Kool Smiles under investigation?

February 11, 2013
I'm hearing rumblings of a Kool Smiles investigation going on by a federal agency but its not the one I have would expected; although I'm not surprised to hear is taking place.

There are literally thousands of complaints from parents and patients online about the Kool Smiles call center, for example:

404-781-0512 "Kool Smiles continues to call my cell phone and harass me almost daily...even after I've told them numerous times to stop..."

"They are so pressed to get your business that they disregard your privacy.."

"...I receive several phone calls a week from Kool Smiles to both my cell phone and my husband's..."

"These callers call me again and again..."

I'm told their automated system was a train wreck and Kool Smiles is fully aware of it.

Essentially set up as an appointment reminder it soon turned into high pressure sales calls to get parents to bring their child back for more torturous dental care. As long as the number was a "good" number Kool Smiles would continue the harassment. Same as they are with children's teeth, as long as there is prospective tooth to treat, it got treated, needed or not.

Apparently there has finally been enough complaints and the FCC is investigating. This is not confirmed by the FCC but my sources are solid.

In further Kool Smiles news:

I'm told Kool Smiles in Texas are being converted to their latest brain child - Resolution Dental. All expansion plans for new offices that were scheduled to open in 2013 have been cancelled.

Conspiracy Lawsuit Filed Against Wal-Mart and Executivies

El Segundo, CA (PRWEB) February 10, 2013
The Layfield Law Firm, on behalf of its client Dr. Kianor Shah, has filed legal action against Wal-Mart Stores Inc. and Comfort Care Dental Management (CCDM), a registered Dental Service Organization (DSO) in Delaware, in addition to several other individuals. Filed in the Superior Court of California - County of Riverside on December 21, 2012, (Case # 1218772) this suit alleges counts of civil conspiracy, misappropriation of trade secrets, breach of contract and confidence, tortious interference with prospective economic advantage, and violation of laws, requirements, and regulations.

According to court documents, in late 2008, Dr. Shah came up with the innovative idea of opening low- cost, full service dental offices in big-box retailers. Dr. Shah pitched the idea to Wal-Mart, who committed to put-into-action his clinics; however, Defendant Wal-Mart reverted back stating that it was no longer interested in having dental clinics inside their retail stores.

Texas Medicaid orthodontics spending off the charts; Facts are facts folks.

WFAA’s Byron Harris must be fed-up with his reports and statistics being questioned by folks hoping to keep the Medicaid dental spending unchecked in Texas. 

Here is Byron’s latest:

 

Bracing Ourselves: How Texas spent $705 million on Medicaid braces

by BYRON HARRIS
Bio | Email
WFAA
Posted on February 4, 2013 at 6:35 PM
Updated yesterday at 2:32 PM

Until last year, the Texas Medicaid Dental Orthodontic program was spending money like a Christmas shopper on Black Friday. Between 2008 and 2011, Texas spent $705 million on Medicaid orthodontics, which experts say many children don't even need. That's because the state was paying the bills without adding them up, or even seeing if the money was well spent.

It was what Doug Wilson, the Inspector General of Texas Health and Human Services, calls a "pay and chase" environment. Texas now is earnestly in the "chase" mode. It has between 300 and 400 open investigations. Wilson took over the Office of Inspector General in 2011, and after a series of WFAA stories exposing questionable Medicaid payments, the state is beefing up its investigation of Medicaid fraud.

"Texas is a huge state. There are a lot of kids out there," Wilson told News 8 in a lengthy interview last month. "Some of the things we're seeing are just errors and other things that we're seeing are more intentional. And we're taking appropriate actions and making referrals as necessary."

The state now is holding payments back from 91 Medicaid providers for Credible Allegations of Fraud. Dozens are dentists and orthodontists.

The first signs of trouble were in 2008. That's when an audit by the OIG revealed problems.

"The volume of prior authorizations (for spending on braces) was extremely high," Wilson says. 

The OIG warned the state that applications for braces (orthodontics) were not being inspected carefully enough, and that the state should consider beefing up its staff. 

"We thought things were going to get better," Wilson says. "As we now know, they didn't necessarily get better. The volume of orthodontia in our state was extremely high. We warned them, and I think they tried to act but they didn't go far enough."

In 2011, News 8 began asking for Medicaid records under the Freedom of Information Act (FOIA) and the Texas Public Information Act (TPIA) to see how much Texas was paying to put braces on kids under Medicaid, and how it compared to the rest of the nation.

Data obtained by News 8 from TDHHS showed that Texas spent $184 million on orthodontics for Medicaid kids in 2010. News 8 had to pay for this data because the state did not compile them on its own. TDHHS has now adjusted the total upward to $200 million.

To get a national picture, News 8 obtained total spending figures from the federal Medicaid Statistical Information System (MSIS). These numbers, which took weeks to obtain, had never been compiled until News 8 asked for them. The most recent totals available were, and still are, from 2009. The entire nation spent $355,550,331 in 2009.

 

Texas alone spent about 70 percent of the rest of the nation combined.

North Aurora Dental Associates fake dentist arrested

 

Aurora Illinois - An Aurora woman faces charges of illegally practicing dentistry at a North Aurora dental office, police said.

North Aurora police and the Kane County State’s Attorney’s Office have obtained a criminal indictment against the woman for illegal dentistry practice at the North Aurora Dental Associates office on the 100 block of North Lincolnway (Route 31).

The defendant is Silvia Hernandez, 37, of the 400 block of Iowa Avenue, Aurora. Hernandez was indicted last week by a Kane County Grand Jury on the following charges:

• Theft, a Class 3 felony

• Deceptive Practices, a Class A misdemeanor

• Unlawful Practice of Dentistry, a Class A misdemeanor

The charges come after an investigation of over seven months by North Aurora police detectives.

Charging documents allege that Hernandez knowingly took control of more than $500 but less than $10,000 from someone by portraying herself as a licensed dentist in the State of Illinois, when in fact she was not a licensed dentist, according to a news release.

This investigation began on July 5, 2012 when a female came to North Aurora Dental Associates to report a problem with her braces. When the office staff could find no record of the female ever having been a patient there, she reported that she paid “Doctor Silvia” to put her braces on in this office about four years prior. Staff at North Aurora Dental Associates contacted North Aurora Police immediately.

It’s getting bizarre in Texas over all the dental Medicaid Fraud being uncovered. The whackos are coming out of the closet and testifying in Austin.

Last week some whacked “organization” had their “President” testify before the Texas Senate Finance Committee singing the blues over dentists being investigated for Medicaid fraud in the state.

Well, it’s not really an “organization” per se, it’s more like 3 highly questionable dentists and a general counsel for a controversial law firm.

Greg Ewing, president of Texas Dentists for Medicaid Reform Fraud (you will understand this later) group said dentists were unfairly having funds withheld by the state because of a “2 years of disinformation” – did he mean by the media? If so, that means the media has mucho power!  He further stated  “evidence of fraud does not exist”. Ewing actually insinuated to even investigate the possibility for Medicaid fraud would be a waste of taxpayers money, saying “the State will lose money because the level of investigation will end up costing taxpayers millions more".

Was he really telling the Senate Finance Committee,  “look guys, they have already stolen it, let ‘em keep it and while you’re at it, tell HHS and OIG to leave them alone?”

Ewing also sat there with a straight face and told the Finance Committee that the Texas Medical Association did an independent review of Carousel Dentistry operations and found the clinics “highly efficient”. Why Carousel was even mentioned in beyond me. More on Carousel later.

Who is Texas Dentists for Medicaid Reform? 

 

The president of TDMR is Greg Ewing, an attorney for Asbahi Law Group.  Asbahi Law Group is more or less a lobbyist started in 2009 by Mazen Asbahi, a former community organizer, but best known for his appointment by the Barack Obama campaign to head up outreach efforts in the Arab American and American Muslim community. Asabahi later resigned after it was revealed he served on the board of the Allied Assets Advisors Fund with Jamal Said which supposedly raised money for Hamas.  Currently it’s reported Mazen Asbahi newest lobby efforts are to get guns to Syrian Rebels.

Wonder why this Mazen Asbahi guy is so interested in Texas Medicaid fraud?

The only other people mentioned on their website are 3 members who are dentists., Dr. Tara Rios, Dr. Juan Villareal, DDS and Dr. Vivian Teegardin, DDS, both of Harlingen Family Dentistry in Harlingen, Texas.

 

Dr. Tara Rios, DDS
Brownsville Family Dentistry
1601 E. Alton Gloor Boulevard
Suite 108
Brownsville, TX 78526
Phone: (956) 542-1956
Fax: (956)542-3672
office@drtarariosdds.com
2010 –D2930 Crowns = 82

In the bios of the “members” of TDMR, they fail to use Dr. Rios’s complete name – Dr. Tara Rios Ybarra. In 2010 then Texas State Representative (D-South Padre Island) was taken into federal custody for Medicaid fraud which also involved Texas dentist Gary Morgan Schwaz and six others. Schwaz, owner of Valley Oral and Maxillofacial Surgery was accused of paying dentists to received referrals for Medicaid recipients. 

Tara Rios Ybarra charged in Medicaid fraud case

Oral and Maxillofacial Surgeon and His Employees Indicted – FBI

Appears it’s not the first time Rios-Ybarra has been used as a patsy.  While a Texas Representative it appears she sponsored bills that were actually put forth by “special interests”.

Tara Rios Ybarra Unprepared and Clueless on her own bills – You have to see this one!!

Comment:
“Well, we can all see that she was basically elected to her district because she is Hispanic and nothing more. I guess this is what happens when you are corrupt. She had no business being elected to any office in the united states. She would be great in Mexico though. Worthless piece of trash!”

Want to work for Aspen Dental?

You might want to reconsider. Below are just a few points made by current or former employees of Aspen Dental -
Pros: Free Lunch w/ meetings, plenty of employees to "vent" with.
Cons: No morals from corporate headquarters, illegal, company is a joke, over worked, all about sales, unethical, money driven, no real concern about patient care, high stress
Read all the reviews here:
Aspen Jobs

Blowing the Whistle Pays

http://therolladailynews.com/article/20130131/NEWS/130139669/-1/opinion

Attorney General Chris Koster said today that his office has awarded $8,239 to a Medicaid fraud whistleblower who alerted the state to fraudulent billings by a group of dental clinics. The award money is 10 percent of $82,000 that the dental provider is paying in restitution and penalties to the state of Missouri, as allowed by Missouri law.

“Medicaid fraud tips are an important part of our efforts to investigate and punish Medicaid fraud,” Koster said. “We encourage anyone who suspects a health care provider is engaged in Medicaid fraud to contact our office so we can investigate.”

Koster said the whistleblower contacted his office in January 2011 with concerns about Ozark Family Dentistry, and the clinics’ owner, Dr. Arrash Ahmadnia. Dr. Ahmadnia, based in Rolla, owns dental clinics in Rolla, Thayer, Osceola and Springfield.

The whistleblower, who worked briefly at one of the clinics, alerted the Attorney General’s Office that Dr. Ahmadnia had instructed him to perform unnecessary work on patients, presumably to bill the costs to Missouri Medicaid. The Attorney General’s investigation found that the clinics had billed Medicaid for treatments under the code for dental fillings, but had actually performed different procedures – preventative resin restorations – which are not covered by Medicaid. The investigation also found some instances of double billing and billing for ineligible adults.

Under a settlement, Dr. Ahmadnia is required to pay more than $208,000 in restitution and penalties to the state and federal Medicaid programs. He is also required to immediately stop submitting reimbursement claims to Medicaid for the preventive resin restoration treatments. The agreement is a compromise of disputed claims and does not contain an admission of wrongdoing by Dr. Ahmadnia. The Attorney General’s Office is continuing to review billing procedures at the clinics.

Trueblood Dentistry and their string of Carousel chops shops finally forced to close!

In all the raw data I’ve seen out of Texas, this one would nearly always fall in the top 5.  This one alone is said to have stolen $18 million from taxpayers.  Just imagine the hundreds and hundreds of millions, if not billions stolen from scam dentists and dental companies in the state of Texas!  Perp walk please!!

I’m sure the “pity” party has begun.

 

By Chuck Lindell

American-Statesman Staff

Carousel Pediatrics began shutting down its Austin dental practice Tuesday night, displacing about 28,000 low-income pediatric patients, after state health investigators cut off Medicaid payments over allegations of fraudulent activity.

Carousel’s owner, Dr. Glenn Wood, who disputed the fraud allegations, said the loss of about $400,000 a month in Medicaid payments required him to shut down his dental affiliate, Trueblood Dental Associates, and lay off about 40 staff members and six dentists.

13 more pages of allegations in latest Aspen Dental Complaint

Aspen Dental - Amended Class Action Complaint Filed 1-18-2013 by Dentist The Menace

Two reports on poor quality of care by dentists claiming expertise in implants

A story by the Bakersfield Californian, reports the California Dental Board has filed a complaint against Dr. Robert Tupac, DDs to the state’s department of consumer affairs.

Dr. Tupac reportedly told one patient “not to worry about a thing, I wrote the book on (dental) implants,"

The report says, the complaint was issued by the state Attorney General raises numerous issues that should result in his licenses being revoked or suspended: for discipline" against Tupac, including gross negligence, altering patient records, aiding and abetting an unlicensed person to practice dentistry, incompetence and obtaining fees by fraud. The document requests that the Dental Board revoke or suspend his license and pay restitution.

According to the report, his dental licenses remain squeaky clean, despite his own professional regulatory board having multiple complaints against him on file AND have filed their own complaint to the California Department of Consumer Affairs!!

“The Dental Board issued Tupac's dental license in 1974. The board's website does not show any previous disciplinary actions against him.”

In a report on KGET-TV’s website it says “The California Dental Board wants to suspend or revoke the license of…”  Well, then why don’t they??  

Newspaper report: Bakersfield dentist accused of incompetence, negligence

California AG Marc Greenbaum’s complaint filed against Robert George Tupac, DDS

Dr. Li Skelton

This situation with Dr. Tupac sounds much like a situation with an implant dentist in Texas who says their office “specializes” in dental implants – Dr. Li Skelton.  Heck her new clinic even promotes tourism dentistry, just to see her.