American Academy of Pediatric Dentistry - Media Information

American Academy of Pediatric Dentistry - Media Information

I can’t believe I missed this in 2010! She’s walking in Steven Adiar’s shoes while she’s suppose to be monitoring his child abusing, Medicaid defrauding company, Church Street Health Management. Adair used to be the Editor.  I’ve heard about how her “monitor” visits go at the Small Smiles Centers. She’s either not looking or turning her head! But that’s what you get with self-policing. It really amounts to more layers of cover-up protection. Disgusting!

AAPD Appoints New Editor-in-Chief
The American Academy of Pediatric Dentistry (AAPD), the recognized leader in children’s dental health, appointed Dr. N. Sue Seale as Editor-in-Chief of Pediatric Dentistry and Journal of Dentistry for Children effective January 1, 2010.

Seale is a Regents Professor of Pediatric Dentistry at the Baylor College of Dentistry, Texas A&M Health Science Center in Dallas, Texas. She received her dental degree in 1970, her certificate in pediatric dentistry in 1972 and her Master of Science in Dentistry in 1979 from the Baylor College of Dentistry. Since 1974, she has been a full-time faculty member in the Department of Pediatric Dentistry at the Baylor College of Dentistry and was Chairman of the Department from 1986-2009.

Seale has served in a variety of leadership roles, including serving as a past president of the Texas Academy of Pediatric Dentistry and on the Board of Trustees of the American Academy of Pediatric Dentistry. She received a Distinguished Alumni Award from the Baylor College of Dentistry Alumni Association and was elected to the Baylor College of Dentistry Hall of Fame in 2010. In 2001, the AAPD named her Pediatric Dentist of the Year. Seale was also a recipient of the AAPD’s Merle C. Hunter Leadership Award in 2003. Seale is a diplomate of the American Board of Pediatric Dentistry.

“I am excited to take on this new role and look forward to participating in the changes that will take place in our journals over the coming years as we strive to meet the changing needs of our readers,” said Seale.

Seale’s areas of interest include pulp therapy for the primary and young permanent dentition, dental education and access to care.

Justice Department and Arizona AG Break Up Dental Conspiracy 1994

FOR IMMEDIATE RELEASE AT
TUESDAY, AUGUST 30, 1994 (202) 616-2771
TDD (202) 514-1888

Press Release

DEPARTMENT OF JUSTICE AND ARIZONA STATE ATTORNEY GENERAL
BREAK UP DENTAL GROUP'S CONSPIRACY TO ELIMINATE DISCOUNTING
WASHINGTON, D.C. -- The Department of Justice and the Arizona Attorney General's office acted jointly today to stop a statewide agreement that made it almost impossible for many dentists in Arizona to cut their prices or offer discounts on dental services.

Similar agreements are common in the health care industry, and those that stifle price competition are likely to be challenged elsewhere, the Justice Department warned today. In a civil antitrust suit and proposed settlement filed in Phoenix, the dentist-controlled Delta Dental Plan of Arizona Inc. was accused of eliminating discounts and reducing price competition under an agreement that had the effect of preventing dentists from cutting fees below those offered in the Delta Plan.

This is the first action challenging such contract provisions, which are known in the industry as "most favored nation" clauses. Approximately 85% of the dentists in Arizona have affiliated with Delta, the dominant dental plan in the state, the Department said.

 

Who are on these committees and subcommittees making these guidelines? Who are they cozy with?

 

2011 Behavioral Management Guidelines

The link above contains the latest version, according to the American Academy of Pediatric Dentistry (AAPD). It’s written and revised by the AAPD Clinical Affairs Committee – Behavior Management Subcommittee. I want to know who is on this committees, don’t you?

In fact, I think it is extremely important to know who is on each of these committees and subcommittees. They are setting guidelines and standards that our federal and state government rely heavily on. Most of the time these guidelines are 100% relied upon.

We certainly demand to know who is making our laws and just who these lawmakers are all cozied up with, well, what’s the difference?! NONE!

I’ve found a helpful little website where you can check guidelines for various healthcare professions. It’s at the Agency for Healthcare Research and Quality (AHRQ). It’s the National Guideline Clearing House.

I’ve not tried it, but it appears you can compare guidelines, now isn’t that cool.  Well, if it works anyway.

You can check past guidelines going back to 1997, that seems handy: browse by Organization,Topic,Guidelines in progress, get expert commentaries and much more.

Of course in checking this place out I got fired up over reading all the guidelines for Behavioral Management (D9920). Various terms for it are used; Behavior Guidance, Behavior Management, Behavior Control. The latest term, “Guidance” sounds so much nicer doesn’t it.

I don’t care what they call it, it’s worse than a straight jacket. In a straight jacket you can at least have use of your legs, but not in the papoose board, rainbow wrap, blankets or whatever cuddly term is thrown at the damn thing.

Shreveport dentist convicted of Medicaid fraud | Shreveporttimes | shreveporttimes.com

It’s not been a good month for dentist committing Medicaid Fraud has it?

Shreveport dentist convicted of Medicaid fraud | Shreveporttimes | shreveporttimes.com

Shreveport dentist David Earl Reed faces prison and fines after a conviction on two counts of Medicaid fraud.

Reed, 56, was barred from participating in the Medicaid program after a fraud conviction in 1992.

He continued applying to participate in the program from 2006 to 2008 and was denied. In 2009, state health officials told him he would be barred from the program for at least five more years.

However, from 2005 to 2007, Reed treated Medicaid patients while working for another Shreveport dentist. Reed submitted false billing claims to the program under the other dentist's provider number and received payment from Medicaid.

Health providers excluded from the program can't provide any services that will be billed directly or indirectly to Medicaid. It's a crime to be employed by, have a contract with or have an ownership interest in a healthcare provider that bills Medicaid, said Louisiana Attorney General Buddy Caldwell.

Reed will be sentenced April 27. He faces up to five years in prison and fines up to $20,000 on each fraud count.

Dentist arrested for Medicaid fraud - Breaking News - www.observer-reporter.com

January 27, 2012

A Washington County dentist, who allegedly prescribed more than 6,600 narcotic pain killers to seven patients, was arrested today by state narcotics and Medicaid fraud agents.

Dr. Charles Kokoska, 48, 2 Mill St., Millsboro, was charged by the state attorney general's office. Koskoska has offices at his Mill Street home and at 161 Waterdam Road, McMurray.

According to the criminal complaint, between January 2009 and October 2010 Dr. Kokoska wrote more than 300 prescriptions for more than 6,600 narcotic pain killers to at least seven different patients.

The prescriptions were written for the powerful prescription pain killers Oxycodone, Hydrocodone, and Propoxyphene and filled at various pharmacies in Allegheny, Fayette, Greene and Washington counties. Kokoska also wrote prescriptions for Diazepam, a generic form of Xanax, commonly used to treat anxiety.

Dr. Kokoska is charged with seven counts of prohibited acts by medical professional and two counts of provider prohibited acts.

He was arraigned before Brownsville Magisterial District Judge Joshua Kanalis and released on $25,000 unsecured bail.

Dentist arrested for Medicaid fraud - Breaking News - www.observer-reporter.com

Centre County Dentist Facing Insurance Fraud Charge | GantDaily.com

 

January 27, 2012 at 6:46 AM

HARRISBURG, PA – Attorney General Linda Kelly announced criminal charges have been filed against a Centre County dentist accused of submitting more than $52,000 in false insurance claims following a joint investigation with the Federal Bureau of Investigations (FBI) State College office. 

Kelly identified the defendant as Dr. Jamshid Assadinia, 53, of 1764 Cambridge Drive, State College, Centre County. Dr. Assadinia owns and operates Jamshid Assadinia DDS,300 South Allen St., State College.

Kelly said Assadinia allegedly submitted insurance claims for dental procedures that he never performed and then billed the insurance companies more than $52,000 under the names of several different patients.

I don’t know, but I’ve been told, ReachOut America is as low as they go.

I’m hearing ReachOut Healthcare America mobile dentistry, and their Big Smiles program has a “service center” type place with hoards of telemarketers in cubicles, burning up the phone lines with a list of potential victims to contact that is as long as your arm. 

Telemarketers? Yes,telemarketers. This is where the “ReachOut” part comes into play. Each telemarketer has a list of the names of children, parents, your child’s school, and parent or guardian contact information.

For example, let’s say you are home, the phone rings, you answer and it’s a nice lady telling you the mobile dental clinic your school has approved, which is staffed with a highly qualified dentist and two assistants will be at your school on such and such date. Sounds just like picture-day doesn’t it?

The telemarketers have their expertly crafted scripts ready, which makes this phone call really a “high pressure” sales call. You’re probably going to be quoted statistics and such about the poor status of children’s dental health here in America, your state or even your town.

The telemarketer tell you they just your verbal permission - probably recorded- or so they might tell you. ReachOut can have their highly qualified and well trained dentist do just a little look-see, a screening so to speak, or maybe its been a while since your child’s last cleaning, they could do that for you too. They may tell you they will send home a report detailing Susie’s dental health.

They might ask, if their highly trained staff does find a problem, with Susie, do you what them to fix it, right then and there, since it is a full service mobile clinic. It will save you all kinds of time and we know as parents, time is a valuable commodity, right? Plus, how can you neglect your child by withholding dental care? Free dental care?! Free, you may ask?

The telemarketer, I mean company representative, tells you there will be no cost to you, since your child is eligible for free dental services because of your states Child Health Insurance Program (CHIP). Sounds like if you are on the “free lunch” list you get free dental care at school too, doesn’t it? 

In fact you may feel at the end of the phone call your this is all arranged by your school system as a service to all the children, included as a normal as the school nurse. Remember the fluoride rinses back in the 1980’s?

You could be lead to believe it’s nothing more than dental hygiene instruction – remember those Bell Telephone movie reels that used to make the rounds at schools?  No, well you’re not as old as me then.

If you decide you would like to be there for the event, you’re likely to be told that since they aren’t sure exactly what time Susie will be called, you could possibly be sitting there in the school all day, and you don’t want to be doing that, right? That’s just another classic separate the child and the parent ploy.

Speaking of that “free lunch” list, is that where ReachOut Healthcare got your contact information?

BUSINESS BRIEFS: Padula chosen citizen of year - The Pueblo Chieftain–more like snake of the century! GAG!

 

The Greater Pueblo Chamber of Commerce will honor Center for American Values founder Adolph "Rudy" Padula with its annual Citizen of the Year award, the group announced Monday.

   The award presentation will take place at the chamber's annual dinner Thursday night at the Pueblo Convention Center. Tickets remain available for the event. For reservations, call 542-1704.

   Padula, a Pueblo dentist for nearly 40 years, launched the Center for American Values several years ago. He purchased and renovated The Waterford, a large, aged building on the Historic Arkansas Riverwalk of Pueblo, into a new retail-office building that also is home to the center's meeting room and Medal of Honor portrait display.

BUSINESS BRIEFS: Padula chosen citizen of year - The Pueblo Chieftain: Local Business

UPDATED: TX Medicaid combats overuse of kids' braces -- 22 visits a year! | Trail Blazers Blog | dallasnews.com

 

UPDATE, 3:30 p.m.: The attorney general's office has 31 orthodontists under investigation for possible Medicaid fraud, David Maxwell, the office's deputy director of law enforcement, testified to the House panel. According to Rep. Lois Kolkhorst, R-Brenham, the panel's chairwoman, 24 percent of the nearly 80,000 children who last year received orthodontic services from Medicaid were under the age of 12. State social services czar Tom Suehs testified that, starting in March, the minimum age for treatment of severe misalignment of upper and lower teeth will be 13. "Some of our providers out there gamed and manipulated the system," Suehs testified. "I won't use the word fraud. ... Clearly, we didn't have some of the controls we should've had."

ORIGINAL POST: Poor youngsters in Texas who were put into braces courtesy of taxpayers saw their orthodontist an average of 22 times in fiscal 2010, state Medicaid chiefs said in testimony they were to give to a legislative panel Tuesday.

"Typically, 12 visits per year is expected," said the written testimony by Medicaid chiefs Tom Suehs (right) and Billy Millwee to the House Public Health Committee.

Read the rest – click below

UPDATED: TX Medicaid combats overuse of kids' braces -- 22 visits a year! | Trail Blazers Blog | dallasnews.com

You may have paper clips in your root canal too! -Michael Clair Guilty Plea

A Massachusetts dentist plead guilty yesterday of Medicaid fraud and assault and jury tampering. Michael Clair had been banned from providing services to Medicaid patients, yet, but in so many cases these days, that means little. He still managed to collect $130,000 in fraudulent reimbursement. He would have other dentists in the dental practice provide billing services for work he did, in order to service Medicaid patients. He also managed to get his staff to fill prescriptions and give him the pills.  Tsk Tsk  His dental license had been revoked in Maryland, West Virginia and Florida, but Mass let him in!  Yes, those dental boards are fantastic!!  NOT!

A couple of sad things, one, it took 4 years to get here!  There were anonymous reports to the dental board (yes, I'm 100000% positive on that and they weren't so anonymous!), many other letters of concern and pleas for someone to stop this man. His dental license was suspended in 2006 and he's supposedly barred form practicing dentistry, which means, he's probably already open another office.

The second, sad, and oh so scary thing is, you may have paper clips in your mouth too! Today I received the following email:

Hi there,

I saw your post regarding the dentist in Mass that "did a root canal with a paperclip. I am not defending him at all. I just wanted to let you know that the use of a paperclip as part of a provisional crown is a legitimate technique. Now, I have no knowledge of the legitimacy of billing this to Medicaid. Attached is a photograph I just took from Herb Schillenberg's "Fundamentals of Fixed Prosthodontics" 3rd edition. This is the most cited text book on the market on the subject of fixed prosthodontics.

Thank you for your time,

DrJ

Thanks Dr. J