Tuesday, May 22, 2012

American for Tax Reform promoting Private Equity’s take over of your dental health.

As Bloomberg report in “Dental Abuse Seen Driven by Private Equity” as has pointed out, this is NOT a good idea. All American’s should be fighting this issue and support North Carolina’s Senate Bill 655.

ATR is demonstrating the lengths the Private Equity firms will go to in order to line their pockets with your health and health care dollars. These dental management companies could care less about your dental health. But they certainly care about the creative dental care they can deliver to you, your children, your family, and your elderly.

Here ya go:

 

ATR Urges North Carolina Legislators to Reject Anti-Free Enterprise Protectionism

North Carolina is one of the top battleground states for the 2012 election. Ads are already flooding the airwaves from Cape Hatteras to Cashiers and, with the DNC being held in Charlotte, the state is expected to become a political fever pitch over the next few months.

A major topic during the campaign season will be the policies that President Obama has signed into law, such as the 20 tax increases in ObamaCare alone, that will drive up the cost of health care. Indeed, Republicans who hope to pick up three congressional seats in the Tar Heel State will make this a major theme of their campaigns. Yet, in order for North Carolina Republicans to avoid muddling their message and contradicting themselves, Republican state legislators would do well to reject Senate Bill 655, legislation currently pending in the General Assembly that would drive up the cost of dental care for North Carolinians.

Yesterday, Americans for Tax Reform sent the following letter to all members of the North Carolina House, urging them to reject SB 655, legislation that uses the power of government to stifle competition and drive up consumer costs:

21 May 2012

Dear legislators,

On behalf of Americans for Tax Reform (ATR), I write today urging you to reject Senate Bill 655. If passed, this bill would add onerous new regulations restricting the ability of dentists in North Carolina to engage in free enterprise and administer their practices more efficiently. Simply put, this bill is an attempt to use the power of the government to eliminate competition. The effects of SB 655 will harm consumers and taxpayers in the state by limiting access to care, restricting competition, increasing costs, destroying jobs and discouraging investment.

It does NOT add “new” regulations. It further defines regulations already in place, because the Private Equity firms have found, and sometimes created loop holes  with direct access to your dental health.

As it stands, North Carolina faces a shortage of dentists, ranking just 46th nationally in dentists per capita, based on data from the American Dental Association (ADA) and US Census Bureau. The result is less access to needed care and higher costs. Dentists in North Carolina earn 25 percent more than the national average according to the Bureau of Labor Statistics.

Who said there is a shortage of dentist? ADA? Seriously!  WTF! The ADA is in bed with the Private Equity firms! Google Dental Group Practice Association and the ADA. The ADA is allowing the president of the DGAP to host and sponsor simanrs to “sell their snake oil.” Various heads of the ADA are owners or partner in the Private Equity owned changes of dental clinics! What does preventing Private Equity and Hedge funds from deciding the treatment your dentist delivers have to do with the above? Nothing!

This costs North Carolina consumers over $250 million more in additional costs every year, with the effects being the same as that of a hidden tax: increased costs and less disposable income for the citizens of North Carolina. SB 655 would exacerbate these current problems.

Tell us exactly how the above is true? Because the ATR says it is? I say it’s BS. ATR is making this a political issue as if your dental care depends on whether you are a Democrat, Republican or Independent. This is ridiculous.

Given the rising costs of health care across the United States and the resulting burden on employers and taxpayers, states should look to promote more efficient models of delivering healthcare. SB 655 would prohibit dental practices from contracting with Dental Service Organizations (DSOs), which allow dentists to focus exclusively on providing care, resulting in both high quality care and lower costs for patients.

More outright bullshit! DSO’s are owned and operated by Private Equity firms and they could care less about your dental health! These rules were put in place to protect the public and NC is trying to continue to protect the public.

DSOs do not own dental practices,[choking and gagging on this one, pure lies, let’s put a couple of these fake owners in front of a grand jury and see if the DSO’s own the clinics or not, I dare someone to do this one.] and the Dental Board already has the regulatory authority required to ensure that all dentists deliver high quality care to their patients, irrespective of how they choose to contract for administrative services. This is a broadly accepted model utilized by many other medical professions, including emergency room physicians, oncologists, anesthesiologists and hospitalists. In a recent statement, the ADA wrote: “States should implement administrative reforms to cut red tape that impedes dentists from delivering care and patients from receiving it.” SB 655 flies in the face of this advice.

What red tape? Go to school? Pass a test? DEA paperwork? Hell, why require any of this, since it appears this is too much red tape.

As the John Locke Foundation noted in its analysis of SB 655, North Carolina lawmakers “should be looking at ways to expand dental care in North Carolina, not restrict it. If a management company is interested in assuming purchasing, billing and administrative duties and a dentist wants to spend more time on patient care, they ought to be allowed to work out whatever arrangement works best for them.” ATR agrees whole-heartedly with this astute assessment.

While many in the dental industry support SB 655, many other dentists, consumers, taxpayers, employers, and investors in North Carolina would be harmed by this legislation. Rather than consider legislation that stifles competition and drives up consumer costs, North Carolina lawmakers should instead be looking for ways to make the state more economically competitive.  As such, I urge you to oppose SB 655. If you have any questions, please contact ATR’s Patrick Gleason at (202) 785-0266 or pgleason@atr.org.   

Onward,

Grover G. Norquist [head idiot in charge]

Read more: http://atr.org/atr-urges-north-carolina-legislators-reject-a6899#ixzz1vcX74nVb

Monday, May 21, 2012

David Bates, DDS, president of Allcare Dental Management and Allcare Dental and Dentures of New Hampshire, surrendered his license to the state Board of Dental Examiners

NASHUA – The president of a defunct dental chain gave up his New Hampshire dentistry license to resolve professional misconduct charges.

David Bates, DDS, president of Allcare Dental Management and Allcare Dental and Dentures of New Hampshire, surrendered his license to the state Board of Dental Examiners. The board approved the agreement on May 9, according to state Attorney General Michael Delaney.

Bates had been scheduled to appear before the board for disciplinary hearings later this month. Bates has also been the focus of licensing boards in Massachusetts, West Virginia and North Dakota, Delaney said.

Most of the company’s offices closed abruptly in December 2010. In Nashua, that meant hundreds of former patients, some of whom said they prepaid for dental work, descended on the Nashua office shortly after New Year’s Day trying to track down their dental records, X-rays and dentures.

Sunday, May 20, 2012

Bloomberg article on private equity firms abusing children with unnecessary and intrusive dental treatment has spurred several articles on the web

Here are some highlights:
Bloomberg – Business Week

Deal Book – New York Times:


San Fransisco Chronicle


BoingBoing 40 comments or more:


Compliance Search

 

Physicians for National Health Program

 

Global Post

 

Watchdog Bytes

Huffington Post

 

Meta Filter

 


Weblog

Protect Quality Dental Care


Bangor Maine Daily News:

Charleston Daily Mail

Democratic Underground

Summary of Twitter links:

 

Happy Birthday to me… Happy Birthday to me….

Dental boards: their mission is clear, but the execution—not so much title

One of my least favorite organizations, but still good points made.

Submitted by Editor at DOCS Education on May 16, 2012 - 4:05pm-Dental boards: their mission is clear, but the execution—not so much

Protect the public. That’s the deceptively simple mission of any American dental board. But while the mandate may be uncomplicated, its execution is anything but. Critics of board actions say they range from misguided and contradictory to baldly self-interested. Controversial decisions are increasingly putting boards under fire. Among the more common sources of complaint are
unfair and unequal treatment of dentists; failure to quickly address malpractice and the unlawful restraint of competition.

Perhaps nowhere is the board under greater fire than in Texas, where the executive director recently resigned. Sherri Meek’s abrupt exit followed a rocky stint punctuated by frequent dispute. In particular Meek was assailed for allowing board members to act as paid expert witnesses in lawsuits against Texas dentists; the practice posed a clear conflict of interest. Long-time opponent Dr. Mark
Stankewitz, a prosthodonist, used YouTube to decry the Texas board as “a good- ole-boys’ network…some dentists receive slaps on the wrists for serious matters and others serious consequences for much less significant offenses.”

Dentist-turned-attorney Frank Recker used the same language—a good-ole-boy’s network—to describe his own experience on the Ohio State Dental Board in the early 1980s.

Parents: Dental Board investigators headed to Bakersfield

Saturday, May 19 2012 10:00 PM

The Bakersfield Californian
Parents: Dental Board investigators headed to Bakersfield
BY KELLIE SCHMITT Californian staff writer kschmitt@bakersfield.com

State dental board officials will come to town in early June to investigate long-simmering allegations that a Bakersfield dentist mistreated children while they were strapped to a papoose, or stabilizing board, several local parents say.

Many of the parents involved also allege excessive, unnecessary or flawed dental treatments from Dr. Edward Dove.

 

"I struggle with the fact that it's taken a long time, but at least movement is coming quickly now," said parent Chris Cook, who has led a grassroots mobilization effort. "I'm exhausted but that doesn't mean I stop -- he ain't getting away from me."

Dove did not respond to an interview request, though he said last year that he gives excellent care, has never hurt a patient and the parents are "making it up." Dove, who has a clean disciplinary record, also said last year that the papoose board was necessary to keep some of his young patients immobile during treatment.

Since the parents banded together with a Facebook page last summer, the Bakersfield Police Department has conducted "a couple of investigations" into Dove's care, said Sgt. Joe Grubbs. He said police have been unable to substantiate any criminal wrongdoing, and are not actively investigating Dove now.

News of the Dental Board of California visit follows the decision by a high-profile Colorado attorney not to take the local parents' case.

Jim Moriarty, who is currently representing a young patient in a case of alleged pediatric dental abuse that's received national lawmaker attention, said the Bakersfield case involved too few local parents, a weak expert on his side, and too much "he said/she said." He also said being an out-of-state attorney was challenging.

Despite that setback, which parent Cook called "extremely shocking," the parents' case is still building momentum. Along with the coming dental board visit, they've collected about 1,000 signatures for an online petition to revoke Dove's license. Several weeks ago, Cook's son was featured with other Bakersfield children in an Inside Edition television segment, which investigated dental papoose boards.

To papoose or not?

Papoose boards, many of which have Velcro straps, are used to hold young patients in a stable position while procedures can be safely done.

Many of the parents' complaints against Dove stem from the slaps and scratches that reportedly happened while their children were restrained on the board, under partial sedation. Parents weren't allowed in the room during the process, something Dove has said is important since they can interrupt and distract from care.

The American Dental Association responded to that Inside Edition show with a press release detailing guidelines on when such stabilization should be used.

The American Academy of Pediatric Dentistry says papoose boards might be used when young patients require immediate diagnosis but can't cooperate due to "a lack of maturity or mental or physical disability;" when the safety of the patient, dental staff or parents would be at risk; or when movement of sedated patients needs to be reduced.

In general, papoose boards aren't considered part of routine dental care, said Dr. Paul Casamassimo, a pediatric expert at the Nationwide Children's Hospital in Ohio and a past president of the American Academy of Pediatric Dentistry. For a typical, healthy child, it would not be the first course of action.

[Dr. Casamassimo has failed to mention since 2008 he has been on the the board of advisors to one of those Private Equity dental chains-Small Smiles. I would like to ask Dr. Paul Casamassimo why he’s done nothing to stop the use of the papooose board, mainly used to expedite treatment, in the Small Smiles Dental Centers. In fact Dr. Casamassimo and Dr. Steven Adair, Small Smiles new Director of Clinical Quality Initiatives and Education and asshole buddies as they say, putting on a CE course together in Adair’s home town of Hilton Head, North Carolina.]

"Most people undergoing procedures in a dental office can stand still," he said. "It would be a hysterical child, or one who is too young to understand what is going on who would need the papoose."

At Ohio State University, a resident in one of Casamassimo's programs is working on a thesis project looking at parental attitudes toward papoose boards as well as other techniques like oral sedation, anesthesia and distraction/positive reinforcement.

Thirty years ago, parents would have said they'd rather have their children held down and the job done, Casamassimo said. Now, though, he has seen a 180-degree shift, as parents prefer putting children to sleep for extensive care.

[Is it the parents, Dr. Casamassimo or is it your pocketbook that prefers sedation. I call BS on that 30 years ago crap, 30 years ago no one had ever heard of such a thing. Were you papoosed Dr. C?]

In a previous interview, Dove pointed out that using general anesthesia is much costlier than using the papoose board, which can be a factor for parents struggling financially.

Another shift in dental practices is the increasing movement toward having parents present during care, Casamassimo said. He said the group of dentists who preferred that parents stay out of the room is largely retiring and a new generation wants the family more involved.

[Increased shift toward parents being present??  Would  that be because of this blog and the lashing you’ve taken for the past four years. If not for the force of the Federal Government, Small Smiles would still be keeping parents in the waiting rooms.

[I want to know when the shirt was away from having parents present? Actually, that was something Dr. Casamassimo and some of his colleagues hatched to not let parents know what they were doing to the children back in those rooms. Dr. C is as much a part of this problem as anyone. He’s held various offices at the AAPD for decades!]  

Regardless of whether parents are in a room, they should actively understand the extent of the procedures, the pros and cons, and be comfortable with it, he said.

That's not what Bakersfield parent Kristy Andreas says she experienced when she took her then-3-year-old son, Evan, to see Dove. If she had understood Evan would be papoosed, she would have insisted on staying with him, or at least behind the door, she said.

Evan says he was scolded and hit during his dental procedures, Andreas said. In addition, Andreas found Dove's care faulty. She ended up getting not just a second but a third opinion to prove it, all of which she said she has documented in her dental board complaint.

Attorney setback

Late last year, Colorado attorney Moriarty told The Californian he was poised to represent Bakersfield parents and was planning a visit here to ink the deal. Earlier this year, he said he was having an expert review some of the children's dental records. But last week, he said he had decided not to take the case.

Moriarty's other dental clients have been in the headlines recently for a case against a dental management company. Such management companies, which are often backed by private-equity money, are the subject of a U.S. Senate inquiry.

Moriarty said some private-equity backed dental businesses routinely bilk Medicaid patients, mistreating them in the process. Even though Medicaid reimbursements tend to be very low, the idea is that the businesses can make money if they practice "assembly line medicine."

"They routinely papoose and grossly sedate children, routinely refusing to allow parents to be present," he said. "They do that to keep parents from knowing what they're doing."

Moriarty said he was drawn to the Bakersfield case because of the parents' mobilization efforts. Ultimately, though, there was too much "he said/she said" and it would have required working with another California-licensed attorney since he was out of state, he said. Besides, he specializes in going up against private equity-funded dental businesses. Dove owns his own business.

Moriarty was clear that he still supports the California parents' mission.

"What Chris Cook and the other families did -- banding together, raising hell and bringing attention to the authorities --brings to light" conduct which otherwise would not be brought to life, he said.

That's exactly what local parents hope to accomplish June 9, when they say dental board investigators will interview their children at the Bakersfield Police Department.

If a dental board investigation finds a preponderance of evidence some violation has occurred, the next step is for the case to go before an administrative law judge, said Russ Heimerich, a spokesman for the dental board. He would not comment on any specific details of the Dove case.

But that could take some time. From January to March of this year alone, the dental board received 969 complaints. From the intake of a complaint to disciplinary action -- if it is deemed necessary -- takes about 1,100 days on average.

"I know some people want it wrapped up in an hour, like CSI," Heimerich said. "But these aren't investigations that happen overnight."

Staff writer Jason Kotowski contributed to this report.

Thursday, May 17, 2012

Private equity, profits and aggressive dentistry

 

Global Post

Bloomberg has published an article today that you just have to read.

It starts with a mom in Arizona picking up her (sobbing) 4 year old after school, only to learn that a dentist had installed steel crowns on two of his back teeth — "pulpotomies" according to a note in his backpack. Baby root canals.

The mother hadn't even been consulted. "I was absolutely horrified," she said.

No, this wasn't Marathon Man for toddlers. So why this aggressive act of dentistry?

It was about money. Profits. Private equity. And a new plague known as "dental abuse."

Bloomberg explains:

Isaac’s dentist was dispatched to his school by ReachOut Healthcare America, a dental management services company that’s in the portfolio of Morgan Stanley Private Equity, operates in 22 states and has dealt with 1.5 million patients. Management companies are at the center of a US Senate inquiry, and audits, investigations and civil actions in six states over allegations of unnecessary procedures, low-quality treatment and the unlicensed practice of dentistry.

ReachOut, Bloomberg reports, is one of just 25 dental management services "bought or backed by private-equity firms in the last decade." The management services take care of the business side, leaving the dentists to focus on teeth. The trouble started when the profit-driven businesses began seeing opportunity in your tax dollars: Medicaid.

Maybe that's why there's a big cavity in the US government's budget?

A former physician once counseled me that dentists were "a bunch of crooks, out to get rich." At the time, I took that with a grain of salt. Thanks to Bloomberg, I won't even floss without exercising caution.

Click here, and read on

And if there's a dentist nearby, keep your mouth closed. 

American’s Dental Health is at Risk: The true crisis in dentistry

As Bloomberg reported today, Private Equity is seen as the driving force behind abusive dentistry and Medicaid fraud. Little Isaac Gagnon, is still suffering from night terror from the abuse he endured while he was supposed to be safe at school.

The Fort Worth Star Telegram followed saying Texas taxpayer are getting hosed for unneeded dental procedures which amounts to Medicaid fraud.

Byron Harris of WFAA in Dallas has been reporting about this for months.

However, it is “We The People” who are picking up the tab and enriching Private Equity firms coffers into the billions of dollars. But that is not the biggest price being paid.

The biggest price of all is the dental health of each and every American!

This is not a Medicaid patient only problem. The same driving force is behind places like Heartland, MidWest, Pacific Dental, BrightNow, Aspen Dental, Affordable Dentures, Comfort Dental and now Wal-Mart is getting in on the action. The list goes on.

It’s not just Texas taxpayers, it’s ALL taxpayers

Texas taxpayers soaked for unneeded dental work

Speaking of Texas teeth, combine devious dentists with dubious private equity firms and what do you get?  

Soaked taxpayers it seems, Bloomberg reports.  

Some private equity firms have figured ways to overcharge Medicaid for dental work, and Texas seems to be a hotbed. The Texas State Board of Dental Examiners is investigating dozens of cases where dentists billed Medicaid for unneeded work or for services they didn't do. A Dallas orthodontist who reviewed Medicaid dental claims for the state told Congress that fraud in Texas is flagrant and that some dental clinics engaged in the illegal practice of dentistry.

Don't credit the state for uncovering the scandal. A series of exposes by Byron Harris of WFAA revealed little oversight of the state Medicaid program. He reported that more than 20,000 Texas children under age 12 received braces in a year's time. One clinic billed Texas Medicaid more than the whole state of Illinois spent on Medicaid dental care.

Chew on that a while if you wonder whether Texas state government is keeping a close watch on spending your tax dollars. 

Read more here: http://blogs.star-telegram.com/investigations/2012/05/speaking-of-texas-teeth-combine-devious-dentists-with-dubious-private-equity-firms-and-what-do-you-get-soaked-taxpayers-ac.html#storylink=cpy

Bloomberg reports rats out Private Equity dental abuses on children in public schools and the public at large

Bloomberg report

Special needs child taken from class and received root canals, stainless steel crowns and excessive X-rays without parents consent or knowledge, while his brother was next to him hearing his screams of pain and fear. 

Dr. Alvin Coon working for ReachOut Healthcare America's Big Smile mobile dental program deliver the horrifying treatment and could be headed to jail. Just two weeks ago a child in California had 4 teeth pulled while at school by the same company.  The company is under investigation in AZ and CA.

Read the shocking story here at Bloomberg

 

Want to see what happens to these children? Watch this!

http://bloomberg.com/news/2012-05-17/dental-abuse-seen-driven-by-private-equity-investments.html

As an after dinner liqueur I suggest this – April 30, 2012

Big Corporations Pony Up Over $1 Million To Oppose Senate Bill 655 in Legislature

Wednesday, May 16, 2012

Pueblo Small Smiles Dental Center Sold?

Rumor has it, Dr. Andrew Loomis – date of hire May 23, 2011- is purchasing the Small Smiles Dental Clinic in Pueblo, Colorado and the current employees last day is late next week.

Anyone besides me crying foul and not believing that an actual sale is happening?

I find it odd that a guy who has been with the company for less than a year is purchasing the original Small Smiles. You know the DeRose family is not going to allow anyone to control their original clinic. I’m sure it hold a massive amount of sentimental value.

The clinic just so happens to be housed in a building owned by the DeRose-Padula Enterprises. This sounds like North Carolina and DeRose’s fake sale of the Smile Starters Dental Centers to his employee, Raf Rivera, DDS about the time he agreed to pay $10 mil to settle fraud charges.

If I were a dentist purchasing the clinic, where I had been an employee for a year. There was a  full staff with whom I had worked all during that time, I would most likely keep them on, wouldn’t you? Why wouldn’t you? Some of those let go will be bound by non-compete agreements won’t they?

I’m pretty darn sure Michael DeRose, Eddie too, are on the List of Excluded Individuals and Entities and are not to participate in the Medicaid program, directly or indirectly. I guess DeRose Padula Enterprises is not on that list so it can participate? All sounds ridiculous doesn’t it? That’s because it is ridiculous.

Presumably Randall Ellis, DDS owns the place, right? He is one of those “fake” owners for Church Street Health Management. One thing is for sure, if Randy Ellis, DDS actually owns the clinic,as he has filed sworn documents attesting to, then he should have some serious capital gains on that 2012 tax return on his.

However, if you go back and look at the entity documents on file with the Colorado Secretary of State’s website, I’m not sure it ever left the DeRose Family in the first place.

Tax Assessor Office

Pueblo Tax Assessor's Office, report on 1022 Liberty Lane,Pueblo, Colorado, 81001

All Personal Property is billed to Church Street Health Management, LLC in Nashville, assessed at $34,996.

Land and Building belongs to DeRose Padula Enterprises. Assessed value for 2012 is $430,411. (land 77,500 structure $352,911)

So what did Dr. Loomis purchase and from whom did he purchase it? Has this been reported to the Bankruptcy Trustee?

How many papoose boards did he get in the deal? I notice they are not actually listed as being part of Church Street Health Management’s assets, but surely they are part of the $34,996 of “personal property”. Did he get his contract back so he’s not auctioned off like a slave in a human trafficking ring?

Church Street Health Management Personal Property (Form B38)– begins on page 32

Church Street Health Management, LLC Credit Agreement with Garrison Loan Agency, LLC