Friday, May 25, 2012

Dental Center Manager Gets Green Light For Sale To Lenders

Nothing really new here…

Law360, New York (May 25, 2012, 12:36 PM ET) -- A Tennessee bankruptcy judge on Thursday approved a credit bid to sell dental center manager Church Street Health Management LLC to a group of its lenders for $25 million plus their debt, just a few months after fallout from Medicaid fraud claims pushed the company into bankruptcy.


U.S. Bankruptcy Judge Keith M. Lundin agreed to the sale to CSHM LLC, an entity owned by some of Church Street's lenders including CIT Healthcare LLC, after no other bids were received at an auction.

Connecticut attorney general to seek restitution from Winsted dentist over billing practices

I’d say if your are a corrupt dentist in Connecticut and have your name on a PC or PLLC you might be a dumbass. Here is what happened to Dr. Doug Macko. So, if you are in a dental clinic there, and pacing the floor with worry, then you know you are doing criminal acts, right? Get your nitro pills ready. (You know who you are)
HARTFORD –Published: Thursday, May 24, 2012
Attorney General George Jepsen said in a statement that he is seeking restitution from a Winsted dentist and his practice for “allegedly violating the Connecticut Unfair Trade Practices Act by illegally billing the Connecticut Medical Assistance Program from April 2002 through October 2009.”

“The state Department of Social Services administers the Connecticut Medical Assistance Program, which includes Medicaid and other programs that pay for medical benefits for certain low-income and disabled Connecticut residents. DSS terminated the provider agreement for (Dr.) Douglas J. Macko ... and on Oct. 26, 2010, suspended him from the program for 10 years,” the statement said.
Macko and his professional corporation, Douglas J. Macko, D.M.D, P.C., in Southington, “had unlicensed dental assistants perform cleanings and other dental services, which may only be performed by licensed dental professionals, and then billed the state as if Macko had performed the services,” the statement said. “Alleged illegal billings were also made for services that were never provided.”
The complaint also alleges that “the acts, practices and course of wrongful conduct by Macko violated public policies against larceny, vendor fraud, health insurance fraud and against a medical provider violating licensing requirements.”
“This action is being brought to seek restitution, civil penalties and other relief authorized by law,” Jepsen said, also in the statement. “It should also send a clear message to other providers that Connecticut will not ignore fraudulent billing and other illegal practices and will vigorously pursue restoration of taxpayer dollars lost as a result.”
Susan E. Kinsman, director of communications for Jepsen's office said Thursday that the action brought by the attorney general is a civil one and, "It is our understanding that criminal charges have not been brought at this time."

Thursday, May 24, 2012

Mom takes 6-year-old out of dental chair to protect him

These places are so corrupt they don’t even care to change their ways during the middle of massive lawsuits or Federal Investigations.

Mom takes 6-year-old out of dental chair to protect him

Jack Dennis

San Antonio Headlines Examiner

When  Karla Cardenas took her 6-year-old son Steven to a San Antonio dentist office on Friday, May 18, 2012, little did she know that she would have to take her son off the dental  chair and refuse the treatment to protect him.

“They wanted to put him in a straight jacket type papoose while he was still screaming in pain from the shots they were giving him in his gum,” Cardenas said. ”They were trying to rush it and they heavily sedated him.”

The single mother of four took her son to The Smile Center Family Dentistry on Blanco Road after getting the approval and direction from Medicaid.

“I had no choice but to take Steven to that center,” Cardenas said. “Medicaid required it.”

“I told them to stop, you are not going to do this while he is in this much pain,” Cardenas said as she grabbed her son out of the chair.

Cardenas now said she is glad she followed her instinct because she has since learned that this dental care chain has been under scrutiny by the news media.

Chantel Brewer said “they did the same thing to my daughter “but “she kept getting out of the papoose so they wanted to send us home with her teeth all shaved down without the caps on.”

It was so bad that “even the assistant had scratches all over her face from my daughter kicking her in the face, neck, arms and even kicked her in the eye because she was in that much pain.”

“How can the Medicaid office send us to that office when there is this much bad news about them,” Cardenas asks. “It looks like they are herding children in and out as fast as they can with little concern about the pain.”  

Earlier this year, Brian Collister of WOAI news issued several reports regarding similar concerns from other parents. According to WOAI, the dental chain has earned $23 million from Medicaid since 2007.

One San Antonio law firm, The Crosley Law Firm, P.C. is representing patients against this chain of dental centers who believe their children “have been victims of substandard dental care leading to injuries and requiring additional treatment.”

According to the Crosley Law Firm website, “many of these parents were approached in parking lots and lured into Smile Center with the promise of dental exams for their children at no out-of-pocket cost to them.”

“In most cases we have seen, the children were covered by Medicaid, and Smile Center would bill Medicaid directly,” the website stated. “ Often the dental care consisted of pulpotomies and the placement of stainless steel crowns.”

Crosley says that for some of their clients “the dental work may have been unnecessary, and resulted in a large bill to Medicaid” and in some cases “the injuries caused from the dental care necessitated visits to the emergency room and/or hospitalization.”

Cardenas, who has been a nursing student, indicated she “didn’t see any kind of resuscitation or life saving equipment or a ‘crash cart’ available” in the event of an emergency.

“This doesn’t mean they don’t have any (life saving equipment),” Cardenas explained. “I’m just saying I didn’t see any there.”

Hey, dental office managers, you too can be arrested, face felony charges, and jail time.

I have to ask is it worth it? Is playing along with the fraud worth giving up your life and family?

Office managers out there, know exactly what is happening with all the Medicaid fraud, children being abused and sit on their asses. Why?

Yeah, I’ve heard it, over and over and over again. “I need to feed my family”. Don’t mean to be so cold, but I’m so over hearing it.

OM’s at the dental mills are paid well, very well, too well in many cases. $50 to $60 thousand dollars a year is over the top to manage an office for a dental clinic. The paycheck is meant to hold them hostage as well keep them gagged and handcuffed.

Several times a week I find folks coming to this blog looking for the answer to their question on whether they- office managers, dental assistants, etc.-can be arrested or held liable in criminal fraud or malpractice behavior they see in their offices. They answer is a big fat YES. Ask Claudia Ventura.

CA Dentist Arrested for Insurance Fraud

Insurance Fraud — By Trace America on May 14, 2012 at 4:48 PM

Beverly Hills often brings up images of huge mansions with beautiful sparkling swimming pools, gorgeously landscaped lawns, and several fancy cars in a large driveway. It often does not bring up images of insurance fraud; but one Beverly Hills dentist to the stars may be changing that.

According to the Beverly Hills Patch and the District Attorney’s Office, Tom K. Kalili, 57, was arrested on May 4th and accused of insurance fraud, grand theft of personal property and filing a false tax return. He was charged in a criminal complaint with 101 felony counts.

Kalili is the owner and operator of Beverly Hills Medical Suites.

It is reported that Kalili and his partners have several celebrity clients, including Jim Carrey, Kathy Ireland, Adam Sandler, Keanu Reeves and Vin Diesel.

Kalili’s office manager and biller, Claudia Ventura, 38, is also being charged, if only with 10 felony counts, including insurance fraud and accessory after the fact.

These charges all come out of a multi-year investigation by the California Department of Insurance, the California Dental Board and the California Franchise Board.

According to DrBicuspid, Kalili directed Ventura to submit fraudulent billing statements to four different insurers for a total of $339,799.99.

Prosecutors are asking for Kalili’s bail to be set at $500,000 and Ventura’s at $25,000.

If Kalili is convicted, he could face over 50 years in state prison, while Ventura could only receive up to seven.

Errol Gillis, DDS v California Board of Dentistry–Appeals Court Decision–Gillis lost on many levels.

Dr. Gillis worked at Sears Dental and things did not go well for him. He fought the law, and the law won. He lost his licenses for "gross negligent and incompetent" professional treatment. He appealed that decision to an Administrative Law Judge. The Dental Board took it to the First Appellate District Division One in California. The Dental Board won. Errol M. Gillis, DDS v California Board of Dentistry - Appeals Court Decision and Order Case CPF-10-510174

Jot this down: After a five-day hearing spanning days in June, July, and September 2009, an ALJ issued a proposed decision on December 3, 2009. The decision found the facts as set forth above and concluded Gillis was both grossly negligent and incompetent under Business and Professions Code section 16702 for overfilling James J.‟s tooth (paragraph 5E), both grossly negligent and engaging in unprofessional conduct under section 1670 for failing to respond to the wife‟s calls (paragraph 5G), and repeatedly negligent under section 1670 for failing to maintain complete patient records and failing to note the overfill or advise James J. about it (paragraphs 5A and 5F). The ALJ found the Board had not proved the other allegations of the accusation.

The Dental Nightmare of Private Equity

The Dental Nightmare of Private Equity

Wall Street Oasis

After years of getting quarterly dental cleanings, my periodontist said he wanted to pull several teeth and do three or four periodontal procedures. My pockets were too deep, I was told. And don't worry, the receptionist said in a cheerful voice, I didn't have to pay all at once. I was given about nine or ten months to get the $8000 together.

I declined the offer. He is now my ex-periodontist.

Several years later, I was on the verge of losing tooth #16, the left upper quadrant wisdom tooth. And tooth #15, the second molar, was not in good shape either. I was willing to sacrifice my wisdom tooth if it meant saving the tooth next to it, but then my dentist wanted to pull that one too! So I set up appointments with dentist after dentist after oral surgeon after endodontist until I found a dentist I could trust. My new dentist filled the tooth with no guarantees--this was about five years ago--and I've been fine ever since. No root canal. No tooth extraction.

So you can imagine my horror when I read the following (from May 17 on the Bloomberg website, an article by Sydney Freedberg: Dental Abuse Seen Driven By Private Equity Investments):

Wednesday, May 23, 2012

Small Smiles can’t pay their creditors but can offer $5000 sign up bonuses to prospective employees? Just saying…

http://www.careerbuilder.com/JobSeeker/Jobs/JobDetails.aspx?APath=2.21.0.0.0&job_did=J3I3NB6W7KYYHNSM80R&IPath=JRM0B

I guess they have cut back, it used to be $10k. lol

Speaking of bonuses, maybe the $10K “loans” mentioned in the March 2012 below expense report were “signing loansnotsigning bonuses”.

Anyone closing these illegal operations down yet? Anyone interested?

Wouldn’t dental insurance companies be held liable for recommending their beneficiaries go to these illegal  operations? What about CSM, for recommending them? What about Tristar and Dentaquest for recommending these illegal dental clinics? Just asking…

Doc 272-March-Monthly Operating Report - Church Street Health Management

May 2012 and still disgusting reports about Small Smiles. Can someone just tell me, why that is exactly?

Ever heard of Small Smiles Dentistry?

May 23, 2012

Firstly I want to say that I am speaking from personal experience with a Small Smiles Dental Office.  I have had some what irritating and bad experiences with them.  My son first went to them when he was three and well I thought nothing of it.  We knew he needed his front teeth pulled on top.  He had acid reflux as a baby till about two years old and does have a pretty bad gag reflex. 

So with that being said puking was his middle name if I brushed his little gums with that blue finger thing, he would puke projectile! He still has some issues with his gagging, he also has a bit of anxiety as well, I wont deny that.  However we needed to go in for cleanings that was fine.  They told me he needed to come in 1 time a year or less that he should be okay.  I asked about the cleanings they said just make sure he brushes.  So I did what they said and we went back again later for another issue he was having a tooth that was bothering him. 

They said it was two teeth and capped  them both with silver, he did gag and puke while there.  Then after they said he didn't need to come back at all for cleanings, to just keep him brushing.  I called another dentist who pushed us away, saying sedate him, he needs to be put under.  I really didn’t think that was the smart thing to do.  He has respiratory problems already with asthma.  I was referred by this new dentist to another dentist and they said put him under, he needs to be put to sleep.  I’m sorry if they can work on other peoples kids to fill a tooth, why on earth was it that horrible for mine.  So I called small smiles again because I felt defeated that NO ONE would see him unless sedated or the others I called weren’t accepting new patients.

So after calling Small Smiles again I just didn’t know where else to go, we honestly cannot afford to pay for him being put under, and I’m afraid to!  By this time the dentist said it would be easier to just pull it, and when he came out, he looked horrible my poor baby.  His face was so red and I said next time my husband or I will be going back there.  We attempted to schedule a cleaning and they didn’t seem to have any openings. 

I called them again recently because my son is having issues.  We take him in and they sit there and put there fingers in his mouth and pull them out fast like they are scared of him, cause he may puke because last time he was there for the same tooth he puked on the woman, she was upset and started complaining my hair, my hair.  I told them its been hard just even trying to get him to properly brush.  The puke filled with stomach acid isn’t for the teeth at all and will rot them!  So she was very childish this time, there is no soothing or trying to make him feel comfortable.  So after poking their fingers in and out of his mouth like scaredy cats, they sent in two other women and left. 

Then told my husband his tooth needed extracted.   It had a abscess on it so we got antibiotics thankfully.  The dentist they referred us to was AWESOME!!! Dr Craig Schmidtke, of Metro Oral – Maxillofacial & Facial Cosmetic Surgery.  He looked at his mouth and said I can send you next door to Dr. so and so  to save the tooth and explained he don’t want to put him under because of his asthma, that he could get his tooth out with no problem if there isn’t any saving it.  We called the other doctors next door and another one they referred to but neither were taking new patients.

So I just said its a baby tooth, it will grow in later just take care of it now.   So they took him back and boom it didn’t take long at all a little topical numbing and gas they didn’t even give him a shot of numbing, at least he said they didn’t!  He said that the guy was really nice and made him feel like he really wouldn’t hurt him.  I was so glad and felt so relieved, happy and so grateful he was good to my boy.

What he did explain to me about Small Smiles is that they have no special training to call themselves Pediatric.  He said he took special courses to be an Oral Maxillofacial etc to be the specialist he is.   He took Psychology classes and everything, that he could do it and boom it would be done, no sedation.  I was shocked to hear there is no special training or nothing, they are basic dentists who take a crash course basically in dental.   Kinda scary to think they are only taking care of kids, then to think they tell parents no when they ask to go back with their children.

When I was there a 12-14 year old girl asked if her Mother could go back there with her, not thinking they would say no her mom was right behind her, they said NO you don’t need your mom.  Told the mother to wait out there and she would be out soon.

HELL NO is what I say!  No one tells me that I cannot go back with my child to have a procedure of any kind done!

I don’t recommend this dental company as a good dentist for kids!

They use very tight restraints that strap there arms to their sides, they are being sued for their behavior now by 10 family’s!

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.