build a football stadium in their own honor.

2001 – Dr. Tu M. Tran and Dr. Thien Chi Pham were dentists working at Smile High Dentistry in Colorado. Smiles High Dentistry is part of the Small Smiles Dental chain.

2002 – Tran and Pham were convinced to move to Atlanta and open up Kool Smiles, starting with 2 centers.

2004 – Friedman, Fleishcher and Lowe bought the centers and established NCDR, LLC to be the dental management division of FFL.

2006 – First Islamic Bank (aka Arcaptia aka Crescent Capital) gave the DeRoses $435-million for the dental centers.

2007 – In Georgia two companies who over saw Georgia's Medicaid benefits kicked Kool Smiles out of their network of dental providers for it’s Medicaid patients. Kool Smiles said it was because Wellcare wanted to cut it’s own costs! Wellcare said it was because children being abused for profit and fraud. Georgia agreed with Wellcare, and found over 6% of all Kool Smiles patients files didn’t need the care they received and over 3% of the treatment was substandard.

2012 - We are still where we were in 2007 with Kool Smiles – children abused, substandard treatment, fraud.

With Small Smiles nothing much has moved either. Pretty close to the same as in 2003 when reports of its child abuse first surfaced – 11 very long years have passed and we are zooming toward year number 12.

Kool Smiles continued to grow to over 120 dental centers today Small Smiles topped out at 72 or 73. Hundreds of dentists, who likely worked for one of these mills, broke off and opened their own smaller versions of this business mode- Abuse and Defraud for Profit. Adventure Dental and Vision is just one example. Their “owner” also worked for a Small Smiles Dental Center.

Small Smiles alone, treats 1-million children a year.

There have been numerous news reports on Kool Smiles Dental Centers since it’s beginning. There have been at least 72 73 news reports on Small Smiles Dental Centers since 2003.

Each report, from coast to coast, contained the exact same allegations:

• Children being restrained and physically assaulted.
• Unnecessary overtreatment.
• Parents filing complaints and nothing being done.
• A State or Federal Agency is Investigating.

There have been a few letters mailed out scolding the business practices, a tiny weeny fine or two – (that has not been paid yet) and a couple of Corporate Integrity Agreements that the executives wiped their asses on. (well, it’s true!) An a few “official” reports. Personally I’m not sure what a “report” actually accomplishes.

Here is reporter, Sydney Freedberg's report for Bloomberg, published just last week!

Today is July 4, 2012 and hundreds of these little houses of horrors will open their doors tomorrow.

So far Small Smiles has seen:

• $24-million dollar fine they have not paid
• A 66 page Corporate Integrity Agreement they have not followed
• A few scolding letters with no bite
• A $230,00 fine – they have not paid. (the actual fines for all the violations amounted to millions, but they got a discount)
• One measly dental center in Manassas, Virginia they swear they do not own had to be transferred to a new owner
• The Oxon Hill dental center closed for two days of training! I’m NOT kidding!!
• Checks from the Medicaid fund still arriving in their bank accounts daily.

Hell, no wonder everyone wants in on the action.

CSHM Breach of Corporate Integrity Agreement March13 2012 <p>&nbsp;</p>

On March 7, 2012, just days after filing bankruptcy, their independent monitor did a check of the Oxon Hill Small Smiles and turned up all kinds of problems. On May 15, 2012 HHS once again sent out another letter, telling them to shut Oxon Hill down for a two day training session.

The letter stress HHS’s concern that just days prior to the March 7, 2012 monitor visits, that the Chief Compliance Officer – Lorri Steiner,- the Chief Dental Officer, Steven Adair or Gus Ghassen or both – the SVP of Operations, Kevin Reilly,- the Executive Director of Operations,Lisa Mullinix or Scott Nearing maybe- the Compliance Attorney, Sheila Sawyer, and the Regional Director, Dr. Marlene Navedo had been to Oxon Hill Small Smiles and couldn’t find a thing wrong. NOT ONE THING! How can that be???

Are they incompetent or criminals, it has to be one or the other. Are the same folks still running the show down there? Yes indeed…several of them are still there.

Something big happened that was quite serious, I don’t know what, by the Oral Surgeon at the Oxon Hill Small Smiles on February 20,2012. I don’t know if I want to know either.

CSHM Agreement with Office of Inspector General May 15 2012

Next Wednesday, July 11, 2012 is the dead line for CSHM to have reviewed and report past overtreatment at the Manassas clinic. As Bloomberg Businessweek reported, with 42% of all the root canals checked, (104 unnecessary root canals out of 244) deemed unnecessary I’m guessing that report will not look good for the dentists working there, or the company.

This company has been under the watchful eye of government regulators since 2007, when the investigation first began. Can you get your head around the fact they have not changed their ways in 5 years!!!! 

Arrests next week?

So far only 2 states have released their share of the $23,900,000 Benevis/Kool Smiles Dental Fraud Settlement

So far only 2 states have released their share of the $23,900,000 Benevis/Kool Smiles Dental Fraud Settlement that covers a 3 year period of Jan. 2009 to Dec. 2011. 

Arkansas - $478,500
Massachusetts – $1+M (the state is to receive $1,700,000 with a portion of that going back to the Federal Government)

They started their business model of “Abuse Children; Collect Medicaid $” in June of 2002 with Drs. Frick (Tu Tran) and Frack (Thein Pham) and Kool Smiles still at it today; it will soon be 16 years! 

One must never forget  Dr. Tu M. Tran and Dr. Thien Chi Pham were dentists working at Smile High Dentistry in Colorado. Smiles High Dentistry is part of the Small Smiles Dental chain in 2001.

That leaves 13 years of the same fraud and abuse that has gone unchecked.

Below is a post from Massachutches Attorney General Maura Healey’s facebook page which nearly caused me to have a seziure.

I have to comment:

"This is a story of an enormous company defrauding Medicaid and pushing unnecessary procedures onto kids. We investigated and reached a settlement. Now millions will be returned and this company will change its practices forever."

ARE YOU KIDDING ME!

First, that statement left out the fact these unnecessary procedures were accomplished whereby small children, even babies, were tied up and tortured for speedy traumatic and painful procedures.

This has been going on in state for over 15 years. MassHealth state auditors noted in a published report Kool Smiles and it's cousin Small Smiles had a high incident of crowns back in 2005 or 2006. I have that report somewhere, I’ll find it and post it for you.

In a report you state “With this settlement, we’re recovering more than $1 million for the state and will ensure this company cannot use these practices in the future.”  That is the most naive thing I've ever heard in my life. They were doing it before auditor walked in, while auditors were there, the minute auditors walked out the door and while they were signing this Settlement Agreement.

Question Attorney General Maura Healey: How much did Mass get in 2010 when Small Smiles was sanctioned $24M? Did they change their business practices? Uh...no! Actually, they doubled down! Small Smiles even signed a 5 year Quality of Care Corporate Integrity Agreement.

Imagine the millions of dollars pillaged and the number of children abused by this “enormous company”.

This is state-sanctioned child abuse, you just can't paint it any other way.

Virginia’s Attorney General Facebook page posted about the settlement as well.  Of course I had to comment:

As I’ve pointed out before, as far back as 2009 Kool Smiles has had representative on the Virginia Department of Medical Assistance (DMAS) Dental Advisory Board (DAC). First David Strange, the Paul Walker.  Small Smiles had representitives as well.

In January 2010 a similar “Settlement” was reached with Small Smiles Dental Centers—Kool Smiles’ step-cousin 2 times removed. 

Small Smiles even went to far as to signed a 5 year Quality of Care Corporate Integrity Agreement and agreed to pay nearly $24M (nearly $27M when you add in the separate amount for the state of New York.) plus interest.

By February 2012, Small Smiles filed for Chapter 11 Bankruptcy protection. Three years later in February 2015 Small Smiles filed Chapter 7 Bankruptcy.  It still owed $26,049.276.61 from the January 2010 settlement. 

What happened to Small Smiles?

They simply sold a few clinics to Kool Smiles, Adventure Dental (also root with Small Smiles) and DentaQuest, also operated by former Small Smiles executives and kept a few for themselves, esepcially in Georgia and South Carolina.

Senators’ Report Reveals Oxon Hill Maryland Small Smiles As Bad Today As It Was In The Beginning.

Despite signing a Corporate Integrity Agreement with the US Government in 2010 Small Smiles Dental Centers continue with their fraud and abuse of children as reported in The Joint Staff Report On The Corporate Practice of Dentistry In The Medicaid Program issued by Committee on Finance United States Senate, Max Bacus,Chairman and Committee On The Judiciary United States Senate, Chuck Grassley, Ranking Member, July 2013.

(Despite the 1,500 pages in the report only pages 1-33 (5-37 of the pdf file) are the findings and recommendations, the rest are exhibits

Oxon Hill Maryland

Oxon Hill, Maryland was one of the dental centers reported on in 2007 which brought Small Smiles Dental Centers to the public’s attention.  It’s been 6 years and appears nothing has changed much.  Here is just some of what the Joint Senate report says about the Oxon Hill Small Smiles Clinic:

Former Compliance Officer for Small Smiles Dental Centers, Allison Luke, is on the hunt for a J O B.

 

Post Job Free resume.

In case anyone needs to know anything about her:

ALLISON K. LUKE, JD, CHC *** *th Avenue N. #***
Nashville, TN 37203
(404)***-**** (mobile)
wzetss@r.postjobfree.com
Primary Areas of Expertise
All aspects of healthcare compliance, generally, and strong knowledge of federal and state laws and regulations affecting healthcare providers, facilities and systems, including Federal and State False Claims Acts, Federal Anti-kickback and Stark laws, Medicare and Medicaid Regulations, HIPAA, and others;
Corporate compliance program development and implementation, including Corporate Integrity Agreement implementation; compliance investigations, resolutions, and development/implementation of corrective action plans; development of compliance audit programs, including creation of audit tools, and determination of audit criteria and implementation of compliance audits; policy development and training for healthcare providers; and
Representation of hospitals, healthcare systems, home health agencies, dental practices, and other healthcare providers in compliance investigations before federal and state authorities.

 

Texas, Nebraska, Ohio, Colorado, Kansas and Kentucky Portions of 24 Million Dollar Settlement

Oklahoma to get $700,000 as it's part of the $24 million dollar settlement.

State to get $70K in case

Oklahoma will get $700,000 as part of an agreement with FORBA Holdings LLC to settle a Medicaid billing dispute. Oklahoma has joined 22 states in the deal with the dental management company. The states and federal government alleged FORBA billed state Medicaid programs for medically unnecessary dental services on children insured by Medicaid. Under the agreement, FORBA will pay the states and federal government $24 million, plus interest, and enter into a five-year corporate integrity agreement with the Department of Health and Human Services’ Office of the Inspector General. FORBA provided management services to Small Smiles dental clinics nationally, including three in Oklahoma.

JULIE BISBEE,

Nebraska to get $270,000.

Attorney General Jon Bruning announced today that Nebraska has joined twenty-two other states and the federal government to settle allegations against FORBA Holdings, LLC., a dental management company that provided management services to Small Smiles dental clinics nationwide.

Under the agreement, FORBA agreed to pay $24 million, plus interest, to resolve allegations that it billed state Medicaid programs for medically unnecessary dental services performed on children. Medicaid is funded jointly by the federal and state governments.

“Taking advantage of taxpayers is bad enough,” Bruning said. “But to do so by performing unneeded dental work on children will not be tolerated.”

Nebraska alleged that FORBA, which operates dental clinics under the name of “Small Smiles,” submitted claims for a wide range of dental services provided to low-income children that were either medically unnecessary or performed in a manner that failed to meet professionally-recognized standards of care.

Nebraska’s portion of the recovery is more than $270,000. In addition, FORBA has agreed to expanded oversight from the federal Department of Health and Human Services.

A team representing the National Association of Medicaid Fraud Control Units (NAMFCU) participated in the investigation and conducted settlement negotiations with FORBA on behalf of the settling states. Team members included representatives from Ohio and South Carolina. Nebraska Assistant Attorney General Mark Collins is the president of NAMFCU.

Courtesy: Nebraska Attorney General's Office

Texas gets $546,000 from FORBA settlement


Kansas to get $1.2 million.

My question here is, why are they in Kansas in the first place. Isn't corporate dental practices illegal in Kansas. Oh, wait, I forgot the story they tell...they don't own it. It's own by, ....well last person to be named as owner was Dr. Mohammad Akbar. Funny thing though, FORBA says it's 'firing' dentists over this. How can they fire dentists in clinics they just 'manage'? If I were to do the bookkeeping for a company that got into deep doo doo, I doubt I would have the power to fire the workers at the company.

Ohio will receive $2.3 million of the $24 million dollars. FORBA/Small Smiles settlement.

Ohio is taking a $2.3 million chunk of a $24 million multi-state settlement with a chain of pediatric dental clinics accused of making Medicaid foot the bill for unnecessary procedures.

Attorney General Richard Cordray on Wednesday said Ohio along with 22 other states and federal officials have struck a settlement with Nashville, Tenn.-based FORBA Holdings LLC, which runs the 23-state Small Smiles chain. In Ohio, the company has pediatric clinics in several cities, including locally in Roselawn and Colerain Township.

Kentucky gets $124,000 of the $24 million dollars.

Kentucky is one of 23 states that reached a $24 million settlement with a chain of pediatric dental clinics accused of billing Medicaid for unnecessary procedures.

Under the terms of the settlement, Kentucky will receive about $124,000 from Nashville, Tenn.-based FORBA Holdings LLC, the parent company of Small Smiles dental clinics. Of that settlement, about $44,000 will go to reimburse Kentucky’s Medicaid program, according to a news release.

In Louisville, Small Smiles has a clinic at 3438 Taylor Blvd. (Home of Dr. Melenie R. Abrams, DDS).

According to the release, some of the procedures billed to Medicaid included extractions, root canals, fillings and crowns. The company, which serves children in low-income families, also allegedly used improper techniques to restrain children.

Through the settlement, FORBA has signed an agreement to change policies at its clinics and establish procedures to detect and ultimately avoid performing unnecessary dental work.

FORBA said in a statement that the agreement “encourages us to continue to focus on vital, high-quality dental care for children in America’s low-income communities and allows us to build on the improvements implemented since the company was acquired in September 2006.”

The $24 million settlement is set to be paid out over a five-year period.

Colorado gets $1.2 million

Colorado is to receive $1.2 million as its share of a $24 million multistate settlement of a series of whistle-blower lawsuits against dental-management company

FORBA Holdings LLC, parent of the Small Smiles chain of pediatric dental clinics, state Attorney General John Suthers announced.

Nashville-based FORBA — which focuses on serving low-income children eligible for state-paid dental care benefits — had been accused in the suits of making Medicaid foot the bill for unnecessary procedures.

The 23-state settlement resulted from lawsuits filed in Maryland, Virginia and South Carolina.

The suits alleged FORBA submitted claims for reimbursement “for a wide range of dental services that were either medically unnecessary or performed in a manner that failed to meet professionally recognized standards of care,” Suthers’ office said in a statement.

As part of the settlement, FORBA signed an agreement to change policies at its clinics and establish procedures to detect and ultimately avoid performing unnecessary dental work.

In a statement Wednesday, FORBA said the agreement “encourages us to continue to focus on vital, high-quality dental care for children in America’s low-income communities, and allows us to build on the improvements implemented since the company was acquired in September 2006.”

FORBA was acquired in 2006 by Arcapita Bank, a Bahrain-based investment firm with an Atlanta-based U.S. unit,

The $24 million settlement is set to be paid out over a five-year period to states where FORBA has clinics.

In Colorado, FORBA operates Small Smiles outlets in Denver, Aurora, Thornton, Greeley, Colorado Springs and Pueblo, according to its website.

New York will get $1.1 million as it's share of the settlement. Steve Flamisch reports below.

Senators Max Baucus and Chuck Grassley issue 1,500 page joint report calling for corporate Medicaid dental clinics to be ousted from the program

Today, Senators Baucus and Grassley issued a 1,500 – 1517 pages to be exact — page report on claims I’ve been making here on Dentist The Menace for nearly 6 years. The report includes 66 exhibits.
The story accompanying the release of the Joint Staff Report On The Corporate Practice of Dentistry In The Medicaid Program can be found at The Center for Public Integrity, here.  In David Heath’s story, he reports the new owners Small Smiles Dental Centers state the following:

“only five of the 20 inspection reports mentioned in the Senate report fell under its watch.”

and

…"We've taken action to help CSHM improve its quality of care and management,"

and

…“The new team immediately initiated an aggressive turnaround effort premised on patient care, clinical excellence and regulatory compliance,” the company said.

Well, that’s nothing to be crowing about, since the “new management”  only legally acquired the company 13 months ago putting a guy by the name of David R. Wilson in charge. That was in June of 2012, (13 months ago) so 1/4 of the inspections mentioned in Bacus/Grassley report took place under their watch. This is not a good record in my opinion — heck it’s as bad if not worse than the Michael Lindley/Al Smith or DeRose Family regimes.  Nor it does it demonstrate anything close to “an aggressive turnaround effort on patient care”.  What it does demonstrate, however, is “business as usual”. 
CPI also reports twice last year the OIG threatened to shut Small Smiles out of the Medicaid program.

“Twice last year the HHS inspector general threatened to exclude Small Smiles from the Medicaid program. But in a letter to Grassley and Baucus, Inspector General Daniel R. Levinson said Small Smiles fixed the problems by selling the Manassas clinic, paying a $100,000 penalty and addressing other concerns.”

Now, did CSHM actually “sell” the Manassas, Virginia clinic?  That is highly suspect!  A guy out of Idaho left his own practice and moved his entire family to Virginia and slapped his name on the place, calling it Kids and Family Dentistry.  Coincidently, at the exact same time, the Small Smiles flagship clinic in Pueblo, Colorado changed it’s name to Family and Kids Dentistry, making the “owner” the same guy who was  the lead dentist working for Small Smiles at the time.  (Logos have a odd resemblance about them, don’t they?)  Anyone taking bets on whether the DeRose family — founders of Small Smiles —are somehow still involved with these two clinics?
As for the $100,000 penalty, that didn’t even cover 1/2 of the amount scammed in the x-ray scam in just one Colorado Small Smiles.  What would add insult to injury is it was probably on a payment plan, like the $24 million settlement in 2010.
The Bacus/Grassley report includes independent monitor reports on Small Smiles Phoenix, Arizona, Manassas, Virginia, Oxon Hill, Maryland and Youngstown, Ohio and others.  Small Smiles signed a Corporate Integrity Agreement with OIG in January 2010 agreeing to 63 pages of terms and conditions, including self-reporting.  Of course the “independent monitor” can only report on what they find.  But what about what they don’t find? 
I’ve not come close to reading the entire report just yet, but so far I’ve not read anything about the $200K x-ray scam in one of Colorado clinic that was NEVER self-reported, or the fact that a corporate staffer took the necessary Continuing Education courses to get the lead dentist in Mishawaka, Indiana credentialed in Indiana, making her effectively non-licensed to practice in Indiana to this very day or a host of other illegal activities going on behind the closed doors at Small Smiles Dental Centers and Church Street Health Management (CSHM). I doubt I find these things in the report, but you can find them here if you look.
It’s scary to think state dental boards and state Medicaid programs have not only turned a blind eye to the child abuse, but promoted and encouraged it.  Those of us following this industry also know this is just the tip of the iceberg. 
More on this eye opening report in the coming days.  In the meantime, I encourage everyone to read The Joint Staff Report On The Corporate Practice of Dentistry In The Medicaid Program and evidence attached by clicking here .

Don’t become part of the crime and cover-up–Report it!

This goes out to any Small Smiles or Church Street Health Management employees.

The Office of Inspector General and Health and Human Services take Corporate Integrity Agreements seriously, especially Quality of Care CIA’s and even more important the agreements that have to do with the treatment of children.

I know many of you are afraid to speak up about the violations and breaches of the Corporate Integrity Agreement.  I know many of you are concerned about other misdeeds happening at the dental centers as well as at corporate headquarters. 

I encourage each of you to report any and all violations.  If you don’t feel comfortable using the Hotline that is set up, and I understand that completely, then at least report directly to the OIG/HHS. 

You may direct complaints of suspected Medicaid fraud to
OIG's Hotline1-800-HHS-TIPS (1-800-447-8477) or directly to a

State Medicaid
Fraud Control Units

If the monitor is visiting your center, please talk to the monitor.  I’m sure all reports and allegations are taken seriously.  If you can’t talk freely right then, surely you can find a way to get the monitor’s attention to slip them a phone number or a note or something.  Get the name of the monitor and contact them later….do something.

Heck do all of the above if you don’t feel comfortable talking to the monitor and your concerns swept under the rug.  Even though I doubt that is the case.  But I understand just about every one of you are terrified. 

You guys are the first line of defense against children being mistreated and Medicaid fraud prevention.  Please do the right thing.  For example, if you see procedure being coded and billed improperly, please report it, please.  Don’t become part of the crime and cover-up.

How do the folks at Small Smiles-CSHM keep it all straight? A Rant.

How the people at CSHM keep it straight as to when they own the Small Smiles clinics and when they don’t is beyond me; since it always depends on who they are communicating as to whether they own them or not. Of course, the truth is they do own them, and Sen. Grassley’s report provided that evidence.

Church Street Health Management (CSHM) f/k/a FORBA had to divest in the Manassa, Virginia clinic in March of 2012. HHS-OIG sent them a Notice to Exclude. Here is the HHS-OIG agreement sent to Sheila Sawyer, General Counsel and Chief Administrative Officer of CSHM at the time.

On April 30, 2012, the sham owner of the Small Smiles of Manassas, Gillian Robinson-Warner supposedly signed a Termination Agreement with CSHM. The Termination Agreement states Small Smiles of Manassas, LLC, a Virginia limited liability company, “owns and operates a dental practice in a dental office at 9012 Mathis Avenue, Manassas, Virginia 20110”. Apparently the Manassas clinic was the worst of the worst of the Small Smiles clinics. However, all clinics have been under a Quality of Care Corporate Integrity Agreement since January 2010.

As the Manassas Termination Agreement reads one would assume Small Smiles of Manassas, LLC is a living breathing human-being. Gillian Robinson-Warner signed as President of Small Smiles of Manassas, LLC and agreed to pay CSHM $80,000 to CSHM if they would terminate the said MSA.

The very next day—May 1, 2012—two Motions were filed seeking the Bankruptcy Court’s approval to terminate the contracts.

Motions? Contracts? More than one, you ask? 

Yes, there were two!

The same day the Manassas Motion was filed in Tennessee Bankruptcy Court, so was a Motion seeking the courts approval to terminate the Management Services Agreement between CSHM and the Pueblo clinic. The Pueblo clinic is the flagship clinic of the DeRose-Padula family; the ones who created this monster. Isn’t that odd? The Pueblo clinic agreed to pay CSHM $300,000 to terminate their imaginary agreement. Dr. Randall W. Ellis supposed signed as president of the Pueblo clinic.

We know, the Small Smiles of Manassas, LLC is just a shell corporation, like all the others; each clinic has its own LLC or PC designation. Each controlled and operated by the people at CSHM and backers. Those are facts that have been proven over and over.

Despite that being common knowledge; CSHM will tell you the grass is purple while you are standing there looking at it and know its green; maybe they have lived in the fantasy world of “we only provide support services to dentist owned dental clinics land” for so long, they believe their own BS.

It is understandable where all of this might lead to an identity crisis for anyone working at CSHM or any of their Small Smiles clinics; particularly troublesome for Linda Zoeller. She isn’t even sure of her title at the various, LLC’s or PC’s. Here are 4 different titles she gave herself at just one of the Indiana clinics. Stop laughing!

Reading over both Motions and Termination Agreements, I had to laugh out loud a couple of times. (Ok, I’ll be honest, it was more than a couple, and it was more like a couple in “I’ve only had a couple of drinks” kind of way.)

Besides all the stated facts in the document being anything but factual, I had to laugh at the language.

More than once “abundance of caution” was used. By my very favorite was “The Termination Agreement reflects the product of extensive arm’s length negotiations”. I’ll admit I blew coffee across the room when I read that one. I don’t know how a PC or LLC verbalizes its intent in negotiations; sign language?