Tuesday, August 21, 2012

Medicaid Fraudster’s “WaterPik Park” being installed

I loved Candy’s name for the Malouf Waterpark going in at 10711 Strait Lane, in Dallas, Texas. Candy, help yourself to anything ya like here at the blog…

Tuesday, August 21, 2012

Dentist charged with fraud is getting water park installed in backyard

waterpickpark1

by Candy Evans of Candy's Dirt

DALLAS — "Texas Drills Down on Medicaid Dental Fraud” (subscription required) was the headline from the Wall Street Journal. What do they mean by that? Why, maybe a blast from the past biz practices of people like Richard Malouf who is putting in a water park that one reader thinks we ought to christen “WaterPik Park” over on Strait Lane. His gates were wide open on Sunday as trucks heaved in the equipment, which is now sitting right in the front yard of what was once 10711 Strait Lane.

That is, as you know, the Family Sports World.

If any of you were as surprised as I was over this Medicaid deal — I mean, I know what Medicaid reimburses physicians for medical care and it is barely enough to cover the exam table paper in the office — it seems as though the problem stemmed from a 2007 civil lawsuit (that really started in 1993) that made the state increase reimbursement rates for Medicaid dental services:

Photo, taken 2012-08-21 15:15:25

“The suit, a federal class action filed by parents in 1993 against state officials, alleged Texas was failing in its duty to ensure that children on Medicaid received proper preventative care in dental and other areas. Eligibility for Children’s Medicaid in Texas is pegged to income. In 2007, Texas legislators agreed to settle, conceding that there was a dwindling number of doctors and dentists in the state willing to treat Medicaid patients and agreeing to increase Medicaid-reimbursement rates. A 2012 report by the House Committee on Oversight and Government Reform offered case studies in various states of supposed Medicaid abuse; it cited dental services in Texas as a particular problem area. By 2010, according to the report, Texas’ Medicaid program was spending more on braces than the other 49 state Medicaid programs spent combined on such orthotics.“

This is just what Byron Harris reported, and I wonder why the WSJ doesn’t mention his report. It has also, like always, resulted in the loss of services for kiddos who really need it: All Smiles Dental Professionals P.C., has shuttered 13 orthodontic offices in the Dallas area because of the investigation, leaving an estimated 12,000 Medicaid-eligible patients without care.

But hey, WaterPik Park is coming! Look at those slides just waiting to be installed! It’s only 6.5 million gallons of water, and Texas sure has plenty of that … right?

Monday, August 20, 2012

All Smiles Dental Center’s Motion for Bonus Payments Revealed

Transparent as it was, on May 25, 2012, All Smiles Dental petitioned the court to allow for a Management Incentive Bonuses to be paid during bankruptcy procedures. [shaking head]

First they tried to establish the separation of the Professional Corporation and the plain ole Corporation, and the Debtors. Kind of like “church and state” but better. Keep the chart below handy as you follow along.

Debtors – All Smiles Dental Center, Inc. and AS Property Holdings, LLC
Inc. – All Smiles Dental Center, Inc.
PC – All Smiles Dental Professionals, P.C.

 

Inc, and PC believe that PC must exit the orthodontic practice in an expedited manner”. Inc will help PC do this in a manner consistent with the State Board of Dental Examiners rules. [Doc. 90, paragraph 6]

Debtors are asking that 8 “Key Employees” who are “vital” to the ongoing operations in assisting the PC’s exit the orthodontic business be given a bonus for their outstanding work, just in case they provide some. They argue, since other employees have quit or been fired, these “Great 8” have “asked” to take up the slack.

Debtors claim these 8 have been “efficient in the administration of the Debtor’s estate” and present that any reorganization of the company could not happen without them.

To reward these 8 outstanding people, Neil Minihane, (acting president) devised a “Management Incentive Bonus Plan, at Inc. to reward them for their efforts based on “specifically identifiable milestones”, up to $180,250.00, with installments up to $90,125.00. – [Doc. 90, paragraph 10]

Mr. Minihane believes PC cannot exit the fraudulent [they didn’t say they were fraudulent, of course, I did] orthodontics services without this bonus plan and paying the “Great 8” the proposed bonus is “necessary, reasonable and in the best interest of the Debtor’s estate.”

The plan is to make two payments to the “Great 8”. The first one is when Inc. converts PC over to strictly “general dentistry”. [Stainless Steel Crown manufacturers, gear up!] The payments will be at the discretion of Inc. 

Yes, I think we are understanding this correctly – Inc (debtor) wants to reward Inc (itself) with a bonus, since Inc (itself) has to follow Dental Board rules closing its “fraud” department (orthodontics).

Here is exactly what it says in Doc.90, paragraph 8 :

The Management Incentive Bonus Plan consists of two bonus payments. At the discretion of the Debtors' management, the first bonus payment will be payable upon the Debtors' successful management of PC's exit from orthodontic services. This is a key element to PC being able to shift its practice area to solely general dentistry, and hence, to the Debtors' reorganization into a company only supporting a general dentistry practice. The Debtors, with the critical assistance of the Key Employees, are currently working toward this goal. This includes labor-intensive tasks such as providing staff, record access, and logistics related to the orthodontists' preparation of letters to patients advising of termination of treatment or managing the SBDE professional dismissal process while managing the customer services issues with orthodontic patients and their families. Without the assistance of the Key Employees, PC would not be able to timely and professionally exit the orthodontic practice, resulting in significant additional costs to PC and the Debtors' estates arising from lack of organization and profitability in the orthodontic business at PC.

The second payout Inc wants to pay itself for work it already does, would take place when they Inc. exits the bankruptcy. They say, when PC stops its fraud (orthodontics) practices, the “Great 8” will still be “required in order to complete the myriad of tasks associated with the successful restructuring of PC as a general dentistry practice”. They further stated the Debtors believe they have demonstrated sound business judgment in this process and should be granted their motion for bonuses. [Doc 90, paragraph 20]

The motion stated, Inc will continue to do as it did before they filed bankruptcy – manage PC. By management of PC, Inc listed “properly restructuring the general dentistry practice, along with negotiating and managing the implementation of the Corporate Integrity Agreement contemplated in the State Settlement Agreement.”

Here is exactly what is said in Doc 90, paragraph 9:

At the discretion of the Debtors' management, the second bonus payment will be payable upon the Debtors' successful exit from bankruptcy, as evidenced by this Court's confirmation of a plan of reorganization. After the Debtors facilitate PC's exit from the orthodontic practice, the services of the Key Employees will continue to be required in order to complete the myriad of tasks associated with the successful restructuring of PC as a general dentistry practice managed by Inc. These services include, but are not limited to, removing Inc. personal property, turning over the facilities to the respective landlords, reorganizing the management operations to support the different PC needs, record relocation and organization, identifying and installing processes and procedures associated with the State Settlement Agreement Requirements,4 identifying the executory contracts and leases to be assumed or rejected by the Debtors, developing financial projections, identifying the amount of exit financing necessary, working through the myriad of patient and employee uncertainty issues associated with the bankruptcy process and answering general questions associated with the plan and with the Debtors' business.

The “Great 8” employees of Inc. are:
John Bevill – Operations Director – West (Former District Manger at Kool Smiles)
Esther Castaneda – HR Manager
John Garry – Controller – (Previous with Lending.com – online mortgage broker)
Spring Helser – Doctor Recruiter – (used to work at CVS)
Diana Loft – Facilities Director – (PlainsCapital Bank, now at Chem-Aqua, left AS 7-2012 after 5 years of employment.
Michael Lozich – Chief Compliance Officer – LinkedIn page says he’s at Broadlane, Inc. since 2009, must need updating, here is press release he issued for All Smiles July 27, 2012)
John Morgan – VP of Information Technology – (Formerly Cano Petroleum, started AS in Aug. 2010)
Lisa Mullinix – Operations Director – East – (Former Regional Manager at Small Smiles)

Specifically the Motion told the court that the “…specific amount of the…payment each…will be eligible to receive will be based upon percentage of the …salary ranging from 15% to 25%.” They motioned for the details of the “Great 8” salaries and detail of the Management Incentive Bonus Plan be placed under seal by the court.

They further stated that, “seven of the Key Employees received offer letters upon the commencement of their employment proposing bonus payments consistent with this percentage of their salary. The remaining Key Employee did not receive such an offer letter. This Key Employee will be eligible to be paid a bonus at the low end of the percentage range.”

In other words, these employee were told they would receive bonuses when we hired them, and we still want to hand out bonuses, capeesh, Mr. Judge?

It was a great attempt to extort more money from the bank accounts of All Smiles Dental. However, 11 days later, On June 5, 2012, Inc. withdrew the Motion on June 5, 2012.

Imagine the danger All Smiles currently poses. Regional directors who were given lots of power and leeway from the top two Medicaid dental mills all under the Malouf roof! Shakes me to the core.

Lisa Mullinix was a Regional Director of Operations for Small Smiles Dental Centers. She is the person who came up with the “scripts” distributed to employees to stop parent from accompanying children back into the operatory.

Much more to come on Ms. Mullininx. Stay tuned.

Related:

All Smiles Dental - Motion to Implement Bonus Program for Staff During Bankruptcy Doc 90

Lisa Mullinix's script for office employees

Director and Chair of Oral and Maxillofacial Surgery at USC School of Dentistry and LA County/USC Medical Center under investigation over death of patient

I'm not trying to get into the politics between oral surgeons and dental anesthesiologists, but what I don't understand is if the dental anesthesiologists want stricter guidelines and they are not asking for it to be mandatory for an office to use a dental anesthesiologists, I don't see what’s the big deal.

I know that the problem mostly involves general dentists trying to play DA by upping dosages - clearly these are the people killing folks, but what harm can come from MORE SAFE PRACTICES?

Are Oral Surgeons afraid their pockets won't stay as fat! Sorry people, someone's life is a wee bit more important than getting rich, especially when you're going to loose all that dough eventfully when you kill someone like this dick weed.

California Dental Board Investigation - Dennis-Duke Yamashita

Anyone want to bet the only sanctions taken will be for record keeping?

Sunday, August 19, 2012

Who is Legally Liable in Texas’s Dental Drama?

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

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

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

NCDR, LLC–Kool Smiles looking to infect adult dental care in Texas-Under the name Resolution Dental

Kool Smiles and NCDR, LLC are venturing over into adult care in Odessa, Texas – buyer beware! Operating under the name Resolution Dental, they are seeking applicants and offering a $25k sign on bonus. Here is the job posting.
While the brakes were put on to the grand openings of their newest Medicaid mills in Texas, its full steam ahead for at least one Resolution Dental office.
They don’t want applicants to know who they are really going to be employed by as Paul has set up an innocuous email address -resolutiondentalhr@gmail.com
Most of the job have you contact Paul Court at 925-407-5383. Paul is a dentist recruiter for NCDR, LLC
Ncdr, L.L.C.
1575 Northside Drive Building 400
Atlanta, Georgia 30318
United States
www.ncdrllc.com
According to Zoom Info, Paul’s past employment consists of:
Employment History



  • Financial Services Manager Robert Half International Inc
  • Branch Manager Accountemps
  • Manager, Dental Staffing Kool Smiles P.C
  • General Manager U.S. Department of Education
  • Friday, August 17, 2012

    Police looking into kidnapping of children by All About Dentistry - Dallas Texas!

    Thanks to a reader !

    Police investigate Medicaid 'recruitment' claims

    Updated 1:52 p.m., Friday, August 17, 2012

    Read more: http://www.sfgate.com/news/article/Police-investigate-Medicaid-recruitment-claims-3796303.php#ixzz23rExCRX2

     

    DALLAS (AP) — Police in Dallas are investigating allegations that children are being offered cash and gifts to come in for dental work funded by Medicaid.

    The allegations reported by Dallas television station WFAA include claims from children and parents that they were "recruited" by dental practices. One teenager told the television station for its Thursday broadcast that she was paid $10 to be driven to a clinic, All About Dentistry in southeast Dallas, where she had seven fillings.

    Afterward, the receptionist asked Keke Gray about her parents.

    "(The receptionist) said, 'You don't have those kind of parents who would come up here and complain or anything like that, right?'" said Gray, 17.

    Federal law prohibits the solicitation of Medicaid patients. Stephanie Goodman, spokeswoman for the Texas Health and Human Services Commission, said federal regulations are intended to allow Medicaid providers and other doctors to compete on equal footing.

    Dallas Police spokesman Lt. Scott Walton said police were looking into the reports.

    "The circumstances of these incidents are being investigated to determine what criminal offense occurred," he said. "Once this determination is made, appropriate action will be taken."

    Messages were left Friday by The Associated Press for the owner of All About Dentistry, Dr. Hamid Farahani, at two of his offices.

    Farahani told WFAA that he uses unmarked vans to bring children from southeast Dallas neighborhoods to his clinics. Others who have previously spoken to the station have said they were aware of cash, gift cards and meals being offered for new patients.

    One woman was recorded on tape being stopped by a van from Access Dental with her kids by her side.

    "Today he offered me a free pizza dinner," Juanita Bonner said.

    The Texas Attorney General's office did not immediately respond to questions about whether it is investigating. Alper Ozinal, a spokesman for the federal Health and Human Services Department, said in a statement that it had seen several instances of improper Medicaid billing.

    "We are working with states to fight any potential fraud — including working with states to audit dental providers, referring potential fraud to law enforcement, educating dental providers on proper billing, and more closely managing the billing processes around dental products," Ozinal said in a statement.

    Read more: http://www.sfgate.com/news/article/Police-investigate-Medicaid-recruitment-claims-3796303.php#ixzz23rF2uz4P

    Kool Smiles–NCDR, LLC cuts this week–No more “recruiting” efforts

    Kool Smiles cutting spending. Besides a halt to all new clinic openings/construction in Texas, this week, now more cuts – see below.
    Dear NCDR and Kool Smiles colleagues:
    Our CRS program (which includes CRS’s, CSM’s and CE’s) has played a very important role in building Kool Smiles over the years, and is an important part of our culture. Our CRS colleagues have helped create a dental home for thousands of patients. Unlike many of our competitors, our CRS's have played by the rules, and we appreciate it. 
    However, regulations and other scrutiny of CRS programs are increasing rapidly: CRS programs are now prohibited or severely restricted in states with nearly half our offices. CRS programs are also under rapidly increasing pressure from muckraking journalists, as well as trial attorneys making bogus claims against us. We expect this scrutiny of CRS programs to expand to other states, as well, and it helps make Kool Smiles an easy target for very damaging attacks on the company, as we've seen in Texas, even though we are "the good guys" in the industry.
    So, unfortunately, we've had to make the difficult decision to eliminate the CRS program, effective September 14, with the exception of the four CSM’s in Texas, where we have important ongoing government relations initiatives. CRS's, CSM’s and CE’s will receive a severance package based on years of service, and will have 30 days of transition time.
    During the next 30 days, CRS's will transfer their most important local relationships to local OMs. We will generate leads with increased use of efficient traditional and new media. We will also continue to educate our patients through media, social media and local public relations programs, and we are establishing a small local community relations fund for each office. We will provide more details on this over the next couple of weeks.
    The CRS program, and the contributions our CRS's have made to the company, are integral parts of our culture, and this is a painful decision, but one that we need to make to help ensure the health and continued growth of the company going forward.  I know this is difficult for everyone involved, but I ask you to help make the transition happen professionally, and to remain focused on providing great care to our patients, every day.
    Thank you,
    Jeff Lane
    President
    NCDR LLC







     
    CRS = Community Relations Specialist. They drum up new business, basically. They are not anywhere near as aggressive as the 'recruiters' for some other corporate dental chains and they certainly aren't kidnapping kids, but they do go to schools, daycares, etc.
    CE = Community Educator. Similar role, but they do more education-oriented stuff like teaching kids about proper dental care...with the motive of getting them to come in to a KS office.
    CSM = Community Smile Maker - Basically a CRS by another name.
    I think this could be happening, in part, because of the “recruiting-kidnapping” that a few notable dental clinics in Texas are partaking in these days.



    Dr. Ralph Green of ReachOut Healthcare America into stem cells? It appears so.

    ralphGreen ImageBW

    Website
    www.StemSave.com

    Dr. Ralph Green, DDS, of Reachout Healthcare America is into stem cells these days. 

    StemSave.com lists Dr. Green as part of the Business Advisory Council. This is scary to me. What is scarier, is how the following individuals hooked up and what is their real plan? Research grants?

    As part of the management team, along with Dr. Ralph Green are co-founders of Stemsave -  Arthur E. Greco and Dr. Gregory Chotkowski, DMD

    Dr. Ralph Green is up to his eyeballs in corruption at ReachOut Healthcare America, so when you see him involved in something, one automatically assumes if it’s not a scam now, it soon will be.

    StemSave Business Advisory Council:

    Dr. Ralph Green, DDS, MBA - has enjoyed an extensive and distinguished career in dentistry and business. Dr. Green received his Doctorate in Dental Surgery from the University of Iowa and his MBA from Boston University. In addition to establishing a private dental practice, Dr. Green was a faculty member of Tufts University’s Dental School as well as the Forsyth School of Dental Hygiene and currently serves as a trustee of The Forsyth Institute in Boston, MA. Dr. Green has conducted extensive research in the areas of bone growth, Implants, resins, tissue engineering and oncology. As a result of his research Dr. Green has developed and holds several patents and has successfully stewarded several devices through the FDA registration process.

    In addition to his extensive experience in dentistry and research, Dr. Green has a long and successful career in business. In addition to maintaining an active private practice; Ralph Green DDS PC, Dr. Green is also the Vice President of Clinical Affairs for Reachout Healthcare America (RHA) providing healthcare services to the brave men and women serving in our country’s armed forces and serving underserved communities in twenty one states.

    Prior to RHA, Dr. Green has been directly involved in numerous start up and early phase companies. Most prominently, Dr. Green was the founder of Nobel USA, the largest dental Implant company in the world today. Dr. Green invented and patented several advancements to implant technology and founded Technology Corporation of America which he later sold and is now part of BIOGEN.

    More recently Dr. Green served as President of ZILA Pharmaceuticals, a division of ZILA Inc., a publicly traded company in the cancer diagnostic arena where in addition to the USA; Dr. Green successfully registered and launched the products in the United States, Europe, China and numerous other Asian countries. Dr. Green has served as the President-Elect of the Dental Manufacturers of America, the largest organization of dental industry companies. He is a member of the American Dental Association, American Association for Dental Research and the International Associations for Dental Research. He served on the Board of the Oral Health of America and presently has been one of the founders of the Arizona School for Oral Health.

    Phone
    877-783-6728
    E-mail
    Ralph@StemSave.com

    Also listed on the Business Advisory Team are:

    Smiles Brands, Inc. job listing appears to be retail sales position within dental care - disguise as a Patient Service Rep.

    sblogo

     

     

     

    Patient Services Representative (Call Center)

    City: Plano
    State: TX
    Company: Smile Brands Inc.
    REQ ID: 12-0491

    If you have customer service or dental experience, this is a great opportunity for you. We are currently seeking self-motivated , high energy and enthusiastic people to join our growing call center in Plano, TX.

    The primary role of the Inbound Patient Services Representative will be to assist patients who need to complete dental treatment in process and schedule appointments with our dental offices.

    • Assist patients with questions or concerns [treatment advice?]
    • Track calls and appointments in the lead database [huh? leads?]
    • Record, report and maintain patient information as required
    • Achieve assigned individual and team objectives [i.e. you and your team will be required to meet quotas]
    • Provide excellent customer service


    Requirements

    • 1+ years Customer Service experience
    • Dental experience preferred [what about a doctorate of dentistry?]
    • Strong written and verbal communication skills
    • Bi-lingual – Spanish
    • Computer skills MS Office – Word, Excel & Outlook
    • Type 35 words (minimum)
    • College coursework/degree preferred
    • A comprehensive benefits package is offered, which includes: Medical, Vision, Life Insurance and 401K. Equal Opportunity Employer.

    Job posting