A court affidavit claimed that Gallanosa offered patients money for accepting free dental work, then billed Indiana's Medicaid program.
In one instance, Gallanosa paid a man who recruited three dental patients from an Indianapolis mental health facility, the Marion County Prosecutor's Office said.
Prosecutors said in one day, he removed 33 teeth from the three patients.
So what happened to Dr. Gallanosa, was he taken off the streets? Nope! He went right back to work. It’s my understand he was not to treat Medicaid patients but he worked in a clinic that did…so…. It’s possible, just possible he saw Medicaid patients and it was billed under another dentists name, know what I mean?
Dr. Gallanosa was before the Indiana Dental Board at it’s February 1, 2013 meeting, and asked just these questions. After some tough questions, Dr. G finally admitted he was working in Evansville, Indiana and was indeed treating Medicaid patients. One board member was furious and wanted his license revoked. The rest, well… they wanted to investigate it further!! What’s to investigate?!
“White House Tours will be canceled effective Saturday, March 9, 2013 until further notice,” according to a White House email. Meanwhile, billions of dollars pour out of Medicare and Medicaid because of waste and fraud. Indeed, eliminating Medicare and Medicaid fraud, rather than White House tours, would offset the sequester cuts for the next decade.
I don’t know how much money President Obama thinks it saves by canceling White House tours, though I’ll bet it’s a lot less than one of his golfing trips on Air Force One, which costs about $180,000 an hour to fly.
But we do have several estimates of how much Medicare and Medicaid fraud cost. Typical estimates, which have been echoed by the Obama administration, put the figure in the $60 billion a year range for each program.
A study by the Rand Corporation pegged Medicare and Medicaid fraud at about $98 billion in 2011, roughly equal to the future annual budget cuts (actually, reductions in the rate of growth) imposed by the sequester.
The Government Accountability Office’s (GAO) most recent estimate for Medicare, released in February, claimed there was a total of $44 billion in improper payments in 2012. That figure is a little lower than the $48 billion for 2010.
Not all of the GAO calculation is fraud. It includes overpayments and underpayments, unnecessary services, coding errors and other problems. And there is fraud that isn’t detected by the GAO report. But you get the idea; it’s a big problem and getting bigger as criminals and the mob get more brazen in their efforts. For example:
On March 6, 2013 Dr. Paul Casamassimo published an article on Dr. Bicuspid - “Second Opinion: Gorillas in the dental operatory”
I know thousands of children who have seen dentists in clinics of which he was closely associated who would damn well agree! Big Ole Gorillas! Big – Mean – Nasty - Cruel - Gorillas!
The whole article was a lot of mumbo jumbo BS. Leaving the mind wondering exactly what “state” his was in. But mostly it was about “more”, as usual. “More” is always the theme.
“Medicaid expansion without reimbursement increases may simply just put more people in cars and on the phone searching for dental care.”
Well, that’s where we’ve been the last umpteen times it’s expanded, right? It should give you more PPP – Production Per Patient opportunities!
“The proposed increase in dental schools and new workforce models carry with them the specter of educational debt and the likelihood that these providers will be reluctant to serve the poor.”
More schools, more student debt, more dentists, …I can only see more whining, crying, boo hoo’ing and bellowing There aren’t enough mouths to keep dentists financially secure now, to hear many tell it. On the other hand others live quite nicely…
As it is, dentists are fighting over who can get the reimbursement for a tooth first; Medicaid or private. A virgin tooth is on the endangered species list and worth a small fortune.
That term he used, “new workforce models” was scary! Wished he had elaborated more other than just using such a catchy term.
“The dental profession may be ill-prepared to take on additional newly insured children under the ACA, not only because of the financial inadequacies in reimbursement, but because of social factors that tend to permeate many health-related behaviors, not just oral health. Repeated surveys of dentists caring for Medicaid clients include "patient characteristics" in the top three reasons provided for lack of their participation. Despite that, reimbursement for care-management costs related to oral health to agencies or providers remains spotty at best.”
Huh?
I take it when the day comes every American is on government funded healthcare we will all be seen as misfits, we will all be “the poor”. Hell, 99% are, right? We will all have those much despised “patient characteristic” he speaks about, right? Whether we actually are or not seems to not matter, as long as someone like Dr. C says it’s so, it must be true.
Does everyone hate the poor? We hear it a lot from the dental community.
“The poor are this… and the poor are that… and they break appointments… and they don’t smell good…despite hating every fiber of your being we want you guys as patients in a bad way, so come on in…new patients welcome”
Is care of the patient the real desire or the tax dollars those nasty poor people can make available?
A big ole “ATTITUDE AJUSTMENT” on the part those with DDS slapped on their last name is what I say is needed!
I guarantee you there are more teeth destroyed in this nation every day from misfit, greedy, unethical dentists, than are damaged by diet, lack of hygiene or fist fights.
State officials allege in a lawsuit that the DentalWorks dentistry chain pressured dentists and dental workers at its North Carolina locations to give patients expensive, unnecessary treatments.
The claim is part of a lawsuit the state Board of Dental Examiners filed in Wake County Superior Court on Feb. 18. It says DentalWorks illegally owns dental practices in this state - by law, only a dentist licensed in North Carolina may own a dental practice here - and therefore is illegally practicing dentistry.
A related lawsuit was filed Feb. 18 against DentalWorks by 14 dentists with DentalWorks offices, including two dentists from Cumberland County.
The allegations in both lawsuits paint a picture of patients being taken advantage of to boost profits.
They say DentalWorks used financial incentives, protocols, internal recommendations, warnings of malpractice lawsuits and other pressures to push dentists and hygienists to make diagnoses that patients had gum disease when they did not.
The patients were given unnecessary treatments, leading to excessive billing, the Dental Board says in its lawsuit and in other documents.
The dentists' lawsuit also accuses DentalWorks of pushing them to give patients unneeded veneers and ceramic crowns in order to boost revenues.
A good example of why you can’t count on local DA’s to enforce the laws!
Bio | Email WFAA Posted on March 5, 2013 at 10:05 PM Updated today at 9:54 PM
Dallas County District Attorney Craig Watkins accepted — then returned — a 2009 campaign donation from the wife of Medicaid dentist Dr. Richard Malouf, who was under investigation at the time by Watkins' office for allegations of Medicaid fraud.
The Texas Attorney General’s Office says Watkins’ settlement of the case was a "sweetheart deal."
Dallas dentist Dr. Richard Malouf is the founder and former owner of All Smiles Dental Centers in Dallas. From 2008 through 2010, All Smiles billed the state of Texas more than $20 million for putting braces on children under Medicaid.
For the past five years, federal, state and local officials have been investigating Malouf for Medicaid fraud.
The Dallas County DA's office was one of those doing the investigating. Watkins' office received a criminal referral from the AG about Malouf.
In 2009, Malouf's wife, Leanne, wrote Craig Watkins — who was running for re-election as Dallas County DA — a $10,000 campaign donation, News 8 has learned.
Soon after, Watkins was asked to attend a meeting at the office of one of Malouf's attorneys, according to Heath Harris, the first assistant in the DA's office. News 8 wanted to talk to Watkins himself about the sequence of events. His office said he was ill and unavailable. Heath Harris spoke on behalf of Watkins.
At the meeting at the attorney's office, Heath Harris said, Watkins was introduced to Malouf.
Malouf wanted to talk to Watkins about his criminal case, Heath Harris said.
"This Malouf person is trying to talk to him about a criminal matter," Heath Harris told News 8. "It's my understanding he [Watkins] immediately shuts him down. And he leaves."
Watkins returned $10,000 to Leanne Malouf with a cashier's check in January, 2010.
March 4, 2013 The answer can be found in court documents filed during their bankruptcy proceedings over the last year. According to Affidavit of Chief Restructuring Officer of Martin McGahan, 100 were on file in February 2012. More recent documents filed by their malpractice insurance carrier states 1100 are "working” so to speak and more lawsuit likely to come.
“Since January 2010, approximately 11 lawsuits on behalf of over one hundred plaintiffs have been filed against the Company and certain of the Dental Centers, in primarily three states, Ohio, New York and Oklahoma.”
“Subsequent to the Debtors’ settlement with the DOJ and the various states, a number of lawsuits were filed throughout the country by or on behalf of the Dental Center patients against certain of the Debtors, Dental Centers and Dentists, alleging claims for damages based upon treatment received at the Dental Centers. In addition to the Patient Litigation, the Debtors contend that “at least approximately 1100 additional patients or former patients” have retained counsel to assert similar claimsagainst the Debtors, the Dental Centers and the Dentists.”
Dentists and auxiliary employee of Small Smiles Dental Centers (current or former) are not likely to be able to exhale for a very long time.
For a list of the 600 plus pleadings and filing of this case see in United States Bankruptcy Court – Middle District of Tennessee, see: Church Street Health Management Docket Report
In other Small Smiles Dental Centers news. I’m told the morning huddles continue and production numbers remain a major topic of discussion.
Texas Dentists for Medicaid Reform has all the trappings of a public interest group: The State Capitol is featured prominently on its website; the Texas star is in its logo; the word "reform" is in its title.
But TDMR, as it calls itself, acts like a private interest group.
Last month, the organization held a dinner at the Omni Southpark Hotel in Austin. TDMR's website invited the public, but the event was not public after all.
An e-mail informed News 8 we would not be allowed to attend.
Board member Dr. Juan Villareal would not disclose who the organization's donors are. "Donors can be anonymous, and a lot of them don't want their names mentioned," he told WFAA, adding that TDMR does not have members, only donors.
"We basically take donations from people who are interested in our cause," Villareal said.
So what is the cause? "Due process" is a phrase overheard in the hallway outside the dinner venue. TDMR offered News 8 an interview with a lawyer — presumably on its payroll — to explain the term "due process."
A look at the name tags outside the dinner show many of of the invited guests have had their Medicaid payments suspended under a doctrine called Credible Allegations of Fraud (CAF). Under CAF, physicians and dentists can have their Medicare or Medicaid payments withheld if the government believes they've committed fraud.
Dr. Villareal had $1.2 million in Medicaid dental payments to his clinic, Harlingen Family Dentistry, suspended under CAF. He appealed his case and won in an administrative hearing, but says he still hasn't received his money.
TDMR's board consists of Villareal, his partner, and another dentist who was charged with Medicaid fraud.
TDMR's website traces to an office labeled "SLS Worldwide Transportation" at a strip mall in Austin. The same address is also home to a website for Dr. Richard Malouf, a Dallas dentist who's being criminally investigated for fraud by the state of Texas.
And the SLS Limousine office is home to the website of Harlingen Family Dentistry, Villareal's dental office.
"TDMR is not so much about the money, as it is about denying due process" Villareal said. "That's the main concern."
"Due process" may summarize Medicaid reform for TDMR's donors.
But Dr. Morna Staffel said that doesn't speak for a Medicaid system she and many other dentists wrestle with every day.
"I don't think there is a group that's speaking out for the legitimate and the ethical dentists... either general dentists or pediatric dentists," she said.
Dr. Staffel's office regularly has to re-do work done by some of the dental chains supporting TDMR.
"Yesterday, in fact, I had to do dental treatment on three different children who'd been treated at another dental clinic during a 12-month period," Dr. Staffel told News 8. "Eighty percent of the restorations that had been placed either were improperly placed, or done incorrectly, or failing."
That work will need to be redone, she says, but getting Medicaid to pay for it is a slog.
"It's very time-consuming. It requires a great deal of my office staff time." Dr. Staffel said. "In the end, if we don't do the treatment, the child gets hurt."
She said her office often ends up doing the work for free.
Dr. Staffel wants parents — even those on Medicaid — to know they have a choice in dentists. And if they feel their children are not getting treated properly, they can go elsewhere.
So who really is Texas Dentists for Medicaid Reform? Thirty-nine dental chains have had their Medicaid payments withheld under Credible Allegations of Fraud.
As for many other Texas dentists, reform means something else.
The attorney for a dentist accused of gross negligence in treating patients said in a statement Friday that he and his client are "pleased with the progress" of an administrative hearing on the allegations this past week and that they "look forward to presenting Dr. (Robert) Tupac's side of the story" when it resumes later this year.
"We expect Dr. Tupac will be fully vindicated at the conclusion of the evidence in this matter," Jason Friedman wrote in an email.
An accusation filed by the state Attorney General's office on behalf of the Dental Board of California alleges that Tupac fitted patients with improper-sized implants, altered patient records, billed a patient for an implant he never delivered and allowed dental assistants to do work beyond the parameters of their license.
It’s complicated to liquidate a company operating illegal dental clinics. As of February 21,2013 there have been 630 various pleadings filed in the bankruptcy case of Small Smiles Dental Centers. The Docket report is dang near 70 pages. Even it is an interesting read.
If you currently work for Small Smiles Dental Centers or have EVER worked for Small Smiles Dental Centers you need to read this carefully. I realized they mass mailed a “Summary” of the Liquidation and Trust Agreement, as well as a “Ballot” but the key word is “summary”.
This junk company is an albatross that will forever more hang around the neck of every executive, every regional or sub-regional manager and every dentist who ever worked there. You will constantly be looking over your shoulder for the next 10 years or longer.
The last time I took the bar exam was… uh… NEVER, so read it and draw your own conclusions.
This the the current PROPOSED Plan of Reorganization and not approved by any means as of yet. There are objections by their malpractice carrier on file, and that’s where the dentists come into play even more I suspect.
[Now, if I found myself in the middle of a malpractice lawsuit and being represented by an attorney assigned to me by a malpractice insurance company who didn’t want to cover claims because they got hoodwinked by some slick willy system scammers, I’m not sure I’d feel that particular attorney had my best interest in mind. Think about it.]
4.17(h) Claims Against Former Affiliates. Each holder of a Class 5(a) Claim will retain any and all claims and legal rights such holder may have against any of Danny DeRose,Edward DeRose, Michael DeRose, William Mueller, or Adolph Padula. All holder of Class 5(a) Claims will be entitled to initiate and prosecute any such claim against any or all of Danny DeRose, Edward DeRose, Michael DeRose, William Mueller, or Adolph Padula without restriction in the tort system. To the extent the automatic stay in these Chapter 11 Cases or any other limitation imposed by these Chapter 11 Cases would limit any such action, such automatic stay or limitation will be lifted thirty (30) days after the Effective Date of the Plan
The American Dental Association is taking it’s cue from the Texas Medicaid dental mills, offering $100 bonus to bring in a patient member. When words like – bonus, recruit and incentive are used in dentistry, I get real nervous.
"While we're recruiting about the same number of members each year, the total number of active, licensed dentists continues to grow, translating to a decrease in the overall market share," said Dr. Bauman. "If every dentist tapped into the value ADA provides to all members, they would see the immediate impact on their practices and within their careers."
Any ADA member dentist is eligible to participate in the Member-Get-A-Member Campaign, and members will be rewarded with a $100 American Express gift card for each new, active member brought in (up to five members or $500 in American Express gift cards). Members may also decline the incentive and the ADA will contribute $100 to the ADA Foundation.
