Saturday, August 27, 2011

Feds to investigate Medicaid orthodontics fraud in Texas

 by BYRON HARRIS
Bio | Email
WFAA
Posted on August 25, 2011 at 10:37 PM
Updated Thursday, Aug 25 at 10:37 PM

NEWS 8 INVESTIGATES

For the past six months, News 8 investigations have revealed hundreds of millions of dollars of questionable Medicaid spending on braces for children in Texas.

Now federal investigators are auditing the Texas Health and Human Services Commission, which controls those funds. Taking the lead in the audit is the Office of Inspector General of the U.S. Department of Health and Human Services.

In a letter to the state, the inspector general says it will examine the "authorization process for orthodontic treatment" under Texas Medicaid. "The objective of our audit," the letter continues, "is to review the State's controls to ensure that only medically necessary orthodontic cases are paid." The time period covered by the audit is September 1, 2008 through May 28, 2011.

Friday, August 26, 2011

Thursday, August 25, 2011

Texas State Dental Board says it can’t stop the dental abuse and Medicaid fraud until someone complains, well someone complain already! Here’s help.

Texas State Board of Dental Examiners
Texas Dental Board Complaint Process
Texas Dental Laws, Rules and Regulations

Complaints
:  
complaints@tsbde.texas.gov
E-mailing the Board
:

Indicate the intent of your communication in the subject and body of your email. This will help prevent our Security System from flagging your email as possible spam and deleting it.
Ms. Abigail Gutierrez, Administrative Assistant
Phone: (512) 475-2019
Fax: (512) 463-7452
Ms. Erica Bommarito, Administrative Assistant Phone: (512) 475-1996
Fax: (512) 463-7452
Ms. Jennifer Carriker, Compliance Officer, Administrative Assistant Phone: (512) 305-8991
Fax: (512) 463-7452
Ms. Gutierrez, Ms. Bommarito and Ms. Carriker can assist with:
          Contacting the Director of Enforcement
         How to file a compliant or check on the status of an on-going complaint           Information about a Closed or Dismissed Case
          Board Order Compliance
              (For Conditional Dismissal Compliance - Ms. Debbie Powell, Legal Assistant - (512) 475-0982)
Other Agency divisions and contact information

Texas State Dental Board Information:
Phone:  (512) 463-6400      (8am - 5pm, Monday - Friday, Except Holidays)
Main Fax:  (512) 463-7452
Open Records Fax:  (512) 532-0637
Open Records Requests: openrecords@tsbde.texas.gov

Mailing Address:
Texas State Board of Dental Examiners
333 Guadalupe, Tower 3, Suite 800
Austin, Texas 78701-3942
File a Consumer Complaint with Texas Attorney General here

File a Medicaid fraud complaint with Texas here
Report the fraud, reap the benefits-share in a portion of the recovery here.
Write your state lawmaker here
File a complaint with your local District Attorney or County Attorney, you can find them in the phone book.
Don’t forget to follow up all complaints with further letters and phone calls. 



American Dental Partners, Inc and Tooth Doctor for Kids Spreading from Arizona to Texas

Another dental mill is opening more Texas dental clinics since it appears the Texas State Dental Board of Examiners has opened the doors to the illegal practice of dentistry by corporations and dental Medicaid fraud.  Yes, Texas is open for business indeed, Mr. Perry. 
a  toothdoctor for kids
A Tooth Doctor for Kids/Braces For Less with 5 locations in Arizona and 7 locations in and around Houston and 2 locations in San Antonio Texas is coming to the Dallas/Ft. Worth area. 
With 9 locations already at work in Texas, Tooth Doctor for Kids has six more locations scheduled to open between August 2011 and late fall 2011, as seen here on their website.
Their website says they offer; Dental checkups, Cleanings, and x-rays; Dental Fillings and Crowns; Sedation; Sealants; Fluoride Treatment; Space Maintainers.
What is hard to find on their website is the name of the dentists treating the children and if those dentists are general dentists or pediatric dentists.  Website design and clinic décor is the main misleading marketing to parents, implying the dentists spent an extra 2 years of dental school to become pedodontists when they did not.

Wednesday, August 24, 2011

CSHM–Small Smiles Dental Centers are among exclusive group of 19 under a “Quality of Care” Corporate Integrity Agreement with US government

There are 346 Corporate Integrity Agreements individuals and corporations have signed with the Office of Inspector General (OIG).  Out of those 346 only 19 have the distinguished designation as being “Quality of Care Corporate Integrity Agreements”.  Church Street Health Management (f/k/a FORBA)  is among the exclusive bunch.

According to the OIG Quality of Care CIA’s:

Monday, August 22, 2011

Small Smiles and Corporate Practice of Medicine

Cashing In by Cashing Out

Texas Board Dental of Examiners allows non US residents to scam taxpayers out of $22 million dollars. Cheap labor from across the boarder helps make the Navarro brothers two of the wealthiest Orthodontists in the US. Texas Dental Board refused to answer these questionable practices.

by BYRON HARRIS
Bio | Email

WFAA
Posted on August 18, 2011 at 10:00 PM
Updated today at 3:16 PM

DALLAS - Many parents know it can cost as much as $5,000 to put braces on a child's teeth. Despite the high cost, it's a financial sacrifice some families make for a child's appearance.

Rarely are braces a health issue. But, while some families struggle to pay for braces, under Medicaid in Texas, tens of thousands of children get braces for free.

Last year, Texas spent $184 million on braces under Medicaid. And while Texas spent as much as the rest of the nation combined, some states, like Michigan and Kansas, spent zero.

Penny v. OrthAlliance, Jordan v. OrthAlliance & Glower v OrthAlliance- Corporate Dentistry Ruled Illegal

 

From Hospital and Health Systems Group – June 2008

One example of provider relations going horribly wrong is the OrthAlliance experience. OrthAlliance is an orthodontic practice management company that follows a model common in the industry: the company first purchases the assets and leaseholds held by individual orthodontists or professional orthodontic corporations; then it enters into an agreement with the orthodontist or practice to
provide comprehensive practice management services; and finally, the practice
management company employs the orthodontist’s existing nonprofessional staff. It appears, however, that the arrangements were not as financially successful as several of OrthAlliance’s orthodontists had hoped, and the relationships between OrthAlliance and many of those providers eventually broke down. By 2001, approximatelyfifty-six OrthAlliance-affiliated practitioners and/or  their professional corporations had filed lawsuits in eleven states.

 

2003 Penny v OrthAlliance
Corporate Dentistry Ruled Illegal

From Orthalliance 10-k Annual Report

On March 26, 2003, the U.S. District Court for the Northern District of Texas, in ruling on the plaintiffs’ motion for summary judgment in a case captioned Penny v. OrthAlliance, Inc. , held that, when construed together, the purchase agreements and service agreements between the plaintiffs and OrthAlliance and the employment agreements between the individual plaintiffs and their practices violated Texas statutes prohibiting the unauthorized practice of dentistry and were therefore invalid. In the court’s view, the interrelationship among these agreements allowed OrthAlliance to own, maintain or operate an office or place of business in which it employs or engages the plaintiffs to practice dentistry, in violation of Texas law. In reaching its conclusion, the court noted that OrthAlliance leases or owns and maintains the office space and tangible assets used in the plaintiffs’ practices and provides comprehensive practice

Terms of Avoidance

 

Essentially

Basically

Associated

Thursday, August 18, 2011

Check the Senators Cardin’s campaign contributions!

Yes, average wait time is 7 minutes!  Yes, 100% approval rating.  Since the asked two people, whom they probably paid!!! 

Senator, you may be a fine man, you may be a smart man.  But no one would know by listening to what you are saying today.

What are you going to say when this company ends up under Federal investigation like Small Smiles?  Will you tell us how great the place is then?  Did you even check to see if they were being investigated before stepping up to that podium? 

Since you want to take credit for this house of horrors, are you going to take the blame as well? 

Maybe we should send all the complaints to your office!!

See: Hey Senator Ben Cardin