http://therolladailynews.com/article/20130131/NEWS/130139669/-1/opinion
Attorney General Chris Koster said today that his office has awarded $8,239 to a Medicaid fraud whistleblower who alerted the state to fraudulent billings by a group of dental clinics. The award money is 10 percent of $82,000 that the dental provider is paying in restitution and penalties to the state of Missouri, as allowed by Missouri law.
“Medicaid fraud tips are an important part of our efforts to investigate and punish Medicaid fraud,” Koster said. “We encourage anyone who suspects a health care provider is engaged in Medicaid fraud to contact our office so we can investigate.”
Koster said the whistleblower contacted his office in January 2011 with concerns about Ozark Family Dentistry, and the clinics’ owner, Dr. Arrash Ahmadnia. Dr. Ahmadnia, based in Rolla, owns dental clinics in Rolla, Thayer, Osceola and Springfield.
The whistleblower, who worked briefly at one of the clinics, alerted the Attorney General’s Office that Dr. Ahmadnia had instructed him to perform unnecessary work on patients, presumably to bill the costs to Missouri Medicaid. The Attorney General’s investigation found that the clinics had billed Medicaid for treatments under the code for dental fillings, but had actually performed different procedures – preventative resin restorations – which are not covered by Medicaid. The investigation also found some instances of double billing and billing for ineligible adults.
Under a settlement, Dr. Ahmadnia is required to pay more than $208,000 in restitution and penalties to the state and federal Medicaid programs. He is also required to immediately stop submitting reimbursement claims to Medicaid for the preventive resin restoration treatments. The agreement is a compromise of disputed claims and does not contain an admission of wrongdoing by Dr. Ahmadnia. The Attorney General’s Office is continuing to review billing procedures at the clinics.
Thursday, January 31, 2013
Tuesday, January 29, 2013
Trueblood Dentistry and their string of Carousel chops shops finally forced to close!
In all the raw data I’ve seen out of Texas, this one would nearly always fall in the top 5. This one alone is said to have stolen $18 million from taxpayers. Just imagine the hundreds and hundreds of millions, if not billions stolen from scam dentists and dental companies in the state of Texas! Perp walk please!!
I’m sure the “pity” party has begun.
American-Statesman Staff
Carousel Pediatrics began shutting down its Austin dental practice Tuesday night, displacing about 28,000 low-income pediatric patients, after state health investigators cut off Medicaid payments over allegations of fraudulent activity.
Carousel’s owner, Dr. Glenn Wood, who disputed the fraud allegations, said the loss of about $400,000 a month in Medicaid payments required him to shut down his dental affiliate, Trueblood Dental Associates, and lay off about 40 staff members and six dentists.
Friday, January 25, 2013
Two reports on poor quality of care by dentists claiming expertise in implants
A story by the Bakersfield Californian, reports the California Dental Board has filed a complaint against Dr. Robert Tupac, DDs to the state’s department of consumer affairs.
Dr. Tupac reportedly told one patient “not to worry about a thing, I wrote the book on (dental) implants,"
The report says, the complaint was issued by the state Attorney General raises numerous issues that should result in his licenses being revoked or suspended: for discipline" against Tupac, including gross negligence, altering patient records, aiding and abetting an unlicensed person to practice dentistry, incompetence and obtaining fees by fraud. The document requests that the Dental Board revoke or suspend his license and pay restitution.
According to the report, his dental licenses remain squeaky clean, despite his own professional regulatory board having multiple complaints against him on file AND have filed their own complaint to the California Department of Consumer Affairs!!
“The Dental Board issued Tupac's dental license in 1974. The board's website does not show any previous disciplinary actions against him.”
In a report on KGET-TV’s website it says “The California Dental Board wants to suspend or revoke the license of…” Well, then why don’t they??
Newspaper report: Bakersfield dentist accused of incompetence, negligence
California AG Marc Greenbaum’s complaint filed against Robert George Tupac, DDS
Dr. Li Skelton
This situation with Dr. Tupac sounds much like a situation with an implant dentist in Texas who says their office “specializes” in dental implants – Dr. Li Skelton. Heck her new clinic even promotes tourism dentistry, just to see her.
Missouri’s Medicaid Fraud Control Unit reclaims $’s from Comfort Dental
January 25, 2013
Today’s Medicaid Fraud Recover story is from Missouri, where Attorney General Chris Koster has announced a $50M recovery by Missouri’s Medicaid Fraud Control Unit.
Of course crowing about the recovery and actually recovering the money are two completely different things. Personally, I read it as “We found $50M we were snookered out of and have they con artists an invoice.”
Of interest to me was this part of the statement:
- Comfort Dental (3 cases): Comfort Dental – a franchise dental chain based in Colorado with offices in the Kansas City area – billed Medicaid for services provided to individuals who were not eligible for Medicaid, resulting in a total loss to Medicaid of more than $17,000. Additionally, the Attorney General’s investigation revealed that each clinic double-billed services to Medicaid, resulting in a loss of more than $4,200, and also charged Medicaid recipients for services paid for by the program.
In three separate settlements, the entities paid $66,265.22 to resolve claims of both the Medicaid Fraud Control Unit and the Consumer Protection Division. The Consumer Protection Division sent checks totaling $6,265.22 to those Missouri citizens who were improperly billed for Medicaid covered services.
Thursday, January 24, 2013
Joseph Bernat, DDS now associated with two dental organization nailed for Medicaid fraud.
New York Attorney General, Eric Schneiderman released a statement this week saying the state had recovered $335M in Medicaid that has been fraudulently obtained in 2012.
The part I found interesting was the dental, of course. Media outlets are reporting $1.6 million recovered from Kaleida Health’s – Buffalo Women’s and Children's Hospital Dental Clinic.
From WGRZ:
The state also recovered $1.6 million for excess Medicaid payments on claims for dental services provided by Kaleida Health through the Buffalo Women's & Children's Hospital Dental Clinic.
“Kaleida” and “Buffalo” rang a bell. Then I did some checking, and low and behold there it was: Dr. Joseph Bernat, DDS – Chair and Program Director of Women and Children’s Hospital of Buffalo.
Amazingly, Dr. Joseph Bernat, DDS — who is was so highly respected; who supposedly carries such influence — now has two organization nailed for Medicaid Fraud under his belt: Small Smiles Dental Centers in 2010 and Women and Children’s Hospital of Buffalo in 2012.
Way To Go, Dr. Bernat!!
Kool Smiles–NCDR, LLC still mistreating children according to parents complaints
Kool Smiles continues its dirty practices and children still suffer the previous trauma this company brought to millions of children over the last 9 years according to posts over on Topix.
NINE YEARS!!!
That’s a long time for authorities and dental boards to allow this. How can any of them explain their lack of action? I have to assume they think it’s OK. What a screw up way of thinking!
Wednesday January 23, 2013 - Be very leery about fraudulent diagnosis from this office. This facility is only interested in taking advantage of low-income families who have access to Hoosier HeathWise and/or Medicaid ... preying on the fact that most of these parents will not question any diagnosis given; ultimately, this facility is billing the government for services NOT needed.
My personal experience:
First of all, parents are not allowed in the back (a BIG red flag), nor shown x-rays, nor consulted in any way. Took my son to this dentist and was "told" that he had FIVE cavities (mind you, I was never shown his x-rays). The office tried to keep us there to do the fillings right then and there. I had an extremely uneasy feeling; therefore, I declined, and stated that I would schedule another time.
We have since consulted another pediatric dentist. Imagine my surprise being told that my son had NO cavities. None. Zero. Zilch. In fact, they told me that he had done an exceptional job keeping his teeth clean and healthy.
My recommendation: Do NOT give your business to a fraudulent business such as Kool Smiles in Terre Haute. Any facility taking advantage of low-income families and the Indiana state government should be audited and shut down for fraudulent business practices.
Tuesday January 15, 2013 - My daughter went to Kool Smiles when she was four for fillings. They put her in a straight jacket and she screamed until her nose bled.
Tuesday, January 22, 2013
Dr. Kristi Ayn Liebau-Grassi doesn’t want to go to jail.
Remember the Erie, Pennsylvania dentist who headed to Texas for a more lucrative position with Pacific Dental d/b/a Modern Dental? Well, she’s not wanting to go to jail. Didn’t work very well for Robin Lockwood in Oklahoma, however Lockwood’s dental license still appears squeaky clean! Amazing!
Published: January 22, 2013 12:01 AM EST
Updated: January 22, 2013 1:38 AM EST
Former Erie dentist seeks to avoid prison term
By LISA THOMPSON, Erie Times-News
lisa.thompson@timesnews.com
A former area dentist who pleaded guilty to defrauding Medicaid is hoping a judge will spare her a term in federal prison so she can better care for her family.
Federal sentencing guidelines recommend a prison sentence of a year to 18 months for the dentist, Kristi Ayn Liebau-Grassi, who admitted in September that she repeatedly billed the government for dental work that was unnecessary or never provided.
Her lawyer, however, is hoping to convince a judge to give her a lighter sentence because of her clean prior record, her family's needs and she accepted responsibility.
"The defendant is a loving and devoted parent whose maternal responsibilities may be greater than almost anyone who has stood for sentencing before this Court," the lawyer, David Ridge, wrote in a sentencing memorandum filed in U.S. District Court in Erie.
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.
Saturday, January 19, 2013
February “Children’s Dental Health Month”– Parents and School Personnel Beware!
It’s almost that time of year again; February “Children’s Dental Health Month” or as I’ve come to call it “Chop Shop Victim Month”. Like so many things, what started out with good intentions became a way for the crooks and unsavory dental mills to increase patient volume. I suspect with their business model taking such a financial hit this past year, patient shopping is high on their list of priorities.
Here’s how it works.
Schools and daycares in low income areas are called by the dental mill and asked if they would like to have a free dental screening day. All it is, a dental assistant doing a quick visual in each child’s mouth, no instruments used.