Boycott Aspen Dental Day–October 6, 2018

For more information click here

Kool Smiles featured on CBS Whistleblower Series

 

Benevis/Kool Smiles Response to CBS Report:
Dr. Greenwald and Dr. Rai blew the whistle on Kool Smiles after they say they witnessed unnecessary dental procedures performed on children. CBS reached out to the company for a comment and they provided the following statements:

Statement from Kool Smiles:
"Our patients and their safety are our top priority and we will continue to work toward our mission of ensuring every child in America has a dental home. The settlement reached in December 2017 addressed treatment provided between 2009 and 2011, and was unrelated to the quality of dental care provided to patients. The company's compliance and quality assurance programs lead the dental industry and we continue to implement ongoing measures to ensure every patient receives the best care."

This past December, 2-year-old Zion Gastelum died four days after visiting the Kool Smiles office in Yuma, Arizona. Zion's death occurred just days after the Whistleblower suit was settled. The case had been in litigation for almost a decade.

Statement from Kool Smiles regarding death of Zion Gastelum:
"Kool Smiles treatment protocols follow the guidelines and best practices established by the American Dental Association and the American Academy of Pediatric Dentistry. Treatment is provided only after conducting a consultation and obtaining the informed, written consent of the patient's parent or guardian. Our dedicated dentists, anesthesiologists and the rest of our Kool Smiles family mourn this tragic loss."

Dr. Behzad Nazari, D.D.S., ET AL. v. The State of Texas; Xerox Corp; and Xerox State Healthcare, LLC, f/k/a ACS State Healthcare, LLC, n/k/a Conduent Business Services, LLC

Despite all the claims, counter-claims, third, forth and fith party claims, here is the the short version:

Texas withheld reimbursement from several dentists due to a high suspicion of Medicaid fraud. Dr. Nazari, his clinic Antoine Dental and others argued they needed and deserved their money for all the honest and much needed work they had done on so many children with terrible orthodontic deformities and rotten baby teeth. They were the saving grace to the underserved population as they saw it.

Being royally pissed, Nazari suesTexas and Xerox (NYSE:XRX) (ACS) demanding his money.

The Feds (that is us, the US taxpayers) says “Hey Texas, we pay 50% of all you spend on Medicaid, and we want our money back!

Texas says, “We really have that kind of cash to hand back, we spent it already. But we will try to get it from Xerox. They ran the show down here for years. In fact we knew nothing about this until Byron Harris did a series of reports for WFAA in Dallas. We learned about it on the local evening news!”

Texas sues Xerox, under whatever name Xerox was using at the time. The suit ends up at the Texas Supreme Court.

Texas tells the Texas Supreme Court justices, it was no seeking actual damages from Xerox in a civil Medicaid fraud suit in a civil Medicaid fraud suit accusing the company of signing off on $1.1 billion in claims for orthodontic services without properly vetting them, and therefore the remedies it has sought aren't subject to proportionate responsibility calculations.

Xerox says that it is wrongly facing sole liability in the matter, despite the fact it trained paid employees to basically rubber stamp “Approvals” as fast as they could. Additionally, in early testimony it was learned they trained the dentists how to game the systems.

Yesterday, June 22, 2018, the Texas Supreme Court handed down its decision. Xerox, it is all on you guys. Pony up the $2 Billion!

Now, doing business as Conduent Business Services (CNDT) reports are that Conduent’s “benefit wallet” is empy and they will probably settle for $500 Million. 

Related:

Dentist the Menace blog posts on this matter

Case Details and Documents

Opinions posted on the SCOTX Blog

December 6, 2017 Oral Arguments Video

Emerging Advocacy Groups Support Small Business Dentistry

20 Apr 2018 Michael W. Davis, DDS

Small business dentistry is increasingly establishing advocacy groups designed to address specific issues. Areas of concern range from protecting the doctor/patient relationship against the intrusion of the insurance industry and corporate dentistry to honest evaluation and solutions for the public’s “access to care.”

These associations are springing up in a variety of different states. Because of their distinctive smaller sizes, they are highly attuned to specific predicaments unique to a given state. Larger national groups may have multiple and conflicting agendas, which too often grind effectiveness to a standstill. These smaller spearhead organizations often serve as the initial testing ground for addressing and solving challenges. Many times, state dental associations will later pick up the banner and carry forth with their added weight and power of membership.

Three organizations that exemplify this movement are the Concerned Dentists of Texas (CDoT), the Concerned Dentists of Washington State (CDWS), and the Massachusetts Dentists Alliance for Quality Care (MDAQC). Each of these relatively small associations is free to examine problems unique to its specific state and discover optimal mechanisms for local problem solving. They aren’t handicapped by the political or economic motivations of a faraway distanced leadership. They aren’t bogged down by neverending and do-nothing committee meetings. And, they lack multiple layers of leadership hierarchy, which often hinders effective action…

Read Dr. Davis’ entire article here.

Southern Dental Alliance and Sale to Pouschine Cook Capital

Keep in on your radar.

Sept 2017:

Deloitte Advises Southern Dental Alliance on Sale to Pouschine Cook

Deloitte Corporate Finance acted as exclusive financial advisor to Atlanta-based VSM Management d/b/a Southern Dental Alliance on its sale to Pouschine Cook Capital Management and its co-investor group.

Southern Dental is a multi-specialty dental service organization in the Southeastern U.S. with 32 clinic locations across eight brands.

“DCF’s assistance was indispensable for us throughout the transaction process, offering both expertise in the space and extensive resources. We are excited about our future growth prospects and the new partnership with Pouschine Cook,” said Mark Lakis, CEO of Southern Dental.

Tom Harbin, managing partner at Source Capital, echoed the sentiment, “DCF’s deep knowledge of the dental space was invaluable and helped lead to a successful transaction. We could not be more pleased with the outcome.”

http://www.abfjournal.com/dailynews/deloitte-advises-southern-dental-alliance-on-sale-to-pouschine-cook/

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

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

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

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

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

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

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

I have to comment:

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

ARE YOU KIDDING ME!

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

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

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

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

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

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

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

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

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

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

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

What happened to Small Smiles?

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

Evidence shows Benevis, LLC / Kool Smiles Dental Centers Knows the Laws.

Screen shot from Benevis website January 20, 2018:

They simply believe the laws don’t apply to them.
Ad from the Kentucky Dental Association Website.

Benevis, (formerly NCDR, LLC) is owned by FFL Partners and operates Medicaid dental clinics under the name Kool Smiles Dental, focused on children (perferably under the age of 5 from the looks of things).  However they operate a disturbing non-Medicaid division under the corporate umbrella of PSBB, PC, Inc. with Dale Mayfield CFO, Secretary and CFO.  Mayfield is the Chief Dental Officer at Kool Smiles.  In 2016, Mayfield was appointed to the Georgia Board of Dentistry by Governor Nathan Deal. (try not to puke if you read this link)

$23,900,000.00 Benevis / Kool Smiles Dental Clinic Settlement Agreement with DOJ

This is for the period of January 1, 2009 through December 31, 2011.

That is 3 years.

They have been in business with this exact same business model since 2002, when FFL Partners found Dr. Tran and Dr. Pham at the Denver Small Smiles Dental Clinic and offered them an opportunity of a lifetime; to start their very own Medical Mill and become “owner dentists”.

It’s now January 2018. 

So, 15 years, right? This settlement covers 3 of 15 years.

The way I see it, they should pony up an additional $286,800,000.00.

I don’t see any Corporate Integrity Agreement; let’s hope that is a seperate Agreement yet to be released.

$23,900,000.00 Benevis Kool Smiles Dental Settlement Agreement with DOJ - January 2018

Related:

September 2009 Office Score Card

FY 2011 Texas Kool Smiles Stainless Steel Crowns Billed

Mother speaks out against Yuma, AZ Kool Smiles Dental Clinic

A mother is speaking out following the death of two children who visited a dental office in Yuma.

Nearly six years later, Elva Aranda is sharing her experience at Kool Smiles, who claims her daughter was being choked by a dental assistant in Summer 2012.

"It was a horrible experience, a horrible experience because when you see someone else hurting your child, you feel helpless," said Aranda.

Aranda says while her daughter was getting her regular checkup, the dental assistant was acting aggressively towards her daughter during the procedure. She claims the dental assistant was adding pressure to her daughter's neck as if she was choking her without realizing it.

"You know the suction tool, she started putting that into my daughter's mouth, and that was making her "gag". I'm here looking at my daughter, and I'm seeing her gag because that tool was shoved in her mouth and I started comforting here saying "it's okay, you're going to be okay" but I did not see that this lady had her whole hand shoved into my daughter's neck choking her."

Read the entire report here.

---

In 2016, 4 year old Liseth Lares died just days after visiting the same Yuma, AZ Kool Smiles clinic as 2 year old Zion Gastelum

YUMA, Arizona --

Two children, one dentist's office, each meeting the same tragic fate.
An Arizona mother is suing Kool Smiles in Yuma after her 4-year-old daughter died days after she visited the dentist's office in January 2016.

Francisca Lares said she is heartbroken, because she was only trying to do the right thing in getting care for her daughter, KNXV reports.

But when little Liseth Lares developed a fever, family attorney Marco Mercaldo said the dentist sent the girl home after a "relatively cursory exam."

"Told the mom essentially there is nothing to worry about, she'll be fine," Mercaldo said. "Unfortunately, the infection spread and she died of the infection."

Mercaldo argues Liseth could have survived the infection if Kool Smiles had given her the proper treatment.

Read full report here.

2-year-old Zion Gastelum dies after dental appointment at Kool Smiles

YUMA, AZ - An Arizona family is left confused, devastated and looking for answers about just what happened during a young boy's dental appointment.

The family of Zion Jay Gastelum said the 2-year-old died after a dentist appointment in Yuma last month. Zion's uncle told ABC15 the child's parents took him to Kool Smiles Dentist on December 16 for a crown and filling, and somehow either during or after the process, it appears Zion stopped breathing. 

According to family, Zion was transported to Yuma Regional Medical Center and then flown to Maricopa County, where he died several days later.

Read more here

Boston Dental Group, LLC vs Affordable Care, LLC

Boston Dental Group, LLC (see more info at the end) and Affordable Care, LLC (Affordable Dentures and Implants) seem to be in a heated lawsuit in Nevada’s Federal Court.  I’ve not looked at the initial Complaint, (case no. 2:15-cv-01636) but I have read (link below) BDG’s Reply in Support of Partial Summary Judgement.  Appears BDG sued (for what I’m not sure) then Affordable Care filed a counter-suit., that seems to sound a whole lot like a SLAPP suit (boy, I’ve been there…lol).  But at this point in the story, I’m not even sure who is cheating who, as the song goes.

Link to Plaintiff’s Reply in Support of Partial Summary Judgement (24 pages) filed August 25, 2017 in United States District Court, District of Nevada.

Anywho…I’ve pulled out some interesting items in this pleading and posted below.  More interesting, much of the this pleading is redacted and all the exhibits are filed “Under Seal”.

Enjoy!

Page 3, Line 3

“The question of the legality of Affordable Care’s management agreements with dentists
goes straight to the heart of whether Affordable Care has enforceable trademark rights. All of
Affordable Care’s claimed rights in its “dental services” trademarks are purportedly through
“oral licenses” it has with independent dental offices around the country. If the financial
arrangements with those dental offices are illegal, this illegal activity cannot form the basis of
any trademark rights, and Affordable Care’s has trademarks are unenforceable.”

Page 3, Line 12

The illegality of Affordable Care’s management agreement was an issue throughout this case and multiple discovery requests by BDG sought information concerning this illegal arrangement.
Despite the numerous discovery requests, Affordable Care refused to identify any
witnesses or produce any financial documents on this issue. Regardless, Defendant did produce
its 2007 Management Services Agreement which is illegal on its face (prior to this case being
filed Affordable Care produced an unsigned copy of this document which began the
conversation on the illegal nature of its arrangement with its dentists).
Now for the first time, Affordable Care decides to bring forth a witnesses and a handful
of select documents to claim that the 2007 illegal management agreement was just a copy-andpaste template and the fact that both it and the Nevada dental office signed the agreement was meaningless. Such a claim is simply unbelievable.

Page 4, Line 12

“Moreover, the specific allegations that Affordable Care’s trademark is unenforceable and
that it has unclean hands due to a violation of Nevada law has been in issue throughout this case,
including in the pleadings and throughout discovery.

In BDG’s Answer to Defendant’s Counterclaim, BDG states the following affirmative
defenses, among others:

Defendant’s counterclaims are barred by unclean hands.
Defendant’s trademarks are invalid and/or unenforceable.
       See BDG’s Answer to Counterclaim, Doc. 10, p. 5, lines 24-25. (Filed under Seal)

In addition to the pleadings, both before and after this lawsuit was filed, counsel for
BDG repeatedly informed Affordable Care that its management agreement with its Nevada
dentist was illegal under Nevada law. This is apparently what prompted Affordable Care to
amend its management agreement with its Nevada dentist and back-date it to January 1, 2016.”

Page 5, Line 15

“Affordable Care’s actions constitute the illegal practice of dentistry in Nevada and cannot form
the basis of any claimed trademark rights for dental services.”

Page 5, Line 19

“As set out in more detail in BDG’s Motion to Strike, Affordable Care failed to name Mr.
Steelman as witnesses and failed to produce the financial information it now claims address
BDG’s arguments concerning trademark priority and the unenforceability of Defendant’s
trademarks. This declaration and these documents should be stricken and not considered by this
court.”

Page 5, Line 24

“Not only was this witness not identified during discovery and these documents not
produced, BDG requested this information and Defendant Affordable Care refused to produce
it. Specifically, BDG requested an identification of all witnesses and documents related to
financial information of the Las Vegas affiliated practice, including:

REQUEST FOR PRODUCTION NO. 9:
Please produce documents sufficient to show for Nevada and California
Affordable Care’s and any Nevada or California Licensee’s monthly and annual
net profit from goods for services sold under Affordable Care Marks from 2007 to
the present.

RESPONSE: In addition to the foregoing General Objections, Affordable
Care objects to this request as irrelevant to this action and not reasonably
calculated to lead to the discovery of admissible evidence. Neither Plaintiff’s
action for declaratory relief of non-infringement nor Affordable Care’s
counterclaims for trademark infringement, false designation of origin, and unfair
competition involves evidence of profit from goods or services sold under
Affordable Care Marks. See Doc. 32-7 as Exhibit 7, p. 3. (Filed under Seal)

INTERROGATORY NO. 11:
Please state in detail the factual basis, including, but not limited to,
identification of all documents and persons, all sums and amounts received by
you from your affiliated practices located in California and Nevada.

ANSWER: In addition to the foregoing General Objections, Affordable
Care objects to this Interrogatory because the revenue that Affordable Care has
received from its affiliated practices in Nevada and California is not relevant to
Plaintiff’s claims and defenses, or Affordable Care’s counterclaims, which all
relate to the use of the AFFORDABLE DENTURES Marks. Affordable Care
further objects to this Interrogatory because the information sought in this
Interrogatory is not proportional to the needs of the case.

INTERROGATORY NO. 13:
Please state in detail the factual basis, including, but not limited to,
identification of all documents and persons, of all reimbursements, including, but
not limited to, fee-for-service methods of reimbursements paid to you and/or paid
by you to your affiliated dental practices located in California and Nevada.

ANSWER: In addition to the foregoing General Objections, Affordable
Care objects to this Interrogatory because Affordable Care’s financial relationship
with its affiliated practices in Nevada and California is not relevant to Plaintiff’s
claims and defenses, or Affordable Care’s counterclaims, which all relate to the
use of the AFFORDABLE DENTURES Marks. Affordable Care further objects
to this Interrogatory because the information sought in this Interrogatory is not
proportional to the needs of the case. See Doc. 32-5 as Exhibit 2, p. 9-10. (Filed under Seal)

Affordable Care cannot refuse to produce this information or identify witnesses during
discovery and then attempt to get into evidence a new witness and select documents because it
now suits them.”

Page 7, Line 17

“C. Defendant’s Arrangement with its Nevada Dentist is Illegal Under Nevada
Law

1. The Evidence of Record in this Case Demonstrates that Affordable Care
Operated Illegally in Nevada.

Page 9, Line 9

“In addition to the fact that Affordable Care’s surprise declaration and exhibits were
never produced and should not be considered, this untimely evidence contradicts the evidence
that is properly of record in this case, including the sworn testimony of Affordable Care’s only
witness, Adam Siegal who testified (redacted) See Exhibit 5, Adam Siegal Deposition, p. 28 lines 17-24”

This was echoed by Dr. Cher Y. Chang who owns the Nevada dental practice. She
testified as follows: (redacted) See Exhibit 6, Cher Y. Chang, DMD Deposition, p. 12, line 16 - p. 13, line 19. (Filed under Seal)

As set out in detail in BDG’s Motion, this is a clear violation of Nevada law. See NRS
631.395 (“A person is guilty of the illegal practice of dentistry or dental hygiene who . . . 10.
Except as otherwise provided in NRS 631.385, owns or controls a dental practice, shares in the
fees received by a dentist or controls or attempts to control the services offered by a dentist if
the person is not himself or herself licensed pursuant to this chapter.”) emphasis added; See also
NRS 631.215(2)(h)(1) (stating that a person who provides goods or services to a dental practice
may not, “[p]rovide such goods or services in exchange for payments based on a percentage or
share of revenues or profits of the dental practice, office or clinic.”)”

Page 9, Line 24

“Even if this Court were to consider the declaration of Mr. Steelman and the undisclosed
Vegas Financial Statements and Vegas Fee Statements, the arrangement between Affordable
Care and its Nevada dental office appears to be illegal under Nevada law.”

Page 9, Line 28

“This is abundantly clear from the Vegas Financial Statements and the Vegas Fee Statements. (redacted) (See 2016 Management Services Contract, Doc. 54-1 as Exhibit A-4, p. 21 AFCA 0009190). (Filed under Seal)

Page 11, Line 6

“Mr. Steelman’s claim that the amounts paid by the Nevada dental practice are
contractually “fixed” simply does not hold up to scrutiny.

”Page 11, Line 15

“Affordable Care’s sham “fixed” fee simply does not stand up to scrutiny and is illegal under Nevada law.

Moreover, Affordable Care has not identified a single state where this type of arrangement
would be legal. Affordable Care’s business practices appear to violate the laws of every, or
nearly every, state it operates in.”

”Page 11, Line 20

“Illegal Activity Cannot Form the Basis of Any Trademark Rights
Affordable Care’s arrangement with the Nevada dental office is illegal under Nevada
law and cannot form the basis of any trademark rights. CreAgri, Inc. v. USANA Health Scis.,
Inc., 474 F.3d 626, 630 (9th Cir. 2007).” (Filed under Seal)

“In this case, BDG, a company owned by a licensed Nevada dentist, is merely seeking a
declaratory judgment that Affordable Care’s trademarks for dental services are invalid and
should be cancelled. Affordable Care (not BDG) filed a counterclaim for trademark
infringement. Thus, while Affordable Care’s priority date in this case is when it first obtained
enforceable trademark rights in order to bring its counterclaim, the relevant priority date for
BDG is when it first began using its allegedly infringing mark, namely when it opened its first
dental office in January 2008.”

“As detailed above, Affordable Care’s illegal practice of dentistry in Nevada was not
lawful commercial use and cannot form the basis of any trademark rights which pre-date BDG’s
use of its Affordable Dental mark. Plaintiff Boston Dental Group’s trademark rights in its
Affordable Dental mark, which began at least as early as January 2008, therefore have priority
over Affordable Care’s illegal activity.s

---

Boston Dental Group, LLC

Registered Agent and Managing Member:

David Tawei Ting, DMD
6960 Westcliff Dr., Ste 200
Las Vegas,NV  89145

Ting has as least 36 companies where he is the registered agent according to a search of the Nevada Secretary of State’s website.

Some of the more interesting ones are:

Affordable Dental At Laughlin, LLC
Affordable Dental at Westcliff, LLC
BDG Coaching, LLC (what exactly is being coached?)
Boston Dental Group at Anthem, LLC
Boston Dental Management, LLC
C and T Dental Laboratory, LLC
Cambridge Dental Consulting Group
Cambridge Dental Technology, Inc
Dapha Dental Technology, Inc.
Dentisting, LLC (huh?)
Friendly Ting, PC
Haider, Ting and Chung, LLC
Handpiece Club, LLC
Looting, LLC (WHAT!  I could run with this like Forrest Gump)
Vita Smile, LLC

Patients, think your dentist has any influence as to how your “Affordable Dentures” are made? Think again.

Patients, think your dentist has any influence as to how your Affordable Care dentures are made, since they are made “in-house’?  Think again.

Affordable Care Sends Goon Squad to Evict Dentist in Louisiana. WHAT?

In a lawsuit filed on November 27, 2017 in Louisiana Federal Court, Affordable Care (Affordable Dentures) is accused of:

Illegal Eviction
Intentional Effliction of Emotion
Interruption of business
Defamation
Breach of Contract
Unfair Competition
Tortious Interference with Contract between Doctor and Patient
Illegal Practice of Dentistry

Excerpts from the Complaint (Civil Action 17-13015) :

Agents?  Whoa!! Sounds more like a goon squad to me, but what do I know?

Full text of Complaint below:

Doc 1 Complaint-Coleman v Affordable Care 171127 by Dentist The Menace on Scribd

Link to revealing Contracts and Agreements in regards to Affordable Care and Exhibits in Louisiana lawsuit.

Doc 1-1 – Purchase Agreement Exhibit

Doc 1-2 – Lease Agreement Exhibit

Doc 1-3 – License Agreement Exhibit

Doc 1-4 – Affordable Care Management Service Agreement

Doc 1-5 – Revenue From Patient Financing Chart

Why is Mark Birner of BDMS/Perfect Teeth, a DSO in Colorado, leading his name and dental licenses to Affordable Care, a DSO in North Carolina?

On May 30, 2017, an entity was registered in New Jersey called, Dr. Birner, PA.  The Manager being Mark Birner.

The “Incorporator” was Sonia Surasky, a paralegal for Affordable Care dba Affordable Dentures and Implants, headquartered in Raleigh, North Caronlina.

The mailing address for Dr. Birner, PA is 156 West State Street, Trenton, NJ, home of State Street Partners, a lobbying firm!

In a legal case recently filed in New Jersery against Affordable Care (which I will get into later),

Affordable Care says it assigned its lease to certain clinics in New Jersey to Dr. Birner, PA.on June 5, 2017.

Excerpts from Exhibit B:

What’s this? A Management Agreement between Dr. Birner, PA and Affordable Care?

Sounds to me that Dr. Birner, PA has complete control of the Premises yet Affordable Care is still the landlord of the dental practice. Huh? I think this is not just double speak, it’s triple speak.

WHAT? But the dentist has spent nearly $200,000.00 to purchase the equipment, furnshings, and other assets”.

Ah Ha!  Mark Birner, owner of Birner Dental Managements (a DSO) operating as Perfect Teeth, is lending his name and dental license to be the “designated dentist” who supposedly leases the premises where yet another dentist operates an Affordable Dentures clinic.

Just my opinion of course but looks to me like the Association of Dental Management Organization is more like a cartel. 

Patients Wonder Why Dental Boards Do Nothing About Bad Dentistry: Here’s why

Below is a list of a few dental boards who have Board Member who work for private equity/corporate owned dental chains.  Keep in mind in most states this is illegal. So what does that make these board members? Just saying…

Last updated: 12-7-2017 6:38PM

Arkansas

Dr. Richard Smith - Monarch Dental

Colorado

Mark William Adams, DDS – ClearChoice Dental Implant Centers

Dr. Vidhyalakshmi Sampath – Bright Now! Dental DSO

Florida

Joseph V. Calderone, Jr.,  DMD – Heartland Dental d/b/a DeBary Dental Care (to find search Heartland for dentist near zip code 32713)

Georgia

Dale Mayfield, DMD - Kool Smiles
Gregg Goggans - Smile Doctors (Dental Board Vice President)

Illinois

Julie Galloway, DDS – Heartland Dental

Indiana

Jeffery Snoddy,DDS – Heartland Dental

Iowa

Monica Foley, DDS  – Heartland Dental

William McBride, DDS – Midwest Dental

Maryland

Robert R. Windsor, DDS – Dental Care Alliance (Unconfirmed)

Michigan

Gregory Heintschel, DDS – President and CEO of My Community Dental Centers

Minnesota

Douglas Wolfe, DDS – Kool Smiles (Unconfirmed)

Nevada

Ali Shahrestani, DMD– Pacific Dental Service

New Jersey

Steve Goldstein , DDS– Dental Care Alliance

George McMurray, DDS – Allied Dental

Daneil DiCesare, DMD – Allied Dental

Pennsylvania

Andrew Matta, DMD – Chief Medical Officer and Founding Partner of North American Dental Group

Texas

Kimberly Haynes-Reese, DDS – Aspen Dental

H. Jorge Quirch, DDS – Heartland Dental

Virginia

Jamiah K. Dawson, DDS – Affordable Dentures and Implants

Washington

Lyle McClellan, DDS – Director of Doctor Development at Williamette Dental Group

Aaron Stevens, DMD – Williamette Dental Group

Check your state boards members.  If you find a member affilliated with a DSO, please email me and I will keep the list updated.

Related:

Big Step Forward: Dental Board Gives Voice to Group Dental Practices at State Level

Gov. Abbott Appoints Aspen Dental Dentist to to Texas State Board of Dental Examiners

Agency Capture at it’s finest!







http://www.kbtx.com/content/news/Local-dentist-named-to-State-Board-of-Dental-Examiners-458947533.html

Checking her dental licenses at the board and it’s sparkling clean.

However:

June 3.2016-Kimberly Haynes, DMD, received non-discipline remedial plan because of a complaint from a patient.  She was found to have fallen below the minimum standard of care, failed to keep adequate records and no informed consent from the patient among other things.

I'm told, David Tillman, the presiding officer is a weak leader and appointed for that very reason. I'm told board member Bryan Henderson, DDS is pro-DSO.  Kimberly Haynes, DMD, as we see is an Aspen dentist and H. Jorge Quirch, D.D.S is a Heartland dentist. One more and the DSO's will have a majority. Not that it matters because I'm also told the hygienists back the DSO's as well.

Texas State Board of Dental Examiners is a RAGING DUMPSTER FIRE!

Here is an article you may have interest in posting on DTM.   All of this information is in good faith and written for the purpose to expose the mismanagement at the Texas State Dental Board. 

----------------------------

It has been six months since an investigative reporter has exposed Kelly Parker's mismanagement and unethical behavior as the executive director at the Texas State Board of Dental Examiners.  Since then, the Board Members have done NOTHING.  She has brought disgrace onto the Board and dental profession as evidenced by negative media reports and multiple employee complaints.

Several employees brought their concerns directly to Board members only to hit a wall.  Employees jeopardized their own jobs by contacting Board members to report what was happening with the executive director they appointed.  Dr. Steve Austin, DDS, the presiding officer of the Board, refused to even listen because he feared being involved in any type of subsequent employee hearing.  See email below.

Kelly Parker shut down criminal investigations which allowed dentists and other licensees to potentially get away with criminal activity.  State Senators Jose Menendez and Charles Schwertner, as well as the Governor's office, were alerted to this fact.  Hello?!  Where are these officials??  Where are the Texas Rangers?  Or the Attorney General's Office?? 

At least nine former criminal investigators can testify in this matter.  NONE of them have yet been contacted by anyone, not even the senators or governor's office even though they said they would "look in to it."  Many of these investigators still have copies of their investigative reports that were written.  These ex-investigators are just waiting to share their stories with the appropriate authorities.

All but THREE criminal investigators left the Texas Dental Board this year because of Kelly Parker.  There are NO criminal investigators left in the entire Dallas region, the San Antonio region, or the entire Houston region!  None of them have been replaced.  After the entire investigative supervisory staff left this year, she promoted one sergeant to lieutenant who resigned his position after just a few weeks of having to deal with Kelly Parker.  He quit the agency shortly thereafter as well.  The mismanagement and unethical decisions coming from Parker prompted many people to leave without having another job to go to.  Once again, NONE of the Board Members want to address the nightmare they created.

It is estimated that over HALF the agency employees have left since Kelly Parker and Nycia Deal started running the agency into the ground.  Due to the large number of vacancies that have been caused by Kelly Parker, the agency HAS to be behind hundreds and hundreds (if not over a thousand) of complaints waiting to be investigated.  She has no one to investigate these complaints!  They are apparently trying to use various staff to clear out complaints.  NO ONSITES are being conducted at dental clinics, NO SANITATION/STERILIZATION inspections are being conducted, so how can they be claiming they're protecting the public??? 

Kelly Parker and Nycia Deal shut down onsite inspections and the ability to allow investigators to issue sanitation citations to violators.  That has been stopped for well over a year.  What is the purpose of that?  Makes as much sense as stopping criminal investigations!  With all the changes being made, one could easily argue that they are in the business of protecting DENTISTS, NOT THE PUBLIC!!

An independent outside audit should take place.  Chances are extremely high that numbers about backlogged cases are being hidden.  The same goes for the severely backlogged cases that are being bungled by Dr. Brook Bell and her dental division.

Kelly Parker has lost her second executive administrative assistant.  This is the second one in a row to just quit.  She lost her communications director, too.  Kelly Parker reportedly received a large number of negative feedback from a department-wide survey that was sent about her.  This should be very telling that all of these new employees already have nothing but negative to report about her and her management style.

In the two years that Kelly Parker and Nycia Deal have so poorly mismanaged the TSBDE, are they any better off than where they were two years ago?  ABSOLUTELY NOT.  In fact, they're probably in such a state of disarray, it will be a MONUMENTAL task for a new executive director to come in and right this sinking ship.

The real shame is that none of the Board Members care enough about their profession, much less the public, to deal with the problem they created by putting Kelly Parker and Nycia Deal in charge to make blunder after blunder.  Hundreds, if not more than a thousand dental complaints are not being tended to.  Hundreds, if not more than a thousand complaints are waiting to be reviewed.  The entire state of Texas only has three experienced investigators left.  People have been leaving the agency in droves.  They cannot retain staff.  Morale is abysmal. 

The TSBDE is now a raging dumpster fire and the Board Members seemingly ignore these facts.

                                                                                                                                                                     ---Anonymous

Dental Dreams, LLC Settles with MassHealth for $1.3 Million

September 5, 2017

BOSTON – The U.S. Attorney’s Office and the Massachusetts Attorney General’s Office announced today that Dental Dreams, LLC, a national dental chain with locations in Massachusetts, has agreed to pay $1.375 million to resolve allegations that it improperly billed the Massachusetts Medicaid program (MassHealth) for unnecessary and unjustifiable dental procedures.

“Dental Dreams enriched itself at taxpayer expense by improperly billing Medicaid,” said Acting U.S. Attorney William D. Weinreb. “We will continue to work with our law enforcement partners to ensure that federal and state health care dollars are spent properly.”

“This dental chain’s extensive improper billing violated state regulations and cost our state’s Medicaid program more than a million dollars,” said Massachusetts Attorney General Maura Healey. “As a result of this joint investigation, today’s settlement provides restitution to MassHealth and ensures that these funds are properly used to benefit its members.”

“Medicaid is designed to provide health care services to some of the most vulnerable members of our society and it’s our agency’s mission to ensure government health funds are spent properly,” said Special Agent in Charge Phillip M. Coyne of the U.S. Department of Health and Human Services Office of Inspector General. “Working with our Federal and State partners, we will continue to hold accountable any medical professional who, just to enrich themselves, bills Medicaid for more intensive and expensive services than those actually provided.”

“The company took advantage of a vulnerable patient population when it submitted claims to MassHealth for medically unnecessary and unreasonable dental procedures,” said Harold H. Shaw, Special Agent in Charge of the Federal Bureau of Investigation, Boston Field Division. “Today’s settlement underscores the FBI’s commitment to investigate health care providers who overbill federal and private health insurance programs to maximize profits. We urge anyone with information regarding overbilling practices to contact us.”

The settlement resolves allegations that Dental Dreams overbilled the Massachusetts Medicaid program for surgical extractions of teeth and for a specific kind of oral examination.

The settlement resolves a lawsuit filed by a former employee under the whistleblower provisions of the False Claims Act, which permits private parties to sue on behalf of the government for false claims for government funds and to receive a share of any recovery.

Acting U.S. Attorney Weinreb, Massachusetts Attorney General Healey, HHS-OIG SAC Coyne and FBI SAC Shaw made the announcement today. The case was handled by Assistant U.S. Attorneys Michelle Leung, Sonya Rao, and Kriss Basil of Weinreb’s Civil Division and Assistant Attorney General Stephany Collamore of Healey’s Medicaid Fraud Division.

September 2017 Conference: Top Trends in Dentistry Not Heard Anywhere Else

Concerned Dentists of Texas Presents: Business of Dentistry 101

When: Friday, September 15, 2017 (9am-5pm) during the Southwest Dental Conference
Where: Dallas Omni Hotel Cedars Room, 555 S Lamar St, Dallas, TX 75202
Registration: Concerned Dentists of Texas (CDOT)
Contact person: Jackie Stanfield, DDS, concderneddentistsoftexas@gmail.com 
                            (972) 355-2273

Topics include:

• Problems facing dentists, new or retiring, involving dental practices owned and operated by Private Equity companies and Wall Street Hedge Funds.
• Understanding dental employment contracts: the vulnerabilities and consequences.
• Discussion about the business model of dentistry such as Dental Service Organizations (DSO’s): the impact on dentists, staff and patients.
• Legal issues and potential ramification facing dentists today.
• Medicaid Fraud
• Government and Legislation issues: overreach and/or underreach.
• Solutions: what you can do to protect your patients, yourself, your business and financial future.

Rare appearance together by following speakers:

Lunch will be provided by the following meeting sponsors: 
Dr. Rene Scott
Frank Brown, ADS Watson Brown and Associates
Johnette Green, Wells Fargo, johnette.green@wellsfargo.com
Dr. Shab Krish, MJ and Sleep Therapy Center of North Texas; and
Josh Knowles, Allstate

Concerned Dentists of Texas (CDOT) is committed to the well-being of the dental profession and the patients we serve.

Gentle Smiles, LLC and Dr. Annie Watson, DDS Settles Fraud Allegations with Masshealth

AG Healey Returns $500,000 to Masshealth in Settlement With Springfield Dentist Over Alleged Improper Billing

August  21, 2017

BOSTON – Attorney General Maura Healey announced today that her office has reached a settlement with a pediatric dentist in Springfield, returning $500,000 to the state’s Medicaid program (MassHealth) and resolving claims that the dentist improperly billed the program for services.
The settlement agreement resolves allegations that Dr. Annie Watson, DDS and her dental practice, Gentle Smiles, LLC, improperly billed MassHealth for palliative care (emergency pain treatment) between March 2010 and June 2013, and failed to comply with MassHealth rules associated with the use of that emergency treatment billing code.

The AG’s Office began an investigation into Dr. Watson and Gentle Smiles upon a referral from MassHealth, which identified Dr. Watson as the top biller of the palliative care code among all MassHealth dental providers.

Palliative care is the emergency treatment of dental pain that relieves the pain but is not curative and can include draining of an abscess or prescribing pain medication or antibiotics. In order to bill this code, the patient’s dental record must contain a description of the treatment provided and must document that the treatment was given on an emergency basis.

The AG’s investigation revealed that Dr. Watson routinely billed for palliative care without any supporting documentation, including when patients only received cleanings and x-rays.
Under the terms of the civil settlement, Dr. Watson and her business will pay MassHealth $500,000 as restitution for improper billing. The settlement also requires that Dr. Watson and her employees review and comply with all applicable state and federal statutes, and all regulations governing participation in MassHealth.

MassHealth provides healthcare products and services to eligible low-income individuals, including people with disabilities, children and senior citizens.

This matter was handled by Managing Attorney Lee Hettinger and Investigator Deborah El Majdoubi, both of the AG’s Medicaid Fraud Division. MassHealth assisted in this investigation.

Bethaniel Jefferson indicted on a felony charge of causing serious bodily injury to a child by omission

Photo: Craig Hartley Craig Hartley, Freelance

Excerpts from Houston Chronicle Story:

A former Houston dentist was formally charged Monday (July 24, 2017) with failing to properly treat a sedated 4-year-old patient who was left with permanent brain damage in what should have been a routine procedure.

The child's mother, Courissa Clark, said she was "overjoyed" when she heard the news.

"We're really grateful that justice has been served and the person that did this to our baby is finally being brought to justice," Hall told the Chronicle.

"When little Nevaeh was taken to the dentist that day, (her parents) turned her over to the dentist trusting that the dentist would protect and look after their little girl," said attorney James Moriarty. "But she overdosed her on sedatives."

The girl was sedated at the Diamond Dental office about 8:30 a.m. Jan. 7, 2016, prosecutors said in a statement. Three hours later she suffered a seizure, and her oxygen level and temperature fell dramatically. Prosecutors say it took more than four hours before anyone called for medical assistance.

Jefferson was reprimanded by the Texas Board of Dental Examiners in 2005 and 2012, prosecutors said. The board revoked her license in November after a state administrative judge ruled that she "fell below the minimum standard of care, failed to uphold the duty of fair dealing and committed dishonorable conduct when providing dental care."

The Chronicle's investigation cast a spotlight on Medicaid dental clinics that had flourished through treatment of pediatric patients whose low-income families qualified for government assistance.

Medicaid dental claims in Texas quintupled between 2005 and 2015 to $1 billion a year after the state doubled reimbursement rates in 2007.

Jefferson now faces trial on a first-degree felony charge.

"This indictment should send a message to the medical community that they will be held accountable for abandoning their patients in times of crisis," prosecutor Stan Clark of the Texas attorney general's Medicare fraud unit said in the statement.

"While accidents in the health care industry occur more than everyone would prefer, practitioners must react appropriately and contact higher level medical care providers when they realize their patient is distressed beyond their capabilities," he said.

Read the Entire Article Here