Academy of General Dentistry and American Dental Association Responces to “Dollars and Dentists” Program on PBS

Considering the Academy of General Dentistry (AGD) and the American Dental Association (ADA) are in the same building in downtown Chicago, my mouth actually fell open when I read this statement from the AGD.

Academy of General Dentistry Responds to “Dollars and Dentists” Program on PBS

Chicago (June 27, 2012)—On Tuesday, June 26, the PBS “Frontline” documentary series aired “Dollars and Dentists,” a special program that investigated what it referred to as the “broken nature of the dental care system” in the U.S. According to the PBS piece, more than 100 million Americans currently do not have dental insurance and cannot afford treatment. “Dollars and Dentists” attributed this lack of patient care to the Medicaid system, stating that it did not provide enough of a profit margin to dentists treating children at Medicaid rates. The segment implied that there are very few solutions available to solve this access to care problem. However, extensive analysis conducted by the Academy of General Dentistry (AGD) and other dental organizations has found that this is not the case.

“Dollars and Dentists” showcased the plusses and minuses of high-production dental franchises, which many claim will help to decrease the cost of care for Medicaid rates. The AGD shares the concerns voiced by “Frontline” that, as a business model, dental franchises that focus on quantity before quality may not be in the public’s best interest.

“I am concerned by business models that emphasize production quotas and do not individualize treatment for every patient,” says AGD President Jeffrey M. Cole, DDS, MBA, FAGD. “The focus becomes the company’s revenue rather than personalized care. Each patient deserves the type of time and attention provided by the traditional dental team business model, which promotes better oral health.”

In the “Academy of General Dentistry (AGD) Barriers and Solutions to Accessing Care” white paper, the AGD renews its call for proven dental care solutions and quality care, which were originally outlined in its 2008 “White Paper on Increasing Access to and Utilization of Oral Health Services.” The AGD calls for an increase in Medicaid reimbursement rates, greater efforts to improve oral health literacy and education, expansion of water fluoridation, and the creation of loan forgiveness programs for dentists working in underserved areas, among numerous other solutions that preserve the focus of providing quality care to each individual patient.

Polly “Wanna Crack Her” Buckey Remix

You can't hide your lyin eyes
And your smile is a thin disguise
I thought by now you'd realize
There ain't no way to hide your lyin' eyes
There ain't no way to hide your lyin' eyes
Honey, you can't hide your lyin' eyes – The Eagles

All joking aside, there is no way you can miss when she’s lying. The corner of her mouth pulls to the left, she looks to the right, and her voice is deep and raspy. (shaky)… and she gets that whacked out look on her face.

What I’m wondering is why Dr. David M. Strange has stopped putting his family at risk by going on TV and lying. Maybe it’s because, even though she sucks at it, she is the one willing to risk it all to do it.

There is a lot of hoopla over the FRONTLINE and Center of Public Integrity investigation, which is well deserved. But all the allegations are not new. These same allegation have been hitting regional and local news stations for years.!

Reports have landed in the local press and on local news stations since at least 2008. It is 2012, right?  Is anyone listening to these parents; to these employees?

Here are some of the reports:

Bloomberg reports on Private Equity Dental Chains thus far in 2012

 

To READ:

by Sydney Freedberg - sfreedberg@bloomberg.net.

Dental Abuse of U.S. Poor Dodges Ejection from Medicaid – June 26, 2012 The latest from Bloomberg demonstrates how the OIG is still turning it’s head to the child abuse for fraud, at Small Smiles Dental Centers. This one is outrageous. They ask CSHM to put the clinic in the name of a third party. Well, according to CSHM sworn testimony on numerous occasions, by various Small Smiles Executives they don’t own the clinics. Their mantra is that they only manage them for already third party dentists. The take away is  that the OIG. HHS and DOJ are fully aware (how could they not be) that the true owners of these houses of horrors is CSHM and it’s Private Equity backers. They must simply give them a wink and a nod to falsifying documents, committing fraud, and perjury, just to name a few illegal acts. These would land you or I in jail, by the way.  I don’t know what else a person could think. Do you? Republicans Hit Dental Bill That Private Equity Hates – June 1, 2012 Dental Abuse Seen Driven by Private Equity Investments – May 16, 2012

Texas Attorney General Lawsuit–Dr. Richard Malouf–All Smiles Dental Centers

Texas AG lawsuits spurred by WFAA dental investigation

 

Posted on June 26, 2012 at 12:38 PM

Updated today at 9:40 AM

Related:

• Dental Investigations

DALLAS - A year-long WFAA investigation into questionable Medicaid dental payments has resulted in the Texas Attorney General filing lawsuits this week.

Greg Abbott charges that a Dallas dentist and his corporate entities bilked taxpayers out of millions for fraudulent orthodontic work on poor families.

Dallas dentist Richard Malouf amassed a multi-million dollar mansion, corporate jets and luxury vehicles through his dentistry, News 8 has found.

He and his former firm, All Smiles, declared bankruptcy following a series of reports detailing how he and other dentists around Texas gamed the welfare system by billing for unnecessary dental work.
WFAA found that over the past few years, Texas has paid out more in Medicaid orthodontic claims than all other 49 states combined.
All Smiles billed Medicaid for at least $15 million over two years, which is twice as much as the entire state of Illinois. The Attorney General’s lawsuits, filed in Austin Monday, seek to recoup “two times the amount of the overpayments.”

WFAA’s findings have spurred outrage among lawmakers and hearings in Austin and Washington D.C.

Madelayne Castillo, a former All Smiles employee, and Dallas orthodontist Dr. Christine Ellis filed separate whistleblower lawsuits in April and May alleging fraud by Malouf and his corporations.
Both lawsuits remained sealed while the Attorney General’s office investigated the claims. On Monday, Abbott’s office joined those lawsuits by refiling them in the state's name.

In April, Dr. Ellis testified before the U.S. House Oversight and Government Reform subcommittee that Malouf and other dentists were responsible for “flagrancy of fraud that is truly unbelievable."
In May, WFAA reported that All Smiles bankruptcy documents showed that Malouf owns 28 percent of the company, and Valor Equity of Chicago had the remaining 72 percent.
A subsidiary of Valor is a named defendant in one of the Attorney General’s suits.

Abbott alleges Malouf and others violated of the Texas Medicaid Fraud Prevention Act.

“The defendants knowingly or intentionally submitted false information, and misrepresented material facts, when seeking prior approval for orthodontic services,” the lawsuit states.
“Defendants submitted claims for services which they did not provide, and misrepresented or concealed the true nature of the services which they provided,” it states.

“Defendants also knowingly paid or received consideration as a condition of the provision of dental/orthodontic services by unlawful recruiting and paying kickbacks for the recruiting of Medicaid clients,” it continues.

The suits allege that Malouf and the other defendants billed for work that was not medically necessary, and in some cases, performed it with unqualified dental workers. They also “upcoded,” or billed for orthodontics which were more expensive than what was actually provided, the suit states.

by BYRON HARRIS and JASON TRAHAN

Bio | Email

WFAA

FRONTLINE–Center for Public Integrity Investigation into dentistry in America

 

WATCH: Dollars and Dentists – June 26, 2012    READ: Sen. Grassley Investigating Abuse at Corporate Dental Chains – July 2, 2012 How The Supreme Court’s Ruling Affects Dental Care -  June 28, 2012 Aspen Dental CEO Bob Fontana: “We’re Big Advocates for the Patient” -June 26, 2012 Kool Smiles Response – June 26, 2012 American Dental Association Response to FRONTLINE “Dollars and Dentists” – June 27, 2012 Senator Chuck Grassley’s Response – Report on Findings Expected – June 27, 2012 Dr. Bill Calnon: Why Dentistry Needs More Prevention, Not More Treaters - June 26, 2012 Dental Professionals Speak Out About America’s Care Crisis – June 27, 2012 How To Fix A Broken Dental Safety Net – June 27, 2012 When the Dentist Won’t See You – June 25, 2012 Do You Live in a Dental Desert? – June 27, 2012 America’s Dental Care Crisis – June 19, 2012

Compromise Reach in North Carolina Dental Board of Examiners v Private Equity Dental Chains: NC residents lose

 

Detente reached in dental dustup

June 27, 2012 2:53 PM

Raleigh, N.C. — A high profile legislative battle -- complete with television ads and attention from federal bureaucrats -- between various groups of dentists has ended in compromise.

The North Carolina Board of Dental Examiners and the state's Dental Society had been pushing a bill that would limit dentistry management arrangements. Under those agreements, dentists affiliate with companies that handle certain aspects of their business.

Some of those agreements ceded too much power to the corporations, members of the board and society said. They worried that corporate officials based in other states would make treatment and scheduling decisions for the dentists. 

But the dental management companies and dentists allied with them said the board was interfering in private businesses. They said DMAs give younger dentists trying to open a practice and older dentists winding down their work options that lone practitioners don't have.

"The DMA organizations are going to grow," Dr. Alec Parker, executive director of the dental society, said today. "We just want to make sure their growth includes patient protections."

The House Health and Human Services Committee approved a much shorter bill than the society had originally sought. Language in early versions of the bill that would have given the dental board sweeping policy powers -- such as being able to scrutinize business records -- were not included in the compromise bill.

Existing dental board rules will be allowed to stand, but both sides agreed to create a task force that would recommend changes that would accommodate new business arrangements. 

Representatives from both sides say they expect that task force and the dental board to hammer out a revised set of rules to the liking of all parties and avoid a return trip to the General Assembly.

Over the past several months, both the dental society and the Alliance for Access to Dental Care, a group funded by dental management executives, aired hundreds of thousands of dollars worth of television ads.

Advocates fighting for the bill painted the fight as one that pitted dentists in traditional practices against big corporations funded by private equity groups more concerned with making money than providing quality care. Dental management firms hit back that old-school dentists were trying to limit competition as thousands of North Carolina residents went without affordable dental care. 

Lobbying was intense and involved well known figures in the national Republican Party such as former Florida Gov. Jeb Bush and Grover Norquist of Americans for Tax Reform. In addition, the Federal Trade Commission weighed in, saying the bill first proposed by the Dental Society would have improperly cut down on competition and consumer choice.

"The tensions between both groups will be considerably less," said Tom Fetzer, the alliance's lead lobbyist in Raleigh.

Making the negotiations even touchier was the push and pull between members of the legislature who were dentists and the stated goal of most Republicans to cut back on regulations. 

"It is in the best interest of all parties that the law be clarified," said Rep. Bert Jones, R-Rockingham, a dentist and one of the members tasked with helping both sides find consensus.

In addition to creating a task force, the bill also redefines terms in dental regulations and clarifies how and when the dental board can exercise oversight powers over dentists entering into dental management contracts.  

The full House is expected to hear the bill Wednesday afternoon.

Private Equity Western Dental opens SmileBest in San Antonio–Sinking Ship before it sales ?

Grand Opening on June 30, 2012 for a new “SmileBest Dental in San Antonio.

SmileBest is really Western Dental - P.O. Box 14226, Orange, CA 92863

The..(clearing throat and trying not to choke)… “owner” is Soumava Sen, D.D.S

See press release here
Media contact:
WesternDentalPR@gmail.com

Kurt Hilzinger, Partner, Court Square – is on the board of Western Dental – see here, pg 11.

May 30, 2012

Western Dental mandates Jefferies for sale process

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Western Dental Services, the private dental clinic chain, has mandated Jefferies for a sale process, a source familiar with the matter and an industry banker told mergermarket.

The Orange, California-based company generated USD 71m in EBITDA for 2011, said the source familiar. Books have been distributed to potential bidders, but a first round bid date has not yet been set, the source said.

Western Dental will appeal to private equity firms, said the banker and the source. Jefferies has been reaching out to private equity firms regarding the sale, said the banker.

The company was acquired by Court Square Capital Partners, formally known as Citicorp Venture Capital, in 2005. This news service previously reported that Court Capital was one of the bidders in the final round of the previous process for the company in 2005, at which time Western Dental had USD 45m in EBITDA and was said to be selling for a multiple of 8.2x EBITDA, according to previous reports by this news service.

Read the rest here

Grassley investigates allegations against dental clinics

For Immediate Release

Wednesday, June 27, 2012

Grassley investigates allegations against dental clinics

WASHINGTON – Senator Chuck Grassley is scrutinizing Medicaid-funded dental clinics in response to allegations of abusive treatment of children in clinics controlled by corporate investors rather than dentists.

“We’re finding that these dental practices, under pressure from owners who are not licensed dentists, have been providing services with the highest Medicaid reimbursement levels more often than less expensive, arguably more appropriate services,” Grassley said.  “There are legitimate concerns that children are receiving unnecessary care, sometimes in a traumatic way, and taxpayers are paying for it.”

Grassley has asked questions about ownership structures, incentives, parental notification policies, and participation in Medicaid from Small Smiles, Kool Smiles, and ReachOut Healthcare America.  The companies have been responsive to his inquiries, he said.  All three treat Medicaid children almost exclusively.

“We’re finding that the business model has led to abuses because dentists are under pressure to perform as many high reimbursement services on the maximum number of children on Medicaid as possible,” Grassley said.  “You have dentists under pressure to perform more services than may be necessary – giving a child a crown instead of a filling, for example – because of a bonus payment structure that creates the wrong incentives.”

The issue involves an investment structure that technically meets some state-level requirements that dental practices be dentist-owned but do not, in practice, have dentists in control.  These “owner dentists” are effectively ghost owners who maintain none of the traditional aspects of ownership of their operations, allowing the corporate investors to have control over clinical operations.

A majority of states and the District of Columbia have laws that require owners of a dental practice to be licensed in the state where the practice is located.

Last year, Church Street Health Management owned 70 Small Smiles dental clinics in 22 states and the District of Columbia.  At least five of these clinics have been closed by state regulators.  NCDR, LLC owned more than 130 Kool Smiles clinics in 16 states and the District of Columbia.  ReachOut Health Care America operates mobile clinics that treat children at schools around the country.

Grassley’s review of allegations about dental clinics also has led to Aspen Dental Management, Inc., which doesn’t accept Medicaid patients.  Questions there have been about complaints that the company promotes unnecessary treatment plans with exorbitantly expensive credit arrangements.  Aspen Dental Management, Inc. operates more than 300 clinics in 22 states.

            Grassley said he expects to issue a staff report on his findings involving the companies that serve children in the Medicaid program.  His investigation into credit arrangements offered by Aspen Dental Management, Inc. is ongoing.

Click here to see the June 26, 2012, PBS Frontline piece on these issues.

PR pushback supposedly “after” FRONTLINE aired

Twenty five minutes after FRONTLINE’s “Dollars and Dentists” aired at 10PM Eastern Time, a link to a “rebuttal” landed in my inbox. Amazingly, June Thomas, it’s author, doesn’t know night from day. She watched the FRONTLINE “Dollars and Dentists” tonight, at 12:32PM.  Just saying… 

Hurricane of reports - Private Equity Dentistry in the news– Week of June 25, 2012

Not a good week for criminal dentistry.
 Texas dental Medicaid scandal far from over – Monday June 25, 2012

Dental Abuse of U.S. Poor Dodges Ejection from Medicaid – Tuesday June 26, 2012

March 13, 2012 – Letter from OIG to Sheila Sawyer and Lorri Steiner of Small Smiles Dental
May 15, 2012 – Agreement with OIG Re: Manassas Clinic to Sheila Sawyer and Lorri Steinerof Small Smiles Dental

                                                               Collection of Documents

Dollars and Dentists – FRONTLINE Tuesday June 26, 2012
Check your local listing for air time
Live Chat Wednesday June 27, 2012 @ 2:30 Eastern Time with Miles O'Brien, and Center for Public Integrity reporter David Heath. You can submit questions right now by visiting here.
http://www.iwatchnews.org/2012/06/26/9224/live-chat-dollars-and-dentists

                                                                  Collection of Documents

 

Patients, Pressure and Profits at Aspen Dental – Tuesday June 26, 2012

Truth is a far cry from the reported wonderful benefits of working at Aspen printed last Friday on Dr. Bicuspid, quoting Dr. John Notarianni, DDS 

Complaints About Kids Care Follow Kool Smiles – Tuesday June 26, 2012

Kool Smiles Response fails to address concerns.

Attorney General files lawsuits related to WFAA dental investigations - Tuesday June 26, 2012

Texas AG lawsuits spurred by WFAA dental investigation – June 26, 2012

Corporate dental chains see profitable market treating poor kids and adults – Tuesday June 26, 2012


Anesthesia deaths – Nightline Wednesday June 27, 2012Check your local listing for time

         CANCELED (again)