Another patient of Dr. Howard S Schneider recalls being restrained

Another patient of Dr. Howard S Schneider recalls being restrained.  Yet some of “experts”  have testified children do not remember. ( I have to wonder if Dr. Schneider went to the Eddie DeRose School of Papoose Board training at some point.)

Howard S. Schneider, DDS, Jacksonville, FL Being Investigated for Medicaid Fraud

 

Dentist investigated for possible Medicaid fraud Embattled Southside pediatric dentist under investigation by state
April 30, 2015

Excerpts:

…Lt. Michael Maloney with the Florida Attorney General's office is in Jacksonville, investigating claims of Medicaid fraud by Dr. Howard Schneider…

…The mother who started the social media campaign against Schneider (pictured) said she decided to post to Facebook what happened to her child in December. Within a few hours of her post, dozens of parents flooded the News4Jax newsroom with calls and emails about Schneider, whose pediatric dental practice is on University Boulevard. Brandi Motley claims her daughter went in to get one tooth fixed but ended up with a mouthful of problems.

…“She's been going to the dentist since she was 2, and she's never had any teeth problems, no decaying no cavities, and now all of a sudden her whole mouth is messed up because of him,” Motley said.

…Motley said she wasn't allowed into the procedure room while Schneider was working on her daughter in December. She said the nurse came into the waiting room three hours later and told her there had been an accident. Motley said the nurse told her to take her child to the emergency room, but she said the story the nurse told her didn't match with the story her daughter told her.

Hear From A Former Patient of Howard S Schneider, DDS, Jacksonville, FL

Imagine the vast number of videos there could be from abused patients who visited Small Smiles and the other dental mills.  I hope Shawn inspires more victims to speak out; maybe even create a Abused At The Dentist Youtube Channel. 

Click the picture below to go to Shawn’s Youtube videos.

Posted April 28, 2015

Just a few of the comments left by parents regarding Dr. Howard S. Schneider of Jacksonville, FL

April 28, 2015

**My two boy's was seeing him and he was very rude to my boy's told them to shut the hell up and that it didn't hurt that bad and he would be really rough with them . And then my son spacer fall out a week later i take him back and he told me that it was going to cost me 112.00 for it . and Both my kids had fill end and all that and even got caps in there mouths . Both my boys told me mom i don't wont to go back to him i told them well he is the olny person who take your ins so we have to see him . But i hope he gets whats coming because this is so wrong how he have don't people kids if he didn't like his job then he shouldn't been working around children .

**that same denist my daughter went because that only denist kids on the southside town of bye my house dont know what street it was butt that man trie he leg up and she was get root crawn and she was mad at him and he call her a bate.... she was 4 year and from that day she was so scare of denist. then denist in sc was so nice and told me she he had no right to tired her leg up and.. noww she not scare of denist any more she 12 year. that man is a jack ass

**he also treat kids that are in wheel chair too that dr was so mean to my daughter and was scare . I hope that dr go to jail.... what he did my child was wrong or any children.

**I took my son there when he was 2 1/2. He had him strapped down and my son screamed the whole time he drilled - he told me it was normal for kids to scream over the drill noise. I always suspected he didn't use anything to numb him. It was a terrible traumatic experience that day. I feel sick to know that I was right - that man needs to go to jail for a long time!!!

**My son was a patient of Dr. Schneider and it was the worst experience ever. my son was 3yrs old getting fill-in, root canals & caps. I couldn't understand why my 3yr old son had such bad dental hygiene especially if it wasn't like that before. Dr. Schneider or his employees don't know how to cater to small children. Instead he do incomplete work and create more problems. He don't care about his patience and is in it for the money. His office over schedule patience which makes your visit an all day process. This office need to be closed down because they are rude, disrespectful, unprofessional and hurt children. I report Dr. Schneider to the police and Medicaid and I'm happy something is finally being done.

**Don't let this so-called "doctor" fool you. He's been at this a very long time. 40 years ago, I was but a child, when my brother and I used to go to him. He was very rough and abusive with us, and if we cried one iota he would slap our faces, and told us to "stop crying." If cried louder, he would choke us. Thank GOD, our father heard us. He pushed through the front nurse, grabbed my brother, and myself right out of the chairs, and we were never brought to him again.

http://www.actionnewsjax.com/news/news/local/action-news-investigates-parents-claim-local-pedia/nk5Hq/

Howard S. Schneider, DDS: 2008 ‘'The child of today is smart, manipulative, and, spoiled”

 

Published in the Southern Society of Pediatric Dentistry Newsletter, August 2008

The Last Word

By Howard S. Schneider, DDS MSD Editor

CHANGE! This election may be remembered as one of the most exciting elections in American history.

Yes! It is time for change. Not only do we need change in our political system, we need change in how we deliver pediatric dentistry. All of us have hung the sign on the door notifying the parent that we are taking the child to the operatory WITHOUT THEM. That was the way it was as long as I can remember. After completing treatment, we brought the happy / or unhappy child out to the parent and discussed procedure and results. And, yes, the parents accepted the comments, made another appointment and case closed. However, changes have slowly been taking place. There is change in the 2008 parents in the philosophy of raising their children; There is change in the child who has a mind of his / her own; change in the laws in treatment of the child / changes in public attitude and their concerns and trust in the professions. All the child has to do is tell the parent “they hurt me.” Then you spend the next hour explaining why you helped him. The child of today is smart, manipulative, and, spoiled. They know how to work the system. Oh yes! The word change in this article is in no way any endorsement of my political preferences. That is one man’s opinion, and,THAT IS THE LAST WORD

No, Dr. Howard S. Schneider, that’s NOT The Last Word!

Another one of those fine dentists who accepts Medicaid! Parents claim Dr. Howard Schneider, a Jacksonville, FL dentist has abused their children and are protesting.

The disturbing story about Dr. Howard Schneider, DDS Jacksonville, Florida is nearly identical to the one about good ole Dr. Edward Dove in California. (Providing dental care under Medicaid shouldn’t mean just any kind of care, for Heaven sake!)  Look at that big brute of a woman, even Dr. Schneider is hiding behind her, imagine her brute force in controlling this poor child!

There are thousands of children who have been treated like this and what is being done; little to nothing. Wonder how much these hotshot attorneys would think their child deserved to be compensated for this type of abuse..? That's a question they are too damn afraid to answer! Bet it would be more than a free cleaning on their next visit!! GRRRRRR!!!

 

Parents claim local pediatric dentist has hurt children

A local pediatric dentist is under fire after multiple parents came forward Tuesday, accusing him of hurting their children while in his care.

Dr. Howard Schneider has been practicing in Jacksonville for 49 years and accepts child patients on Medicaid.

On Tuesday, nearly a dozen people began protesting against Schneider outside his south side office, the result of a Facebook page that was established by parents who advise against his work.
After hours of protests, and his staff’s refusal to answer Action News’ requests for a statement, we found Schneider sitting on the steps of his Riverside home Tuesday evening..

- See more at: http://www.actionnewsjax.com/news/news/local/action-news-investigates-parents-claim-local-pedia/nk5Hq/#sthash.JTkIJauf.dpuf

 

Raw video of parents confronting Dr. Howard Schenider, DDS

People have plenty to say over on Yelp about Dr. Schneider.

Google Reviews on Dr. Schneider

Sign the Petition demanding an investigation of Dr. Howard Schneider.

Contact info:

Howard S. Schneider, D.D.S., P.A.
Address: 1871 University Blvd S, Jacksonville, FL 32216
Phone:(904) 721-2565

Florida Dental Board Search

Dental Practice Office Managers Making Dental Treatment Decisions Should Be Shaking In Their Boots.

The news about the arrest of Valbona Yzeiraj, an office manger at a dental office in Bronx, NY for performing root canals on patients seems to have people in shock and awe; it even landed in the Wall Street Journal today. 

Yzeiraj is charged with assault, reckless endangerment and unauthorized practice as well as a charge of larceny. 

To the public it appears they are shocked, to those of us who have been watching this for years are not. 

Yeah this office manager pulled teeth and performed root canals; allegedly.  But, office managers make dental treatment decision that put patients health at risk every day in the corporate-owned branded dental chains.  I can’t tell you how much evidence there is or how often I’ve heard dentists tell me they feel like they are working for the office manager in the branded clinic they mistakenly decided to practice their profession.

Heck, why aren’t the corporate heads who are sitting in their plush offices and flying around in their corporate (and privately owned) jets getting arrested for the same?  They make treatment decision endangering patients as well; many with severely more negative outcomes. 

Aspen Dental Business Practices Remain Under Fire

Below is a story I received yesterday about Aspen Dental. The relator asked to remain anonymous, I understand why.

I read your recent post regarding Aspen dental. What happened to that patient you most recently wrote about happens all the time. As a former employee of Aspen Dental I know firsthand that if we see a mistake made by a dentist we are to keep her mouth shut. If we speak up or God forbid inform the patient of a mistake we are terminated. We are not allowed to question a doctors treatment plans. It is very frustrating especially when you have over 10 years experience in the dental field and you know beyond a shadow of a doubt the treatment is incorrect. I have watched doctors pull the wrong teeth, leave root tips and charge the patient for an extraction, sell them prosthetic devices they don't need and illegally bill them. When a doctor is caught pulling the wrong teeth, the document is falsified saying the remaining teeth were found to be periodontally involved and we extracted them for free for you, then the patient is tricked into signing it.

 

New York Class Action Against Aspen Dental Dismissed?

Patients who have had their lives turned upside down due to shoddy dental work by Aspen Dental dentists appear to have been shut down in pursuing their case against this nasty company.

I read this to mean, the court agrees Aspen Dental is operating dental clinics illegally; that the Attorney General should/could pursue them and has the power to dissolve their phony business entity; and there was a breakdown of some sort in procedure for patients to further state their claims.

But none of this by any means says Aspen Dental is innocent of malpractice, and in my opinion should be avoided by the public at all costs. As so is that the opinion of a recent patient. (see below).

If you read anything further into it, please post in the comments, as it may help patients and future employees of the pace.

 

Doc 78 - Aspen Dental Motion to Dismiss Decision and Order - Cause No.v3:12-cv-1565 US District Court Syrac...

Related:

Aspen Dental Amended Complaint filed Jan 18, 2013

Aspen Dental Letter to Sen. Grassley, Feb 13, 2012

Aspen Dental Letter to Sen. Grassley, April 18, 2012

Letter to Aspen Dental from Sen. Grassley, June 14, 2012

FRONTLINE – Dollars and Dentists, June 26, 2012

Transcript of Dollars and Dentists

In another related Aspen Dental issue, just today I received a complaint from a patient who just recently saw Dr. Ajayi at an Evansville, Indiana Aspen Dental Clinic.

Email dated: April 15, 2015

I was recently in as a patient on the Aspen Dental West side of Evansville Indiana location and overheard the most sickening conversation of my life.  I was a little skeptical of the place due to horrible reviews all over the internet, but unfortunately I am one of those victims who's employer changed dental insurances and Aspen Dental was the only one in network so I had to do what I had to do. On my first visit I grew quite fond of the Dental Assistants,.  I could sense they had much experience and were very knowledgeable.  They appeared to not have any liking towards their doctor.

When I was back in for a crown prep, Dr. Ajayi was in such a hurry that he kept jerking my head back and forth yelling "turn to me!" when I was trying my best.  He about drowned me with water and kept laughing as the Dental Assistant apologized and kept wiping my face with a towel.  She asked him once to turn down the water please and he said very rudely NO! I began to get frightened.  Then he gets up and the Assistant asked, are you done? He said yes.  She didn't seem confident that he should be done.  He shoved a bunch of gauze in my mouth and I was bleeding profusely.  She kept asking if I was ok but I was numb so of course I couldn't tell. Later I found out he cut my cheek and tongue so bad I had canker sores for 2 weeks!

Texas Governor Greg Abbott Fails Dental Health Patients- Again

Dr. Michael Davis Bio

This report begins in a small Appalachian town in the hill country of East Tennessee; Bristol. Many call this community the birthplace of country music. It also boasts of a very modest but proud NASCAR track. This community is not wealthy by the standards of Westchester County, Marin County or Beverly Hills. Its wealth is in its people, traditions and strength of community. Folks have lived together as friends and family for generations. Success is more often measured in terms of spiritual values and connections with neighbors, than numbers in bank accounts. It’s a place where people trust and rely on family and neighbors. It’s a community where doctors still hold an esteemed position.

This may not be a town which “sophisticated” people on the East or West Coasts can relate to. In fact, they may use demeaning terms like “hillbillies” or “rednecks”, to dismiss these hardworking Americans. However, most of America absolutely respects people and towns like Bristol, Tennessee. That’s definitely true for most Texans, who hold similar values.

A doctor allegedly betrayed the trust of Bristol, TN, back in 2013. This dentist took the money from many patients of very modest financial means, most often for lay-away and payment plan dentures. Then he simply locked the doors to his clinic, and left the state. Unlike the Texas Alamo hero, Davy Crockett also from East Tennessee, Dr. Hardev A. Patel had a different spin on the phrase, “You may all go to hell and I will go to Texas”.

In January 2014, over 100 people filled the Bristol Tennessee General Session Court Room, to discuss the closure of Dr. Patel’s dental clinic and loss of their very hard-earned money. By then, Dr. Hardev Patel had already voluntarily retired his Tennessee dental license and relocated, and allegedly retired to Texas. But, was Dr. Patel truly retired from dentistry? The Tennessee Board of Dentistry listed no disciplinary actions against his license. In effect, weren’t they opting for a geographical solution to abuses on the public interest? Dr. Patel now potentially became the problem of Texas.

Dr. Hardev A. Patel earlier obtained a Texas dental license on 12-06-2013. All the while, multiple reports were in the public domain on his alleged abuses to the people of Bristol, TN. As of this report, the Texas State Board of Dental Examiners (TSBDE) has no public advisories relating to Dr. Patel. Any computer search engine will quickly arrive at numbers of highly disturbing stories concerning Dr. Patel. Any reasonable due diligence background check by the TSBDE on Dr. Patel would have raised a serious alert.

Today, Dr. Hardev A. Patel is publicly listed as a dentist provider at San Filipe Dental Health Center, in Del Rio, TX. Working for this non-profit clinic requires Dr. Patel be credentialed in Texas, as a Medicaid provider. He must pass background checks by this non-profit organization, as well as the Texas Department of Health Services.

Are authorities in Texas all asleep at the wheel, or is there a massive corrupt cover-up in play? Regardless, this isn’t the first cluster-f’ed dental rodeo for Governor Greg Abbott. We all recall the recent debacle and closure of Austin Cosmetic Dentistry, and unlicensed practice of dentistry by an unlicensed manager. We recall the corrupt oversight of dental Medicaid mismanaged by Xerox (ACS) for years. We also remember the troubling oversight efforts by the Texas Health and Human Services Commission relating to dental Medicaid abuses and fraud.

There’s a clear pattern of misconduct from Texas state authorities relating to dental healthcare. Former state attorney general and today, Texas Governor Greg Abbott is leader of the pack. It’s well past time to stop focusing on the myriad of smaller ethical and criminal breaches, from low level political hacks. The top dog needs to be held to account.

Smile Magic Dental Clinics Settle Texas Medicaid Fraud Allegations for $4.5 Million

Waters & Kraus, LLP is pleased to announce a qui tam lawsuit it filed has resulted in the largest recovery to date in a Texas dental Medicaid fraud case. 
DALLAS – March 5, 2015 – Four dental clinics of the Texas Smile Magic chain have agreed to settle Medicaid fraud charges for a total of $4.5 million. The four clinics that will pay the record-setting settlement include: Smile Magic of Denton, PLLC; Smile Magic of Lewisville, PLLC; Smile Magic of Garland, PLLC; and Smile Magic of El Paso, PLLC.

Amy Smith, represented by Waters & Kraus, LLP, blew the whistle on Smile Magic. To protect Texas children and taxpayers, Ms. Smith first reported to Texas officials that Smile Magic was allegedly engaging in several acts of misconduct that violated the rules of the Texas Medicaid program and later filed a qui tam lawsuit under the Texas Medicaid Fraud Prevention Act (TMFPA).

It was alleged in the qui tam lawsuit that Smile Magic defrauded the Texas Medicaid program by performing unnecessary or excessive dental services on young children, billed Medicaid for dental services never-performed, targeted young Medicaid beneficiaries through improper financial incentives, and used paid recruiters to round up poor kids to be used to commit Medicaid fraud. At times, the clinics allegedly solicited young Texas children by targeting their parents in grocery store parking lots, bus stops and other locations in poor neighborhoods, paid money to parents to induce them to have their kids treated at these Smile Magic clinics, and orchestrated teams of solicitors to round up Texas kids for all of these purposes. As further alleged in the qui tam lawsuit, once these young, mostly poor kids were in the dentist’s chair, Smile Magic’s goal was to maximize the amount it could bill Texas Medicaid, regardless of whether the services were medically necessary or, in some cases, even provided to the patient.

Based upon the allegations by Ms. Smith and another whistleblower, the Texas Health and Human Services Office of Inspector General (OIG) and the Civil Medicaid Fraud Division of the Texas Attorney General (OAG) conducted their own investigation of Smile Magic and determined that Smile Magic submitted improper claims to the Texas Medicaid program. The OAG intervened in Ms. Smith’s qui tam lawsuit.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Drs. Michael and Rebecca Tarver: A Serious Threat to Children? I think so!

The latest report out of Ocala, Florida reveals some of the dangerous practices taking place inside Churchill Dentistry, formerly known as Polliwog Dentistry.  I can’t believe there haven’t been a host of dead children due to these two quacks.

Here are a few items pulled from the latest article:

• "…Churchill Dental billed Medicaid and the Medicaid recipient for the same service and also delegated their duties to dental assistants who sedated patients,"
• “…Tarver would tell parents that he had to apply the sealant to the patient's teeth and Medicaid doesn't reimburse him for the procedure.”
• “…Tarver would use a dental tool called a gold flame bur on the top of the child's teeth where natural grooves and cracks were present and would remove "pieces of healthy tooth…Tarver would then fill the space with a resin composite and bill Medicaid as if he had "filled a one- to two-surface cavity. Parents would later complain because they had received a bill from Medicaid, which charges recipients $25 per tooth for each resin filling, though Tarver had told them their children had no cavities.”
• “…both dentists would sedate every patient with hydroxyzine, which is used as a sedative to treat anxiety and tension, and with other medications for anesthesia..dental assistants would weigh patients and report the weight to one of the two dentists, and then one of them would say how many milligrams to administer…sometimes 12 to 15 children were being sedated. The average number, she said, was 10. For most kids, blood pressure and oxygen levels were not checked during sedation, the former office manager said, yet all their charts reflect blood pressure and oxygen readings that were "almost the same."
• “…Those who didn't respond to hydroxyzine were given Versed, a brand version of midazolam, used to "produce sleepiness or drowsiness and to relieve anxiety before surgery or certain procedures," the report states. Dr. Michael Tarver would inject it into the child's mouth.”
• “…the dental assistant — estimated that the office would treat 60 patients a day. It was open 9 a.m. to 5 p.m. Monday through Thursday with only the two dentists.”

Read the entire shocking story here.

Polliwog Dental f/k/a Churchill Dentistry Raided By Medicaid Fraud Control Unit.

Wednesday, January 28, 2015

OCALA - Investigators were executing a search warrant at a pediatric dental office in Ocala Wednesday morning.

As part of a Medicaid fraud investigation, officials with the Florida Attorney General's Office and other investigators were at Churchill Dentistry, at 255 SE 17th St., the former Polliwog Dental.

Capt. John W. Nicks Jr., of the Florida attorney general's Medicaid Fraud Control Unit, declined to give other details about the investigation. He said agents would take whatever has evidentiary value in connection with their case, including anything from computers to papers….

…Ocala Police Department officers were telling patients that the office was closed. Dr. Rebecca J. Tarver, who works there, was not at the office Wednesday morning. Nor was her husband, fellow dentist Dr. Michael Tarver….

Read the entire story at Ocala.com

Scams on the public by nonprofit dental clinics

 

By: Michael W. Davis, DDS

Dr. Michael W. Davis practices in Santa Fe, NM. He currently chairs the district dental society peer-review committee, and is active as an expert witness on dental legal cases. He has authored numbers of articles relating to clinical dentistry, dental ethics, and protections for the public.

The recent legal settlement between Sea Mar Community Health Centers, which provides dental services to low-income residents in 10 Washington state counties, and the Washington state attorney general’s office, for $3.65 million highlighted this growing problem. These scams don’t generally benefit the professional staff, patients, contributors, and certainly not taxpayers. These swindles are designed to elevate overall clinic revenues, to enhance salaries and benefit packages of clinic directors. These nonprofit clinic directors often have compensation packages comparable with those working for Fortune 500 companies. Most other employees are not tapping in on the dishonest largesse. Here’s how this particular hustle is played.

These clinics have favorable tax status not enjoyed by private sector companies. They are exempt from most taxes. Clinic “profits” are not taxable. However, these profits are rolled-over in the dishonest clinics, into increased personal revenue for the clinic directors. Dishonest clinic directors may also generate a kickback fee from vendors providing dental equipment and/or supplies, especially if unaudited.

Unlike private sector dental clinics serving the disadvantaged Medicaid population, nonprofit clinics may access federal, state, county, & charitable grant moneys. This can be a huge income generator, especially important since Medicaid fees are often set at a level below the cost to provide that service, to standard of care. Grant moneys provide the nonprofit clinic with a per patient served, “encounter fee”. Patient encounter fees are paid to Federally Qualified Health Centers (FQHC) as a set amount, per patient visit. The patient must lawfully visit with a duly licensed healthcare professional of that nonprofit healthcare clinic, for the FQHC encounter fee to be paid. This nonprofit encounter fee often ranges in the $200 per patient visit range.

Dental billing fraud is more common than you think

Everybody knows going to the dentist is important, yet half of American adults skip out on regular dental care.

Some avoid dentistry out of fear of pain or sheer busyness, but a large portion of Americans can’t afford it without financial assistance.

Unfortunately, it’s Americans on government assistance programs for dental care who are being taken advantage of. Worse, their children are suffering for it.

It started as a solution

Many low-income children don’t receive dental care until they’re brought to the emergency room with a toothache, simply because their parents can’t afford it. Nearly half of American children are on some form of government-funded health insurance, either Medicaid or the Children’s Health Insurance Program (CHIP).

…As a result, corporate dental chains started accepting Medicaid and CHIP, and even opening new offices specializing in Medicaid…

…most of the charges were coming from one dental chain, Kool Smiles, and that the x-rays didn’t justify their treatments. Kool Smiles was investigated, and state officials found that the crowns were not only unnecessary but that the dental work was shoddy….

…Kool Smiles isn’t the only dental chain implicated by government officials in fraudulent billing practices. Dental chain Small Smiles settled with the United States in 2010 for $24 million to resolve allegations of fraudulent charges. In April 2014, the company that owns Small Smiles, CSHM, Inc., was excluded from participating in federal health care programs like Medicaid for five years…

Read the entire story at Fox.com

What the story fails to mention:

Small Smiles/CSHM is still operating Small Smiles clinics.  They are simply using a different corporate name—First Quality Management, Inc.  Many of the original corporate level employees still in place. Some clinics are under the control of Hero Management who operates Adventure Dental and Vision and others have been taken over by Sarrell Dental based in Alabama.

A Wide Range Discussion with Dr. Fred Quarnstrom: Dental Ethics, Regulations and Professional Turf Wars

 

A Wide Range Discussion with Dr. Fred Quarnstrom: Dental Ethics, Regulations and Professional Turf Wars

 

By: Michael W. Davis, DDS

Dr. Michael W. Davis practices in Santa Fe, NM. He currently chairs the district dental society peer-review committee, and is active as an expert witness on dental legal cases. He has authored numbers of articles relating to clinical dentistry, dental ethics, and protections for the public.

 

INTRODUCTION

With an extensive education and history in the dental profession, Dr. Fred Quarnstrom has been an outspoken advocate for the public when it comes to their dental healthcare. For decades, Dr. Quarnstrom has often taken a heroic stand in protecting the public which often times lands him on the opposite side of fellow professionals and dental organizations.

Recognized as an expert, Dr. Quarnstrom’s many accomplishments include: his current private practice, a faculty member at 3 dental schools, quality assurance consulting, independent expert testimony, and speaker. He has also held positions on what is the equivalent to the dental board in Washington state and Western Regional Examining Board. Dr. Quarnstrom graduated from the University of Washington in 1964 and completed a residency program in General Anesthesia at Washington Hospital Center, Washington D.C. in 1967.

INTERVIEW

Dr. Davis: Dr. Quarnstrom, a number of years ago, you completed a residency program in anesthesiology. You went on to utilize sedation services for your patients, and taught sedation courses, to fellow dental professionals. We both see how dental sedation can be a very helpful adjunct in the practice of dentistry.

What concerns do you have relating to weekend seminar sedation courses, often offered hotel conference rooms? What are the dangers to the public, as well as professionals offering sedation, for marginally trained and minimally emergency equipped dental clinics? Do you have specific concerns relating to the public health and safety; is the public being protected or it is buyer beware? What are the regulating agencies who are setting the standards and rules, and do you feel there is “agency capture” at work?

Are you concerned that it seems violators of sedation rules and regulations of state dental boards, far too often receive little or no disciplinary actions, and what advice do you have for state dental boards?

What advice can you offer to the public, whereby they can more actively protect themselves and their families? What advice do you have for the professional who chooses to offer sedation to patients?

Dr. Quarnstrom: First, I along with a Doctor of Pharmacy and a Professor Emmeritis teach weekend courses in the use of nitrous oxide and oral CONSCIOUS sedation. There is heavy emphasis on CONSCIOUS. We do not teach multiple drugs. When you add a little of drug A plus a little of Drug B plus maybe a little of drug C, D, and/or E. There is simply no research to suggest what the results will be. Personally, I have taught 245 nitrous oxide courses and 110 oral conscious sedation courses.

Nitrous Oxide is very safe. You really only need to know a few things. Never give more than 50% nitrous for more than a minute. Always check your system to be sure the gases have not been switched.

I know of one near death from switched gas in a surgery office doing IV sedation/general anesthesia and another 70 cases, where gases were switched but there was no damage to the patient.

In the oral surgery office the one patient was under general anesthesia. The surgeon expected him to be unconscious. He discounted the fact that the pulse oximeter reading dropped as low as 35%. His staff had asked him several times if they should call the paramedics. The third time he agreed. But the oxygen levels had been very low for too long. 95% to 98% is the normal saturation at sea level. You should get concerned if it drops to 90%. The patient who was an a student and star athlete ended up with severe neurologic and vision problems. 

In the other 70 cases patients either got too relaxed or went to sleep.The dentists have been taught when this  happens you should take the mask off and get them breathing room air and they quickly returned to normal with no residual problems. I published research 15 years ago to show it was safe to do this. If a dentist insisted on giving the patient 100% Oxygen and the gas lines are switched they would be giving 100% nitrous oxide. You need a minimum of 30% oxygen when being sedated preferably it would be 70 to 80% oxygen. I have taught for 40 years— “if something is wrong take the mask off”. 

The final thing you need to know. IF THE PATIENT BECOMES UNCONSCIOUS OR STOPS REACTING TO VERBAL COMMAND, TAKE OFF THE MASK. If in doubt it is never wrong to call 911. My patients who are paramedics plead with me to tell the dentists at our courses that they will not get into trouble for calling 911. As they state, “Our save record goes way up if we get there while the patient is still alive”.The ADA guidelines and most states require a 14 hour course to administer nitrous oxide sedation.

Blasts from the past much like today penalties for Medicaid Fraud? No today the fraud is worse and penalties even less.

December - Three Omaha Nebraska dentists plead innocent on fraud charges stemming from a 6 month investigation of the Douglas County Medicaid program. 

After their arrest, Dr. Leon E. Fellman (six counts), Dr. Stanley F. Galaska (five counts) and Dr. William V. Harrison (three counts) were released on $500 bond. Reports said the three would likely be tried early next year. Each count carried a prison sentence of 5 years.

That was December 1969!

The Lincoln Star Tue, October 21, 1969 pg. 1

Lincoln Evening Journal Tue, December 9, 1969 pg.51

Fast forward nearly 4 years.

All three were found guilty of the felonies in District Court and placed on probation. After hearings in November 1972, Henry Smith—State Health Director—suspended Dr. Stanley Galaska license for a mere 20 days while suspending Dr. William Harrison’s license a mere 25 days.  Dr. Leon Fellman surrendered his license for 6 months. Only the attorneys for the defendants and Gary Snowden, attorney for the state health department, were present. The State Board of Examiner were then notified of the suspensions.

Dr. B. J. J. Moran, a member of the State Health Board and former president of the Nebraska Dental Association said the disciplinary actions taken “seemed inadequate… based on the information on the case.”

All three had their convictions nullified and civil rights restored based on a 1969 Kansas law.

Lincoln Evening Journal – Thu, April 26, 1973, pg.15

Imagine what Dr. Moran would have to say about today’s actions!

Rick Perry and Greg Abbott Culpable in Debacles of Corporate Dentistry DSO Poster-Boy, R. Kirk Huntsman

 

by Dr. Michael Davis

 

December 17, 2014

Soon to assume the Texas governor position, from his prior office of Texas state attorney general, will be Greg Abbott. Mr. Abbott takes over the governor’s office from another dental industry failure, current Governor Rick Perry. Mr. Perry is most noted in dentistry for his dubious appointments to the Texas State Board of Dental Examiners (TSBDE). The consumer protection group, Texans for Dental Reform, have highlighted a number of these self-serving and corrupt appointments. Members of the TSBDE included a number of notorious Medicaid fraudsters, and at least one convicted sex offender.

Hapless state watchdogs for Texas citizens extended not only to the TSBDE and their incompetent legal counsel, but also to the Texas Office of Inspector General. Despite the fact that Texas is currently the state most recognized for the severity and volume of dental Medicaid fraud, the Texas Office for Inspector General has so far failed to effectively prosecute violator after violator. These habitual failures go directly to the (in)activity of Greg Abbott and Rick Perry.

Federal Fifth Circuit Ruling 07-30430

Let’s examine a case in point. Federal Fifth Circuit Court ruling 07-30430, which is largely based on Texas state statutes, determined that non-dentist ownership of a dental practice in Texas represents the unlicensed and unlawful practice of dentistry. The ruling further stipulates that corporate violators are to receive the same legal penalties, as individual person violators, with no special treatment. The acts of establishing doctor production quotas and bonuses are an action only lawfully permitted by a licensed dentist. State dental regulatory boards are charged under this federal ruling with the responsibility and obligation, of disciplinary actions against both individual person violators and corporate violators. The federal court also determined OCA (f/k/a Orthodontic Centers of America) could not enforce employment contracts with duly licensed Texas doctors, because the corporate entity OCA was not in fact a licensed doctor. The dentist employment contracts were determined unlawful and unenforceable, in their entirety, without being severable.

The federal court clearly saw though the sham presented by OCA (a dental service organization, “DSO”). OCA presented licensed dentists, whom they retained to misrepresent themselves as clinic “owners”. OCA controlled the dental clinics’ bank accounts. OCA held the power to buy and sell assets, such as the doctor employment contracts and individual clinics. In reality, these “owner dentists” were merely nominee owners. OCA, like nearly all DSOs, was the true and unlawful beneficial owner.

In conflict with this federal ruling —and further, avoiding addressing this ruling —the TSBDE has repeatedly stated they have no mandate to enforce the unlicensed practice of dentistry by a corporate entity. This flagrant obfuscation of law by legal counsel for the TSBDE is highly disturbing. Even more troubling is watching Rick Perry and Greg Abbott hide under their desks. Additionally, Mr. Abbott further abandoned his duty as Attorney General by failing to provide a legal advisory opinion based on clear and current legal precedence.

Xenith Practices, LLC & Austin Cosmetic Dentistry

Let’s examine another case, where Mr. Abbott was asleep at the wheel leaving dental consumers in harm’s way. In October 2014, Austin Cosmetic Dentistry simply closed and locked their doors. No notice of the closure was given to patients or staff. The staff was left unexpectedly unemployed and patients were illegally abandoned. Many patients were in the middle of their treatment. Many others, who had pre-paid, were scheduled to begin or finalize their restorations.

Representatives of Xenith Practices purchased the now-failed Austin Cosmetic Dentistry clinic from Dr. John Schiro, a couple of years earlier. The highly disturbing public record of Dr. Schiro with the TSBDE must have been aware to Mr. Huntsman and principles of Xenith Practices. It’s easy to download from the TSBDE website, with the slightest due diligence check. The earlier legal disputes between Dr. Schiro and Dr. Douglas Terry, who openly spoke out about alleged improper clinical care by Dr. Schiro, were also of public record. I have no idea what matters the investors were informed, by way of a lawful full disclosure by Mr. Huntsman. None of this should have escaped the attention of the Texas attorney general’s office, governor’s office, nor the TSBDE.

Xenith Practices, LLC, a DSO, managed the failed Austin dental clinic. Mr. R. Kirk Huntsman, —a business executive with no formal dental education and unlicensed to practice dentistry—formerly served as CEO of Xenith. As we shall see, Mr. Huntsman has quite the storied history in the dental industry. As for the true beneficial ownership of Austin Cosmetic Dentistry, that will be for the courts to sort out. It is alleged that Mr. Huntsman’s son-in-law—a Texas licensed dentist who lives and works in Colorado— signed on as the figurehead, “owner dentist”. Mr. Abbott could not have missed this obvious violation to Fifth Circuit ruling 07-30430, and negative fallout to the public health and safety.

What’s in a name: NCDR and CSHM rebranding

NCDR, LLC (Kool Smiles) can become Benevis, and CSHM (Small Smiles) can become First Quality Management (FQM) but the people are the same, the service is the same and the business model is the same.

  It would be interesting to hear from Adam Ditto, who has been with them all:

FORBA>CSHM>FQM (Small Smiles now “fill in the blank Smiles Youth Dentistry)

Hero Management  (Adventure Dental and Vision, taking over at least some of the old Small Smiles)

NCDR>Benevis (Kool Smiles and Resolution Dental)

 

 

 

 

 

 

 

What secrets does Adam Ditto hold?

Myths, Rumors, and Bald Faced Lies- Truths Revealed about the DSO Industry

Myths, Rumors, and Bald Faced Lies- Truths Revealed about the DSO Industry

By: Michael W. Davis, DDS

There exists a great deal of misinformation, as well as intentional misrepresentations, within the dental service organization (DSO) industry. Much, if not most of this of this, is fostered by the DSO industry itself.

Historically in healthcare, dentists were held to ethical and legal standards within the doctor/patient relationship (legal contract) always placing their patient’s interest, above all other interests. Court rulings have determined that because of a doctor’s expert knowledge, which is not easily accessible to the general public, the patient is at a distinct disadvantage within this contract agreement. Obviously, the delivery of healthcare services is a very different matter, than the buying and selling of widgets.

A corporate third party, the DSO, may enter into this contract agreement (doctor/patient relationship). This is usually without the knowledge or consent of the patient. Such an action may invalidate as unlawful, the doctor/patient relationship. (Please reference Fifth Circuit Ruling: 07-30430.) DSOs, which utilize bonus systems and production quotas for professional providers, are engaging in the unlicensed and unlawful practice of dentistry. Such corporate violators are subject to the same regulatory sanctions and disciplinary actions, as individual violators. Unfortunately, too few government regulators have advanced past their current ineptitude and corruption. This must change.

“At XYZ Dental, we allow you to focus on what you do best; provide excellent dental care for patients. We take care of all the rest.” is a common corporate dentist-recruiting message. Even the provider contracts include a proviso waiver that only licensed dentists provide dental care. Unfortunately, contract verbiage is far from the reality.

Unlicensed corporate managers, not doctors, very often make clinical decisions effecting direct patient care. This may include the quantity and quality of dental supplies for a dental clinic. It may include a very limited selection of utilization of dental laboratories, many of which are undisclosed offshore dental lab sweatshops. Unlicensed corporate clinic managers, who are not under any doctor’s supervision, may be utilizing arm-twisting sales techniques, to get patients to sign on for financing of unnecessary dental care. Similar arm-twisting may be used on doctors and hygienists, to increase clinic profits, by selling unneeded dental treatments to their patients.

Hygienists, who lawfully must be working under the direction and supervision of a duly licensed doctor, are today working for whomever writes their paycheck. Periodontal probing measurements are invented, to generate additional cases of unnecessary scaling and root planing (deep cleaning). Sulcular antibiotic therapy is sold to patients, even before assessment of results, to initial therapy of scaling and root planing. Adult cleaning visits are often restricted to 20-30 minutes, which nearly always leaves excessive disease-causing agents. In fact, often unlicensed dental assistants are providing hygiene services.

Generation of corporate profits trumps the interests of patients. Any dental professional employee who dares question the corporate model will soon be out the door. After all, a corporation’s first fiduciary responsibility is to generate maximal returns for shareholders. The interests of patients never enter the picture.

Upper management in the DSO industry will often argue, that numbers of non-corporate doctors are engaging in the same or similar patient abuses, within their smaller businesses. And, this justifies their grand scale abuses, how? It’s the old lame failed argument, of justifying bad behavior, with other examples of bad behavior. Reality: dental regulatory boards have reported a far greater percentage of statute violations originating from corporate dentistry, than from smaller doctor-controlled practices.

Another DSO fallacy often relates to doctor financial compensation. Verbally, their management and doctor-recruiters advise dentists of compensation, clearly based on a percentage of the doctor’s clinical production and/or hourly wage. Yet, the complex legalese of the employment contract, seemingly tells another story. These contracts are often so complicated, only a law firm concurrently expert in business law, contract law, and finance could hope to decipher the maze of legal verbiage.

Fortunately, any American Dental Association (ADA) member can have these contracts reviewed, as a benefit of membership. Few recent grads take advantage, as they not only lack finances to hire an appropriate attorney for contract review, but also are often not ADA members.

Mechanisms of Dental X-ray Scams

By: Michael W Davis, DDS

Dr. Michael W. Davis maintains a private general practice in Santa Fe, NM. He chairs the Santa Fe District Dental Society Peer-Review Committee. Dr. Davis is active in dental care for disadvantaged citizens. His publications are on ethical issues within the dental profession, as well as numbers of clinical research papers.

 

November 19, 2014

Frequently, the media, non-dentist investigators, and the public ask me, the methods and means of swindles played out with dental x-rays. Most incorrectly assume, that patients are simply given excess numbers of unnecessary radiographs, to increase billing statements.

Both the insurance industry and Medicaid generally pay 100%, for the costs associated with dental x-rays. These third party payers have limits on the frequency and types of radiographs, which they will cover for benefits under their contracts with dental providers. Most dental insurance carriers have computer-generated algorithms, which are triggered when excessive x-rays are taken. Moneys are then not paid out, or immediately recuperated, in the next insurance payment cycle.

Medicaid oversight is generally more lax. However, there is a very real risk with dental x-ray over-billing, that this will be caught by Medicaid oversight mechanisms, even as incompetent as they usually are. Generally, large sums of Medicaid over-payments are generated, and regulators chase down very large sums, well after the fact (“Pay-&-Chase”). Often, only pennies on the dollars are returned to taxpayers. However, it represents a scam with some element of downside risk. As dental Medicaid fraud has become an accepted business model with in the dental industry, swindlers desire to minimize or eliminate regulatory risk.

Today, large interstate corporate dental providers retain former state and federal dental investigators. These corporate dental providers, which are usually beneficially owned by the private equity investment industry (Wall Street parties), have a good idea of which forms of fraud will be potentially investigated, and which methods of fraud will fly under the radar. Regardless, the corporate beneficial owners always retain licensed doctors acting as nominee owners (sham-owners), to assume any potential regulatory liabilities.

Most commonly, we observe the following forms of dental scams with dental radiographs.

Unbundling of X-ray Services

The American Dental Association (ADA) has established a clinical coding system called, “Common Dental Terminology” (CDT). Numerical codes are designated for nearly every possible dental service. This system is updated annually. Every insurance carrier and Medicaid will establish fees for each dental service, for which coverage is provided under their program. One such dental service is called a “complete series of radiographs”, which has a set fee, and CDT code number.