Monday, December 09, 2013

Tip of the hat to Dr. John Armstrong and state investigator Michael Knezevich

 

 

Dr. John Armstrong and Michael Knezevich-
A Story of Two American Patriots

by: Michael W. Davis, DDS

Dr. John H. Armstrong led a highly distinguished and venerated career as a physician, in the US Army. His active duty responsibilities included orthopedic surgery, supervision of a specialized trauma unit, as well as education for our next generation of physicians. He assumed responsibility not only for active duty personnel injured in the line of combat duty, but also their families at times. As a command medical officer, he was there for the well being of our nation’s soldiers.

Dr. Armstrong fully comprehends working with a team, and within chain-of-command, to obtain the desired objective. He will get results. He will support his command subordinates, in the field. As such, he generates team morale. He serves as both a leader by example, and importantly as a teacher, mentor and coach, to his subordinates.

This is the remarkable individual, Florida Governor Rick Scott appointed to position of Florida State Surgeon General, in 2012.

(for more please read: http://www.floridahealth.gov/public-health-in-your-life/about-the-department/ssg/index.html)

Michael Knezevich is a retired police officer veteran, of over twenty years. His skin is calloused from years, of dealing with the criminal element in our society. It’s in his blood to “protect and serve”, the public welfare. Today, Mr. Knezevich works at a salary of approximately, $36,000 per anum, as a malpractice investigator for Florida’s Department of Health and Human Services. He investigates allegations of Medicaid and Medicare fraud, for basically a peanut’s income. Mr. Knezevich is only a few paychecks himself distanced, from the disadvantaged, who depend on government assistance. He’s often up against highly skilled white-collar criminals and medical professional criminals, who cheat the taxpayer and harm the most vulnerable in our society. Mr. Knezevich is definitely fighting the good fight, “in the trenches”.

The bipartisan US Senate report of July 2013, on corporate dentistry offered firm evidence of dental Medicaid fraud, as a well-established industry and business model, within the dental profession. Further troubling evidence has been provided by reports of Bloomberg Business News, PBS Frontline, investigative reporters Byron Harris and Roberta Baskin, Debbie Hagan’s “Dentist The Menace” online blog, etc. At the federal level, the Office of Inspector General for Health and Human Services has been continually admonished for “wrist slaps” on violators, which enable and perpetuate unlawful activities. Individual state auditors and regulators fare no better, in their enabling of Medicaid and Medicare abusers and fraudsters.

Dr. Thomas Floyd recently embarrassed Florida. He was an entrenched icon of organized dentistry, both in Florida and nationally. Dr. Floyd was allegedly involved in numerous acts of physical abuse of disadvantaged Medicaid children, going back for over a decade. Florida’s “good old boy” system gave him pass after pass. Allegations came and went, as did witnesses, but it was business as usual for Dr. Floyd. Florida’s regulatory authorities were in perpetual hiding, under their collective desks. Eventually, even this disturbing boil came to a head and popped. Dr. Floyd has since surrendered his dental license, and agreed to never again practice dentistry. However, this alleged Medicaid violator’s abuses were so egregious, this amounts to “a day late and a dollar short”, when it comes to protection of the public interest.

Next came the alleged actions against Dr. Michael Tarver, a pediatric dentist and Medicaid provider. His actions of amending patient records, after knowledge of those records being under Florida State investigation, have been confirmed. He added entries into patient records, but neglected to openly signify the amendments were at a later date, and not the day of patient care. This represents a potentially serious misrepresentation, which any first-year medical or dental student would be sanctioned for. In my personal work as an expert dental witness, this act alone usually changes the questions asked. It’s no longer a question of malpractice or not, but a question of fraud, and how severe the settlement will become against the violator.

Supporters of Dr. Tarver nitpick over a parent’s complaint of lack of informed consent for general anesthesia. In actuality, medicated conscience sedation was employed for the minor patient. Either way, medications were delivered to a child, which have known risks, without the consent of the parent, and with their expressed disapproval. Only a trained medical or dental expert is held to the standard of care, of understanding different levels of sedation and their associated risks. An untrained person can’t be held to medical/dental standard of care, but the doctor certainly is.

Dr. Tarver allegedly resuscitated a child patient, after they stopped breathing during dental treatment. The parent was allegedly never informed of this adverse clinical outcome, which violates standard of care, as well as Florida statutes relating to practice of dentistry. Parents were routinely denied access to accompany their children during dental care by Dr. Tarver, so they often had no direct knowledge of exactly how their children were being cared for. Although Dr. Tarver claimed in a press report, that the American Academy of Pediatric Dentistry (AAPD) condones his actions of denying parent’s access to their children during dental procedures, the opposite is the truth. The AAPD Guidelines state that most children behave better (not worse) with their parent’s presence. One is left to wonder, what Dr. Tarver may be hiding?

Thursday, December 05, 2013

The Smile Center—San Antonio—Settles Malpractice Lawsuit Involving 253 Patients

As the San Antonio Express-News reported December 3, 2013, Dr. Stephen Simpton, owner and operator of  The Smile Center, with 6 clinics in the San Antonio, TX area settled the malpractice lawsuit involving 253 patients. Details still about the dollar amount of the settlement have not been released.

Shorty after the law suit was filed in 2011, Dr. Stephen Simpton filed a defamation lawsuit against the law firm representing the parents of the children, as well as the television station and reporter, Brian Collister. 

Protecting First Amendment rights in Texas, District Judge David Berchelmann’s ruling in July 2012, threw out the lawsuit against the attorney representing the parents, and ordered Simpton’s Smile Center to pay $108,000 in attorney fees and sanctions.  The following month Dr. Simpton was sanctioned for his attempt to silence WOAI-TV, and ordered to pay $70,000.

Simpton further tried to escape the spot light on his misdeeds, having his attorney, Mr. Jon Michael Smith, send “Cease and Desist” letters to anyone else who reported about the abuse taking place in his dental clinics, including Flap’s Dental Blog and this one.  This one actually received two, after the first one didn’t seem to phase me.

Wednesday, November 27, 2013

Kenneth Morris Wiggins, Jr., DDS–Medicaid Fraud: Former Ohio “prison dentist” who fled to the Netherlands is returned to Georgia and sentenced to 7 years in prison.

 

Kenneth Morris WigginsMARIETTA, GA — Dr. Kenneth Morris Wiggins, Jr. pleaded guilty and was sentenced Monday (November 25, 2013) in Cobb County Superior Court for Medicaid fraud. Records indicate between January 1, 2007 and March 11, 2009 Dr. Kenneth M. Wiggins, Jr.,owner of Cosmetic and Family Dentistry with two locations, one in Marietta and one in Roswell, defrauded the state and federal government of $2.2 million.  That, ladies and gentlemen would be you!

In perfect Joran Van Der Sloot style, Wiggins fled to the Netherlands after he was indicted by a Cobb County grand jury in 2011.  (Joran Van Der Sloot, you remember, is the admitted murder of Stephaney Flores and suspected murder of Natalee Halloway, who disappeared while on spring break in Aruba.) 

In February 2013, Wiggins was apprehended in Punta Gorda, Belize where U.S. Marshals transported him to Miami, Florida.  There he waived extradition, and subsequently returned to Cobb County, Georgia, where he has been held without bond.

According to a September 2011 report, Wiggins submitted some 7,000 fraudulent Medicaid claims on 220 patients for “tooth re-implantations and “complicated suturing of wounds” that he never performed.

Wiggins’ plea deal would satisfy any sweet tooth.  He pled guilty to 1 count of Medicaid fraud and Judge A. Gregory Poole sentenced him to 7 years in prison and restitution of $2,230,718.81.

Cosmetic and Family Dentistry, originally ownership was Dr. Kenneth Wiggins and his wife, Dr. DeAnthia Childs-Wiggins.  Cosmetic and Family Dentistry became Family First Dentistry in February 2012 with Dr. Wiggins wife, DeAnthia at the helm according to records at the Georgia Secretary of State’s website.  Searching Cobb County court records fails to find a divorce between Kenneth and DeAnthia Wiggins.

Just a wild guess, but I imagine more than that has been spent since the investigation of Dr. Wiggins began.

Thursday, November 21, 2013

Medicaid dentists giving children multiple stainless steel crowns–Reddit

That’s the headline of a discussion happening over at reddit.  Check it out.

reddit

Discussion:

I have read news stories about a 4-year old girl named Savannah who had all of her teeth capped during a visit to an Arizona dentist. The mother believes she was scammed. There were cases where kids had almost all or all teeth capped and there were accusations of dental Medicaid fraud (Medicaid Dental Center in North Carolina). Papoose boards are used to restrain the kids.

If state dental boards are unable to stop this, how should the public stop it?

Comments

AIG’s “Creepy” and “Seedy” Stalking Attorney Story from Dr. Bicuspid’s Donna Domino

 

New trial ordered for Small Smiles case

Dr. Bicuspid

 

By Donna Domino, Features Editor

November 19, 2013 -- A New York judge on November 18 ordered a new trial in the Small Smiles case after ruling that a lawyer for the insurance company stalked the jury during the trial. The judge found that the lawyer's misconduct intimidated the jury and probably influenced the verdict in favor of Small Smiles.

In October, the jury found that Small Smiles dentists did not perform unnecessary dental procedures on Jeremy Bohn. Justice Deborah Karalunas found that corporate ownership of the clinics was illegal under state law, but the jury found no liability by the company or the dentists.

But after the jury's verdict, jurors complained about a man who "stalked them throughout the trial," according to the November 18 ruling by Justice Karalunas in the New York Supreme Court.

Jurors complained that Scott Greenspan, an attorney who works for the National Union Fire Insurance Company, was following them and videotaping them. National Union is the insurer for Forba Holdings, the former operator of Small Smiles, and the three dentists named in the lawsuit. The jurors said Greenspan followed them when they went out to lunch, took smoking breaks, and when they were in the elevator.

Read more here

Wednesday, November 20, 2013

Are Dentists Drilling For Dollars?–Inside Edition Video Shocking Report of November 2013

Aired November 13, 2013

This  “metal mouth” epidemic has been reported since as early as 2003—if not before.  WJLA-TV did a shocking report in November 2007. 

It is 2013 and no one in government or governing agencies have bothered to stop it. 

Why?

I want some answers!



Here is the contract information for the attorney mentioned in the above report.

Crosely Law Firm Logo

Tom Crosley, Esq.
877-535-4529
information@crosleylaw.com


San Antonio Location
755 East Mulberry Ave
Suite 250
San Antonio, TX 78212
210-354-4500

Houston Location
4203 Montrose Blvd.
Suite 150
Houston, Texas 77006
281-661-4250

Rio Grand Valley Location
323 West Cano St
Suite 200
Edinburg, Texas 78539
956-314-0561

The “Creepy” and “Seedy” Stalking Attorney” story is spreading.

The “Creepy and Seedy” Stalking Attorney” story is spreading.  I think once I used “sleazy”.  That was a mistake, it was “seedy”.  I want to make sure I correct that right away.  LOL
courthouse news logo


'Stalking' of Jury Leads to Malpractice Retrial

Wednesday, November 20, 2013

By NICK DIVITO 
SYRACUSE, N.Y. (CN) - Near "stalking" by the attorney AIG hired to monitor a dental-malpractice trial "violated the sanctity of the jury" and compels a retrial, a judge ruled.
     With the verdict thrown out, Kelly Varano will have another chance to prove that her son, Jeremy Bohn, did not receive proper care from Syracuse dental clinic Small Smiles and its parent company, Forba Holdings.
     It's one of 2,900 such lawsuits filed across the nation against the dental chain, which is insured by AIG.
     After the jury in Varano's case ruled for the defense last month, its members confided in Judge Deborah Karalunas that they felt they were being "stalked" by a spectator from the trial.
     Identifying that man as AIG's Manhattan-based attorney, Scott Greenspan, Karalunas ordered a new trial Monday.
     "Mr. Greespan's conduct violated the sanctity of the jury, raises ground for suspicion that the decision was founded on something other than the evidence, and was prejudicial and likely to influence the verdict," Karalunas wrote.
     One of the attorneys who filed the underlying lawsuit, Jim Moriarty, told Courthouse News that he was "thrilled" with the decision.
     In 40 years practicing law, "I have never seen an attorney go as far out of line as this lawyer did," Moriarty added. "To me it's dumbfounding."

“Dirty Dentist” sparks in-depth report on infection control in dentists offices that could (and should) spread nationwide

After news broke that patients of Dr. Wayne Scott Harrington's dental practice may have been exposed to HIV and two types of hepatitis, thousands of patients across the state were urged to get tested. It's a medical scare that's left many wondering how this could have happened, and how to keep it from happening again.

This story aired on the ONR on OETA-The Oklahoma Network. The reporter is Cathy Tatom; the photographer is Tony D'Astoli. For more information, go to the ONR web site www.news.oeta.tv and ONR blog http://blog.oeta.tv/onr For more about OETA-The Oklahoma Network, visit www.oeta.tv.
Published on Apr 8, 2013

Dr. Scott Harrington – November 2013 UPDATE: 100 Patients now test positive for Hepatitis, 4 test positive for HIV

A class-action lawsuit was filed against Oklahoma oral surgeon, Dr. W. Scott Harrington - license number 3666 (creepy) - on September 3, 2013; included were two assistants, Terri (Waugh) Velega and Lisa Young.  Now, more patients have tested positive for infections.



In the class-action Terri (Waugh) Velega and Lisa Young are accused of administering IV sedation illegally.The lawsuit also accuses Hospira, Pharmaceutical Systems, and Southern Anesthesia & Surgical -- the makers, distributors, and marketers of the propofol used in Dr. Harrington's practice -- of selling multiuse vials that are "unreasonably dangerous and unfit for use as anesthesia in an oral surgery center because of the foreseeable misuse of treating multiple patients from the multiuse propofol vials."Class Action Complaint - Dr. W. Scott Harrington, filed September 2013


Below are two of the latest reports:

By DrBicuspid Staff
Dr. BicuspidNovember 15, 2013 -- Oklahoma health officials have confirmed that 100 patients of oral surgeon W. Scott Harrington, DMD, have now tested positive for hepatitis and HIV.
The state health department said 90 patients have tested positive for hepatitis C, six for hepatitis B, and four for HIV, according to a press release.
More than 4,200 people have been tested since the dental board launched in investigation in March. Health officials have notified 7,000 of Dr. Harrington's patients that they may have been exposed to blood-borne viruses at his Tulsa and Owasso offices and should be tested for hepatitis B, hepatitis C, and HIV.
The Oklahoma Board of Dentistry launched the investigation after being notified that health officials were looking into complaints about potential hepatitis C contamination at Dr. Harrington's practice. Investigators found numerous violations of health and safety laws, including the use of rusty instruments on patients known to have infectious diseases.
Two new lawsuits were filed against Dr. Harrington in November, according to a newson6.com story. The most recent case was filed on behalf of a man who had 14 teeth extracted last December.
A class-action lawsuit was filed in September by seven former patients, including five who claim they contracted infectious diseases during treatment at Dr. Harrington's dental clinics.
Dr. Harrington is scheduled to appear before the dental board on January 17, 2014, in Oklahoma City.







6news
Lawsuits Piling Up Against Tulsa Dentist Accused Of Spreading Diseases

TULSA, Oklahoma -
November 13, 2013 - The lawsuits are mounting against a Green Country dentist accused of exposing thousands of patients to diseases. Two new suits were filed against Dr. Scott Harrington this month.
The health department has confirmed 90 of Harrington's patients tested positive for hepatitis C, six for hepatitis B and for HIV.
Harrington's practices in Tulsa and Owasso have been locked up tight since March. The State Dentistry board said Harrington was using unsafe and unsanitary practices. He's now facing a number lawsuits by patients, who say the dirty practice left them with a potentially deadly disease.
"To think that it's happening in Tulsa, Oklahoma, it just boggles my mind," said Attorney Paul Boudreaux.
Boudreaux is representing five former patients of Dr. Scott Harrington.
9/18/2013 Related Story: Attorney Says Client Contracted Hepatitis C At Dentist Harrington's Office
The most recent case was filed on behalf of a Mannford man who went to Harrington to have 14 teeth extracted last December.
"Now his life is probably shortened, now he can look forward to significant health problems and treatment as a result of contracting hepatitis C, because he went to the dentist," Boudreaux said.
The attorney said the Tulsa Health Department told his client in April that he'd tested positive for the disease. He said the man is so ashamed by the diagnosis, he didn't want to go on camera.
"He's obviously devastated, as is his wife," Boudreaux said.
In September, the health department confirmed genetic tests by the CDC proved one of Harrington's patients transmitted hepatitis C to another patient. But a spokesperson with the state's health department told us Wednesday that only a select few of the positive results were sent to the CDC--those who met specific criteria, like having no other risk factors and matching the right time frame.
Boudreaux said his client lives a clean lifestyle.
6/18/2013 Related Story: More Lawsuits Filed Against Tulsa Dentist Scott Harrington
"He's a very healthy individual. He practices martial arts, he's a married man," he said.
Boudreaux said his client's DNA was not sent to the CDC, but he said the only place the man could have contracted the disease was in the dentist's chair.
"I certainly don't know of any indication, other than going to this dentist and having 14 teeth extracted by no telling what equipment," the attorney said.
The health department said it's unlikely any more results will be sent to the CDC.
Boudreaux said he has a team of experts examining his cases and said it's possible his clients will look into private genetic testing.

















Wayne Scott Harrington 2001 mugshotAccording to court records, W. Scott Harrington was arrested following a DQI arrest in Dallas, Texas November 2, 2001
 
 
Other Videos News Reports on Dr. W. Scott Harrington:
March 29, 2013 – Local dentist reacts to allegations against Dr. Scott Harrington
March 29, 2013 – Dr. Gary Burnidge personally knows and defends Dr. Scott Harrington
March 29, 2013 - Tulsa dentist investigation gets national attention
March 29, 2013 – Dentist tracked down
March 30, 2013 – Dentist under investigation in Tulsa, OK has second Carefree, AZ home (neighbors shocked)
April 12, 2013- KOTV interviews attorney Pat Carr regarding Dr. Scott Harrington
patients not testing positive have “still suffered at Harrington’s hand”)
May (6, 2013 – Do you have a dirty dentist?
 
 
Reporters have interviewed attorneys representing patients of Dr. W. Scott Harrington. Below is the contact information for each.  


logoAttorney Paul Boudreaux representing patients of Oklahoma dentist Scott Harrington
7447 South Lewis Avenue
Tulsa, Oklahoma 74136-6808
Phone – 877-777-4539 or 918-492-7674


pat carr logoAttorney Pat Carr representing patients of Oklahoma dentist Scott Harrington
4416 S. Harvard Ave
Tulsa, OK  74135
Phone – 918-747-1000 or 800-777-4878


Sill Law Group
Sill Law Group has filed the class-action against Dr. W. Scott Harrington
15005 N. Eastern Ave.
Edmond, OK  73013
Phone – 405-509-6300 or 855-329-8276


















Tuesday, November 19, 2013

AIG’s stalking attorney, Scott Greenspan is making headlines.

scott greenspan - stalking attorneyAIG’s stalking attorney, Scott Greenspan is making headlines.  Below is the article from The Post-Standard in Syracuse, NY.  Most interesting are the comments.  I’ve reposted just a few following the article.  There is an article at the New York Law Journal as well – subscription required

 

 

 

 

 

The Post Standard - Syracuse

 

 

 

'Creepy' jury stalker hired by insurance giant AIG forces retrial in Syracuse dentistry malpractice case

Douglass Dowty | ddowty@syracuse.com By Douglass Dowty  ddowty@syracuse.com

November 19, 2013 at 6:07 AM

Syracuse, NY -- A jury's finding of no wrongdoing against a Syracuse dentistry accused of mistreating poor children will not stand after a "creepy" jury stalker prejudiced the verdict, a judge ruled Monday.

State Supreme Court Justice Deborah Karalunas ordered a new trial in the malpractice case against Small Smiles dental clinic, which operated on South Geddes Street before closing in March 2012.

The parents of Jeremy Bohn were among nearly three dozen to accuse Small Smiles of unneeded and improper treatment involving poor children. Bohn's case was decided by jury in October, which found no wrongdoing by the dental clinic.

But in a weird twist, the jurors complained to the judge after the trial about a stalker. The man was identified as Scott Greenspan, who said he was hired by the dental clinic's insurance company, AIG. Greenspan told the judge he was hired to observe the trial, nothing more.

But here are some descriptions of Greenspan's actions, taken from court transcripts after the trial:

Judge Karalunas:

The first question the jurors asked me was whether they did a good job. The second
question the jurors asked me was who was the individual who was stalking them
throughout this trial. When I inquired of the jurors what did the person look like who was "stalking" them, to use the juror's word, they advised me that it was the individual who I had admonished - I don't know that the jury used that word - during the course of the trial, the individual with the computer.

Monday, November 18, 2013

Aspen Dental Nightmares on Facebook

If you have an Aspen Dental Nightmare, there is a Facebook page dedicated to such.

https://www.facebook.com/pages/Aspen-Dental-Nightmares/213106462203040?fref=ts

Judge Orders Retrial for 1st Small Smiles Malpractice Case in New York–“Creepy” AIG Attorney Stalks Jurors

Syracuse, NY -  In October a verdict for the defendants was handed down by the jury in the 1st of 33 malpractice cases against Small Smiles and their dentists slated to be heard in New York courts.

Just after the verdict, the jury informed the judge they were stalked throughout the 15 day trial by a “creep” and “sleazy” guy who turned out to be a New York attorney by the name of Scott Greenspan.  Greenspan was hired by malpractice insurance carrier National Union Fire Insurance Company, a division of AIG .

Now, “upon examination of the facts”, Judge Deborah Karalunas. has ordered a new trial, concluding “…that Mr. Greenspan made improper contact with the jury.”

In her November 18, 2013 decision, Judge Karalunas finds AIG attorney Scott Greenspan’s conduct “violated the sanctity of the jury, raises ground for suspicion that the decision was found on something other than the evidence and was prejudicial and likely to influence the verdict.”

“This is not a matter of an isolated elevator conversation, cake for juror appreciation day or expression of condolence.  This is a case where jurors over a 15-day period believed that they were stalked, videotaped and closely monitored by a person they believed worked for the defendants,” says Judge Karalunas.

“This is a case where jurors performing their civic duty were made to feel bothered and scared.”

Under questioning by Judge Karalunas, one juror said:

“He followed us everywhere. When we would go to lunch, he’d follow us to where we were going.  One day we had an hour and 15 minutes, a little extra time, so we walked down to the Armory Square to Blue Tusk.  And I told the other jurors, this guy is following us everywhere.  So after the third time I saw him, I said look behind you, that’s what I’d say to them, and he would always be there.

“But when we would go on the elevator, he would always be there.  when we got outside, we would go to have a cigarette right out front, he’s always be standing close by.  When we got back on the elevator to come up,he was always there.”

‘…the only times we did not see him out of the whole time was once we went to Ale and Angus and once we went over to The Mission and we didn’t see him there.”

The juror told Judge Karalunas that Mr. Greenspan was in the elevator “at least half the time, if not three quarters of the time.” 

So there ya have it.  A new trial and I would guess that National Union/AIG would need to pick up the tab for this. Now, wouldn’t it have just been easier to write this child a check for all the hell he’s been put though?!  Just saying…

Small Smiles Dental Syracuse Bohn Malpractice New Trial Decision

Florida Dental Board allows Dr. Michael Tarver access to children after Florida Department of Health says he’s too dangerous

Apparently the Florida Board of Dentistry is more concerned about “saving face” of one of their licensees—Dr. Michael Addair Tarver— than they are about the  safety of the public, most notably, children.

At a board hearing on November 15, 2013, the board voted to reinstate the dental license of Dr. Michael Addair Tarver and agreed to a proposed settlement  with a few changes. Reports say the Dental Board members agreed to “reduce the fine imposed by 1/2;  from $15,000 to $7,000 and to removed a stipulation whereby Dr.Tarver must publish a 2,500 word article. (don’t worry, Dr. T, I think the the 2,500 word article is covered)

In September 2013, the Surgeon General and Secretary of Health, John H. Armstrong, MD, FACS, issued an Emergency Suspension Order for the dental license of Dr. Tarver after an investigation of serious allegations of patient endangerment and malpractice.  (see Background below)

According to the Ocala Post article, Tarver admitted he would sedate children if they misbehaved!  This is far past outrageous!  It’s criminal!!!  What next will happen that sends the message it is acceptable to sedate a child for misbehaving?!  Teachers?  Daycare providers?  Parents?  Grandparents?  Does this not scare anyone but me?!

Tarver must also complete continuing education on Ethics and keeping Dental Records.  By reading the Emergency Suspension Order, Tarver knows all about record keeping, since he was able to go into the computer an altered many of them.  Maybe this required CE class is about how to restrain the urge to alter patient records when investigators come knocking.  Reports also say he must be “monitored” by another dentists, someone other than his wife. 

WSJ - Getting a Grip on Dental Expenses

LOL, ya gotta love it.  There’s a “grip” on it alright.  A damn tight one!

 

wsj

 

 

Getting a Grip on Dental Expenses

Health Law Should Help Children and Some Low-Income Adults

By Kristen Gerencher

Nov. 16, 2013 8:05 p.m. ET

Oral health typically isn't covered by traditional health insurance, but kids and low-income adults soon may have more opportunity to take care of their teeth. As many as 8.7 million children are expected to gain dental insurance through the Affordable Care Act by 2018, according to the American Dental Association, though some experts expect a more modest addition of about 5 million children.

The news for adults is mixed. Medicaid, the federal and state health-insurance program for low-income people, will expand in some states under the health-reform law, providing more adults with dental coverage. While 29 states offer adult Medicaid recipients limited or comprehensive dental coverage, 21 states offer bare-bones, emergency-only coverage—or none at all, according to Oral Health America, a national nonprofit based in Chicago.

Medicare, the federal insurer for the disabled and for adults 65 or older, doesn't cover routine dental care, so many seniors still face hefty out-of-pocket costs. Two-thirds of 407 seniors earning less than $35,000 a year said they couldn't afford a procedure such as a crown, implant or bridge, according to a recent survey by Oral Health America and Harris Interactive.

Here are a few tips for managing dental costs, whether you're shopping for insurance or discounts:

Starting Jan. 1, more kids may find coverage through Medicaid, as 25 states and the District of Columbia make plans to expand the program, and through state or federal health-insurance exchanges. But the options can be confusing. Only two states, Washington and Nevada, require families who shop for health coverage on the exchanges to buy pediatric dental insurance as well, says Evelyn Ireland, executive director of the National Association of Dental Plans in Dallas.

On the exchanges, you need to weigh whether to buy a separate "stand-alone" dental plan or one that is part of a health plan. In some markets, because of the way deductibles are structured and because premiums could exceed the cost of expected care, it may make more financial sense to forgo dental coverage altogether.

If you choose to get pediatric dental coverage through a medical plan, check to see how the deductible is applied, Ms. Ireland says. "We've seen them all over the map," she says. The health plan may require you to pay its deductible before the dental plan will cover routine care such as well-child cleanings, sealants and X-rays. Because dental insurance has traditionally paid the full cost of preventative care, "it will be a big shock if [consumers] go under a medical plan and end up having to pay all of it out of pocket instead of none of it out of pocket."

Sunday, November 17, 2013

Texas Dentists for Medicaid Reform Press Release Re: Antoine Dental Center

Hey folks, it’s not the Office of Inspector General who “lost”, it’s not just the taxpayers of Texas, it’s all taxpayers.  The Medicaid system is funded with state and federal funds.  Taxpayers should be outraged over this ruling! 

Texas Dentists for Medicaid Fraud Reform Press Release Re: Antoine Dental Center:

Judges Finds Another Texas Orthodontic Practice Innocent of Medicaid Fraud and Misrepresentation

Two administrative law judges with the Texas State Office of Administrative Hearings (SOAH) have issued their proposal for decision in the case of Antoine Dental Center of Houston (ADC) SOAH Docket No. 529-13-0997. ADC had been placed under a 100% payment hold in April of 2012 by the Texas Health and Human Services Commission Office of Inspector General (OIG) for "credible allegations of fraud" and willful misrepresentation in their orthodontic billings from 2008 to 2011. ADC had been one of the top 25 billers of Medicaid for orthodontic services in the state. The judges, in their decision, found that ADC had not committed fraud or any willful misrepresentation and ordered the payment hold discontinued.

"I am extremely relieved and happy with this decision," stated Dr. Behzad Nazari, the owner of ADC. "We had been crippled to the point of near bankruptcy by this payment hold and the allegations that had been swirling around the practice. I have been saying for a long time that we weren't guilty and I am thankful that the judges recognized that fact. There is something wrong with the way these cases have been prosecuted by the state."

Oh, I bet Dr. Nazari is happy happy happy.  Just because some judge (or jury)says you aren’t guitly doesn’t make it true.i.e.Casey Anthony, O.J. Simpson.

Judges Howard S. Seitzman and Catherine C. Egan wrote in their decision that "the prima facie evidence failed to support a credible allegation of fraud or willful misrepresentation and failed to show that ADC filed claims for non-reimbursable services. The few non-fraudulent record retention violations that ADC committed were technical violations that do not warrant a payment hold."

Sorry, judges, I 100000% disagree!  Anyone at that hearing could clearly see the fraud, and their expert Dr. Orr, was a joke.

It’s hard to pin fraud on top executives in big complex companies! Poppycock, says Judge Jed Rakoff

This may seem to have nothing to do with corporate dentistry and fraud, but you would be wrong.
Judge Rakoff Blasts Breuer, Prosecution of Companies Rather than Individuals in Bar Speech

Thursday, November 14, 2013

naked capitalismAbsent sitting on the Supreme Court, it is difficult for a single judge to effect much change. Yet Jed Rakoff, in sending the SEC back to the woodshed in two separate cases over its failure to get factual admissions, meaning admissions of misconduct, on civil settlements of SEC cases, singlehandedly embarrassed the SEC and the Department of Justice into seeking these statements (for instance, numerous media reports indicate that the Administration wants that sort of confession as part of its pending settlement with JP Morgan).

Rakoff threw down another gauntlet in a New York Bar Association speech on Tuesday. I’m taking the liberty of quoting it at length because his rebuke is a breath of fresh air and roused the Department of Justice to issue a “we really are doing our job” response.

But if, by contrast, the Great Recession was in material part the product of intentional fraud, the failure to prosecute those responsible must be judged one of the more egregious failures of the criminal justice system in many years.

Rakoff then pointed to the fact that the FCIC and numerous government officials had discussed fraud in connection with the crisis and went further:

While officials of the Department of Justice have been more circumspect in describing the roots of the financial crisis than have the various commissions of inquiry and other government agencies, I have seen nothing to indicate their disagreement with the widespread conclusion that fraud at every level permeated the bubble in mortgage-backed securities.

He then goes through their litany of excuses (his word). Ooh, it’s hard to pin fraud on top executives in big complex companies! Poppycock, says Rakoff:

Who, for example, were generating the so-called “suspicious activity” reports of mortgage fraud that, as mentioned, increased so hugely in the years leading up to the crisis? Why, the banks themselves. A top level banker, one might argue, confronted with increasing evidence from his own and other banks that mortgage fraud was increasing, might have inquired as to why his bank’s mortgage-based securities continued to receive triple-A ratings? And if, despite these and other reports of suspicious activity, the executive failed to make such inquiries, might it be because he did not want to know what such inquiries would reveal?

This, of course, is what is known in the law as “willful blindness” or “conscious disregard.” It is a well-established basis on which federal prosecutors have asked juries to infer intent, in cases involving complexities, such as accounting treatments, at least as esoteric as those involved in the events leading up to the financial crisis. And while some federal courts have occasionally expressed qualifications about the use of the willful blindness approach to prove intent, the Supreme Court has consistently approved it.

The second, “weaker” excuse came out of Lanny Breuer’s mouth in his notorious Frontline interview: that the investors in mortgage-backed securities were sophisticated; it would be hard to prove they relied on ratings and fraudulent misrepresentation. Rakoff basically says that Breuer is a crappy lawyer:

Actually, given the fact that these securities were bought and sold at lightning speed, it is by no means obvious that even a sophisticated counterparty would have detected the problems with the arcane, convoluted mortgage-backed derivatives they were being asked to purchase. But there is a more fundamental problem with the above-quoted statement from the former head of the Criminal Division, which is that it totally misstates the law. In actuality, in a criminal fraud case the Government is never required to prove reliance, ever. The reason, of course, is that would give a crooked seller a license to lie whenever he was dealing with a sophisticated counterparty. The law, however, says that society is harmed when a seller purposely lies about a material fact, even if the immediate purchaser does not rely on that particular fact, because such misrepresentations create problems for the market as a whole.

The third excuse is that prosecution might hurt the economy. Rakoff indicated his discomfort with the “too big to jail” idea, but used that to lambaste the notion of prosecuting institutions as opposed to individuals. No institution would perish if an executive were prosecuted.

Rakoff carefully and pointedly says he’s not accusing prosecutors of revolving-door corruptions and that prosecutors maximize their value in the post-government service market by collecting scalps. Whether of not he actually believes that to be true, he has to say that or risk never hearing a big securities case ever again, in that both defendants and regulators could ask to have cases assigned to other judges based on the notion that Rakoff had said that prosecutors were soft of big corporate crime because they were currying favor with prospective future employers. Notice, by contrast, the cautionary example of Judge Shira Scheindlin, who had a ruling opposing New York City’s stop and frisk rules overturned because she violated the code of conduct for Federal judges by showing partiality.

But he point out other reasons why no one could be bothered to go after the conduct that wrecked the economy. The best US Attorney’s office, the Southern District of New York, was busy on the Rajaratnam case. Any smart prosecutor would ride that horse, which was ready to go, rather than take on the slog of a case that was years away from being files. So basically, with Congress starving the SEC of budget and making it capable only of handing out parking tickets in the form of insider trading cases, SDNY staffers were incentivized to go after the comparatively easy cases the SEC threw over the transom rather than pursue far more important crisis-related cases. Rakoff argues the other reason for the government’s reticence to prosecute is that it would embarrass government officials and expose policy failings.

And Rakoff described why prosecuting companies, rather than targeting individuals, produces lame outcomes:

But if your priority is prosecuting the company, a different scenario takes place. Early in the investigation, you invite in counsel to the company and explain to him or her why you suspect fraud. He or she responds by assuring you that the company wants to cooperate and do the right thing, and to that end the company has hired a former Assistant U.S. Attorney, now a partner at a respected law firm, to do an internal investigation. The company’s counsel asks you to defer your investigation until the company’s own internal investigation is completed, on the condition that the company will share its results with you. In order to save time and resources, you agree. Six months later the company’s counsel returns, with a detailed report showing that mistakes were made but that the company is now intent on correcting them. You and the company then agree that the company will enter into a deferred prosecution agreement that couples some immediate fines with the imposition of expensive but internal prophylactic measures. For all practical purposes the case is now over. You are happy because you believe that you have helped prevent future crimes; the company is happy because it has avoided a devastating indictment; and perhaps the happiest of all are the executives, or former executives, who actually committed the underlying misconduct, for they are left untouched.

Saturday, November 16, 2013

Terrence Ewing Syler, DDS was sentenced to 22 months in jail

A joint investigation between the Feds and the State have landed another Texas dentist in the poky.  70 year old Terrence Ewing Syler, DDS was sentenced to 22 months in jail by U.S. District Judge Thad Heartfield.

Texas dentist sentenced to prison for Medicaid fraud

Dr BicuspidBy DrBicuspid Staff

 

November 14, 2013 -- A Beaumont, TX, orthodontist has been sentenced to federal prison for Medicaid fraud after submitting claims for palatal expanders that were never provided to his patients.

Terrence Ewing Syler, DDS, 70, pleaded guilty in June to healthcare fraud and was sentenced to 22 months in federal prison on November 7 by U.S. District Judge Thad Heartfield, according to a U.S. Department of Justice statement.

Dr. Syler, who owned and operated Syler Orthodontics in Beaumont, submitted the fraudulent claims from January 2007 to October 2012, according to the statement. As a result of the scheme, Dr. Syler received $829,000 to which he was not entitled. As part of his plea agreement, Dr. Syler agreed to forfeit several bank accounts totaling just over $829,000 and pay a $6,000 fine.

Friday, November 15, 2013

Small Smiles Dental Center Attorneys Want “Jury Stalking” Proceedings Sealed

I know a little about creepy attorneys and Small Smiles. See, it was about this time of year in 2008, Small Smiles Dental Centers sent a creepy attorney, named Thor, knocking on doors, of anyone in a 100 mile radius of me that had my same name. (By the way, there are several)  It was well into the night when he knocked on mine.  He was searching for the person (me) who was exposing the secrets of their criminal dental scam, which was defrauding Medicaid from hundreds of millions of dollars. They wanted me to shut the hell up! 

Now, Small Smiles Dental Centers and their malpractice insurance carrier want to silence the post-trial proceedings dealing with their jury tampering in the first malpractice trial in Syracuse, New York.  I’m shocked! (sarcasm)

National Union Fire Insurance Company (NUFIC) a subsidiary of American International Group (AIG) hired New York attorney, Scott Greenspan to “monitor” (a.k.a. “stalk”) the jurors of the first Small Smiles Dental/FORBA malpractice trials in Syracuse, New York.  Mr. Greenspan is a partner at Sedgwick Law, with offices around the world.  According to Mr. Greenspan he was hired by Denise D’Assaro,  AIG Complex Claims Director and it was pure coincidence he was in every restaurant they jurors visited.

Read:

NUFIC/AIG wants State Supreme Court Justice Deborah Karalunas to seal all records and court documents related to the jury stalking event.  Frankly, they would like to wave a magic wand and have the whole incident removed from, not just the record, but the memory of all parties.  I would think they especially want the transcripts where their employee Mr. Scott Greenspan is said to be“creepy” and “seedy” buried under the courthouse. 

They also want the public barred from any hearings about said jury stalking event. Well, of course they do!  They would like it if the jurors didn’t notice they had a creepy and seedy stalker but that ship has done sailed.

Apparently, on October 16, 2013 - shortly after the verdict, Judge Karalunas  called at least one juror back to court for a hearing.  I’m sure this judge wanted to hear more details of the jury stalking incident.   Heck yeah, I want to know just how far Mr. Greenspan went in his intimidating and harassing of the jurors during the 10 day trial.  What line did he not cross?  What lines did he cross without hesitation?  No doubt NUFIC/AIG wants the transcript between Judge Karalunas and the juror marked “Super Duper Top Secret”,

If there is anything that should NOT be sealed it would be this!  The public doesn’t need to know the jurors names or other person information — that should be redacted.  But, boy oh boy, the public sure needs to know the extent NUFIC/AIG will go to in order to deprive young children from being compensated for injury, pain and suffering at the hands of one of their insured.

AAPD Behavior Guidance Symposium Nov 2013

According to the American Academy of Pediatric Dentistry, their Behavior Guidance Symposium “kicks” off today at their headquarters in Chicago.  I can simply not believe I was not invited to this event!  I should pay much closer attention to their event schedule in the future.

AAPD BHM Symposium 11-15-2013

Frankly, I’m not sure why the AAPD even has the event, since apparently the AAPD and their “policy and guidelines” are of little value.  According to testimony from ethically challenged dentists involved in various malpractice lawsuits across the nation, he policy and guidelines are mere “suggestions”.

Attending the event will  garner you Continuing Education credits.  With the massive number of dentists working in the Medicaid dental mills, you would think they would need a venue such as McCormick Place or the United Center instead of the Westin Hotel.

Thursday, November 14, 2013

Inside Edition puts spotlight on Happy Valley Pediatric Dentistry and The Smile Center

I’m sure Dr. Simpton of The Smile Center is popping a cork over this Inside Edition piece.  I’ve been a “victim” of Simpton’s cover-up, his attorney sent me a cease and desist letter, a year or two ago.  Why you ask?  Because I reposted a story or two out of Texas. I’ll be watching my mail for yet another one!

 

Airdate: 11/13/2013  Are Some Dentists Drilling For Dollars?

insideeditionGoing to the dentist is a scary proposition for many people. But imagine what it must be like for a child who goes to the dentist and comes out with a mouthful of metal crowns that may have been unnecessary.

When she was just four-years-old, Savannah’s mother Alicea White says she took her daughter to the Happy Valley Pediatric Dentistry in Phoenix, AZ for a routine appointment.

But Alicea says instead of just filing four cavities on Savannah, dentist Dr. Karan Nett turned Savannah’s mouth into a smile of steel.  

“I was completely shocked,” said Alicea. “All that silver in her mouth. I was like, ‘Oh my God, what happened?’”

Alicea says every single tooth in Savannah's mouth was crowned with metal!

People compared her new smile to the James Bond villain, Jaws.

Alicea said, “It broke my heart. I was in tears right along with her.”

Alicea believes Dr. Nett was just drilling for dollars; doing unnecessary and excessive work to jack up the bill.

INSIDE EDITION’s Lisa Guerrero tried to speak with her outside her clinic.

“I'd like to talk to you about a little girl whose mouth you filled with metal? Would you like to look at these pictures and explain these pictures?” Guerrero asked Dr. Nett as she walked to her car.

Dr. Nett did not respond to Guerrero but has denied any wrongdoing, saying the work was necessary due to Savannah's significant tooth decay.

It turns out that metal mouth cases like Savannah's are not rare.

One look at Maya Anderson's mouth and you can see why she falls to pieces reliving her traumatic trip to this dental chain in San Antonio, Texas called the Smile Center.

“I had 24 teeth worked on. All I have is like five teeth left. I’m sorry. He ground down my teeth so small they were like little stubs.”

The dentist who worked on Maya's teeth for eight hours is Dr. Mark Hong, and Maya's isn't the only patient who claims he drilled for dollars. 

On just five children, parents allege that Dr. Hong performed over 30 baby root canals and crowned over 50 teeth.

Tuesday, November 12, 2013

Maine DHHS may reduce fines for dentists–No danger there!

Paperwork mistakes is the number one excuse for fraud for heaven sake! 

 

portand press

November 12

Maine DHHS could reduce fines for dentists

Dentists complain about large fines by an auditor for minor clerical errors in MaineCare patient cases.

By Joe Lawlor jlawlor@pressherald.com
Staff Writer

The Maine Department of Health and Human Services could reduce or eliminate the controversial fines recently levied against dentists serving MaineCare patients, according to a contract between the agency and the independent auditor who issued the penalties.

Dr. Michael Dowling works on Aiden Serber, 8, of Westbrook, as dental hygenist Trisha Drewry assists at Falmouth Pediatric Dentistry in Falmouth.

Gabe Souza/Staff Photographer

Related Documents
Read Maine's contract with Health Management Services

The fines have been appealed and are in limbo awaiting DHHS rulings.

Dentists have complained to the Portland Press Herald that they were shocked to receive fines as large as $200,000 from new audits required under the federal Affordable Care Act. Statewide, the fines totaled about $800,000, and dentists have said they may have to close or sharply curtail services to low-income patients served under the MaineCare program if the fines are allowed to stand. The fines were based mostly on minor paperwork and coding errors, dentists have said, and the contract gives auditors financial incentives to penalize Medicaid providers for clerical errors.

“This has just been incredibly spiteful and petty,” said dentist Mark Zajkowski, of Oral and Maxillofacial Surgery Associates in South Portland. Zajkowski said his practice is facing a “substantial” fine. “The only thing this is going to do is disincentivize dentists serving MaineCare patients.”

While the ACA requires more comprehensive audits of Medicaid services, the specifics on how the audits are carried out and what types of penalties can be imposed are controlled by the states. In Maine, dental services are the first to be scrutinized by the new Medicaid audits, while hospitals are next on the list.

Monday, November 11, 2013

Dan DeRose–Soda in Schools King

Here is a “Blast From The Past” article on Small Smiles Dental Centers founder, Dan DeRose and his visions of sugar plums – Soda in Public Schools. This article was written during the period his dad, Eddie DeRose, formed DeRose Management, LLC.  DeRose Management, LLC was the precursor to FORBA, LLC — the “test” dental management company of sorts.

New York Times Articles

 

Today's Lesson: Soda Rights; Consultant Helps Schools Sell Themselves to Vendors

By CONSTANCE L. HAYS
Published: May 21, 1999

Dan DeRose, marketing consultant, was busy doing the math for his new client, the Newark Public Schools.

The question on everyone's mind: how much money could the district make if it sold a soft-drink company the exclusive right to vend its products on school grounds? The answer, according to Mr. DeRose: a lot more than it gets right now.

''Let's just say everyone drinks one product a day, and let's just count the students,'' he said. ''At 45,000 times 180 days of school, that's 8.1 million cans. At 75 cents apiece, that's $6 million walking out the front door of your school every year in quarters and dollars.

''Let's get a lot of it,'' he told his audience, a collection of school principals, athletic directors, P.T.A. officials and one student. ''Let's get some of it back to the schools.'' Even $5 million would make a difference in the district's $550 million budget.

With his square shoulders, steady smile and conscientious use of the first-person plural, Mr. DeRose and his company, DD Marketing, are storming a once-quiet backwater in the soft-drink business. Schools regard him as a font of information. Soft-drink companies, which used to make low-key deals on their terms with local school districts, hate him with a passion.

Wednesday, October 30, 2013

Ontario Teachers Union Pension Fund takes over My Dentist Complete Care Dentistry

 

My Dentist Complete logoAccording to reports, including the one at The City Wire, Heartland Dental has taken control of My Dentist Complete Care Dentistry, founded by the late Dr. Rodney Pat Steffan in Oklahoma City, OK. What reports fail to mention is who actually “controls” Heartland Dental.  That would be Ontario' Teachers Union Pension Fund.  According to Business Week, the union pension fund took over in December 2012, to the tune of $650 million.

 

city wire logo“Heartland Dental’s vision and values align perfectly with the principles on which Dr. Steffen founded My Dentist,” stated Kevin Offel, My Dentist president and CEO said in a statement.

That is a scary statement for any and all My Dentist patients! 

city wire logoThe My Dentist locations will continue to use the same branding and signage now used.

 

This is what makes it so shady and hard to determine the ownership and control of these corporate mills. 

city wire logo“Through our affiliation with Heartland Dental, I am confident we will continue operating My Dentist with the integrity and same caring heart we have always demonstrated,” Dr. Jennifer Chambers said. “I am personally excited as both a Clinical Director and a practicing dentist to carry-on the values and practices instilled in us with My Dentist while enhancing our capabilities going forward with our Heartland Dental affiliation.”

There is that word, ‘affiliation” again!  Jot down Dr. Jennifer Chambers’ name, I’m sure someone will need this information in the future.

 

city wire logoThe transaction is subject to certain regulatory and other approvals and is expected to be completed within 60 days. Upon completion of the transaction, My Dentist will be affiliated with a company that provides dental support services to more than 500 dental offices in 26 states.

Wednesday, October 23, 2013

Is CSHM, LLC taking full responsibility for all future legal actions against Small Smiles Dental Centers? You decide.

Update: 10-24-2013 10:58AM

On October 9, 2013 the so-called “new company” who owns and operates all the Small Smiles Dental Centers that have managed to remain open denounced its association with the so-called former owners and management company.  (see statement below)

[image%255B2%255D.png]

In making this claim, they must also be taking full responsibility for any and all illegal activities and/or malpractice issues that could arise in the future, right?  As the below email suggests, those will be coming.


Hi - I have kept up with your site for a while now because honestly it was the only way to find out the "real" news on Small Smiles. I am former employee of Small Smiles in South Carolina. When I took the position I had NO clue what I was getting into. I resigned from my position due to the horrible reputation Small Smiles has and it was mentally exhausting to even go to work.

Friday, October 18, 2013

Small Smiles Dental Centers Release Statement RE: New York Malpractice Case #1

image

 

 

 

 

 

 

 

 

 

 

 

Sorry, there is no mistake or confusion. It's the one and the same.  Creative financing and a few (very few) corporate heads rolling does not a completely different company make. Good try.

I suspect in the future we will see New FORBA and NEW NEW FORBA side by side in court just as we have Old FORBA and New FORBA today.

A dead fish by any other name still stinks.

PS. there is issue with jury being "stalked" so verdict is not set in stone.

Saturday, October 12, 2013

AIG Operative Stalks Jurors in 1st Small Smiles Dental Center Malpractice Case

Remember when the American taxpayers (you) bailed out American International Group (AIG) to the tune of $185 BILLION dollars in 2008?  AIG Bailout[1]Remember the company’s offices were converged upon by angry Americans.  So much so, that in typical bully fashion they actually took the name off headquarters in New York City in order to “hide” their location.  .

The latest victim of AIG’s bullying is an 11 year old boy in Syracuse, New York and the jurors who were to decide how much this child should be compensated for their policy holders misdeeds. 

There were 30 trials on schedule in New York by former patients of Small Smiles Dental Centers.  Many of these patients were 2, 3 and 4 years old when they victims of the clinics formerly located in Syracuse, Albany and Rochester.  There is much information about Small Smiles Dental Centers and their so called “management company” on the web and this blog, so I’m not going to bore anyone with more of that.

The first of the 30 trials finally made it to a jury October 7, 2013.  The complaint was filed in April of 2011 against, Edward DeRose, Michael DeRose, Dan DeRose, William Mueller, Adolph Padula, Michael Roumph, Dr. Naveed Aman, Dr. Koury Bonds, Dr. Yaqoob Khan and more, plus a host of dummy corporations set up to hide the true ownership of the clinics and make it difficult to track the hundreds of millions of dollars in fraudulently obtained Medicaid money they pocketed.

After trying to bury two judges and the attorneys representing the little boy—now 11 years old—in mountains (and I do mean mountains) of ridiculous pleadings, testimony finally began September 23, 2013 in Syracuse. 

The trial lasted for 2 1/2 weeks.  You can read all the transcripts here. I urge you to take time to read them.  It’s more entertaining than anything on television this fall and better read than any book on The Times Best Seller list since 50 Shades of Grey—however I do think the transcripts and the book could carry the same title.  There was a lot of shadiness happening in that courthouse and the testimony from the accused had more twists of the truth than a pretzel factory and there were so many bodies being thrown under the bus, the courtroom could have doubled for a Greyhound bus station.

Friday, October 11, 2013

Texas stepping up its game to recover stolen funds from Medicaid fraudsters


On Dental Claims, State’s Bark Worse Than Its Bite

by Becca Aaronson

Texas WeeklyOctober 15, 2013

Texans discovered nearly two years ago that the state was spending more on orthodontic claims in its Medicaid program than the other 49 states combined, but recovery of millions in purportedly misspent Medicaid money has moved slowly.

After a couple judicial setbacks, the Health and Human Services Commission’s Office of Inspector General has stepped up its game by bringing in the big guns at the attorney general's office and private counsel. The OIG also hired a chief dental director, Dr. Linda Altenhoff, and is making sure that multiple dental experts review cases before they’re brought to a judge. The outcome of those efforts will be apparent when an administrative judge rules on a case testing the state's evidence for withholding payments to Antoine Dental Center in Houston, which was argued in May.

Meanwhile, the accused Medicaid providers have made it clear they aren’t returning any money — or allowing the state to sully their reputations — without a fight. They’ve formed a coalition, Texas Dentists for Medicaid Reform, and filed a lawsuit against the state challenging the OIG’s hardball tactics of withholding Medicaid payments for months on end during fraud investigations with limited evidence that fraud occurred.

[We can’t forget about Texas Dentists for Medicaid Fraud.  See links at end of this blog post.]

After WFAA-TV in Dallas reported in December 2011 that Texas spent more on braces and Medicaid orthodontic claims between 2008 and 2010 than the other 49 states combined, the U.S. House Committee on Oversight and Government Reform released a report that found the Texas Medicaid and Healthcare Partnership, the company contracted by the state to process Medicaid claims, had only one dentist on staff and essentially rubber-stamped dental and orthodontia claims without reviewing whether those services were medically necessary.

Thursday, October 10, 2013

Dentist, Gary Anusavice sentenced to 8 years in prison for Medicaid Fraud

 

CBS Conn

Prison time for a Connecticut dentist who swindled millions from the federal Medicaid program.

Gary Anusavice, 60, used recruiters, to seek poor patients who used Medicaid. Then he would perform unnecessary dental procedures and file fraudulent Medicaid claims that added up to $20 million, $3.3 million he collected for himself from 2008 through 2012.

Anusavice is now sentenced to eight years in prison and has been ordered to pay $10 million in fines, give up his luxurious Rhode Island home, a boat, his Mercedes, and about $90,000 in cash found at his home.

He operated a network of clinics where the fraud went on in the central, southern and western parts of Connecticut.


thecourant

Dentist In Massive Medicaid Fraud Case Sentenced To 8 Years

By EDMUND H. MAHONY, emahony@courant.com The Hartford Courant
9:32 p.m. EDT, October 9, 2013

HARTFORD — A dentist barred from practicing elsewhere in New England was sentenced Wednesday to eight years in prison for operating assembly line-style clinics in Connecticut that targeted poor patients, performed unnecessary dental procedures and collected on more than $20 million in fraudulent claims from Medicaid.

Gary Anusavice, 60, operated networks of clinics in the south, central and western parts of the state from 2008 to 2012 and personally collected more than $3.3 million from the fraud.

Under a variety of settlements with the state and federal governments, Anusavice will pay more than $10 million in fines and restitution, in addition to giving the government his 8,000-square-foot home in Rhode Island, his boat, his Mercedes-Benz and about $90,000 in cash that investigators found in the home.


Anusavice opened clinics in areas where high concentrations of low-income people relied on the federal government's Medicaid program for medical treatment. Medicaid, which is administered in Connecticut by the state Department of Social Services, reimburses physicians for costs they incur while treating patients who are unable to pay.

Monday, October 07, 2013

Fortress Insurance Company v. Ocean Dental PC, Dr. Chad Hoecker and Dr. Robin Lockwood

Case Number:
5:2013cv00322

Filed:
May 2013

Fortress Ins. v. Ocean Dental, Chad Hoecker, Robin Lockwood Amended Complaint  Filed August 23, 2013

Fortress alleges neither Dr.Lockwood, Dr.Hoecker, nor Ocean Dental complied w/ requests for patient records, as their MP insurance carrier, against terms of their contract. They allegedly never alerted Fortress of pending claims, as required under the insurance contract. IMHO- Fortress makes a good point for Declaratory Judgment. That would leave Dr.Lockwood & Ocean Dental "naked", w/out Malpractice coverage.  Yikes!

Dr Lockwood is currently serving time at Federal Medical Center Carswell, in Fort Worth, TX. http://en.wikipedia.org/wiki/Federal_Medical_Center,_Carswell

One big issue is the policy time period for Dr.Lockwood & Dr. Hoecker. Some acts were allegedly made outside the time period of insurance coverage. If so, Dr. Lockwood & Dr. Hoecker were operating "bare" (w/out coverage). Depending on terms of employment w/ Ocean Dental, Dr. Lockwood has a potential counterclaim against Ocean Dental, if they neglected to provide MP insurance coverage to her, as defined under her employment contract.

Dr. Hoecker denies knowledge of the terms in the Dr.Lockwood policy. If Ocean Dental purchased this policy, that would be absurd. BTW- a "claims made" policy will not cover for acts filed AFTER the term period of the policy expires. Thus, a "tail" policy would need to be purchased. Obviously, there was no tail coverage purchased.

Seem just serving time for ones sins is just the beginning of a long life of misery for Dr. Lockwood, while ole Chad Hoecker is singing “Free Bird”. 

I hope all these dentists are paying close attention!

Here is a link to all the documents found on the case-

http://www.scribd.com/collections/4366323/Ocean-Dental-Stilwater-Oklaho