Wednesday, December 14, 2016

Corporate Dental Branding- What Dental Consumers Need to Know


Dr. Michael Davis
Dr. Michael W. Davis maintains a general dental practice in Santa Fe, NM. He serves as chairperson for Santa Fe District Dental Society Peer-Review. Dr. Davis also provides a fair amount of dental expert legal work for attorneys. He may be contacted via email: MWDavisDDS@comcast.net
 
   

Corporate Dental Branding- What Dental Consumers Need to Know



A brand is a name, term or symbol which one company uses to differentiate its products and services, from that of another company.1 Corporations employ numbers of different strategies in branding. Healthcare professionals are generally fairly ignorant on corporate branding practices, as this is not an element of their formal education. By contrast, those parties which beneficially own corporate dental practices retain individuals well-skilled and well educated in all forms of retail sales, marketing, and finance. Their abilities include a plethora of differing and complex branding methodology.



In its simplest form, a chain of corporate dental clinics may seek direct brand recognition by consumers. They may market “outstanding dental care at reasonable prices”, all associated with their brand. Branding may be part of a marketing program to generate public goodwill via broad mechanisms, ranging from well-publicized charitable events to sponsoring a NASCAR driver.2 Branding may also be associated with the business model of dental Medicaid care.



Unfortunately for the corporate dental industry, many of their more established brands have become associated with abuses to the public welfare.3-9  

(Author’s note: References only cite a mere handful of well reported abuses generated from corporate dentistry, disclosed by government officials.) 

Dental clinics managed and directed by non-doctor corporate management often have a troubling record, which the public is witnessing. Likewise, dentists who may be employed in such workplaces are also witnessing abuses to the public interest generated and facilitated by brand-name companies in corporate dentistry. As such, many in the public are avoiding dental services offered by branded corporate dental practices. Further, these branded corporate practices are finding employee/doctor attraction and retention increasingly challenging. One corporate chain recently reported over 10% loss in total dentist staff for a one-year period.10



Crowd Sourced Branding-

Numbers of branded corporate dental groups are increasingly discovering their branded identity has negative consequences. In fact, the term “corporate dentistry” is an example of “crowd sourced branding”, in which the public assigns a company a brand (positive or negative), versus the traditional method of branding, in which a company designs their branding scheme.



Some dental corporations have fought back by explicitly marketing their distance from “corporate dentistry”. One such ad from a corporate dental chain openly states, “You Hate Corporate Dentistry and So Do We”. The veracity of their claim seems highly suspect, especially when one views their multiple settlement agreements with multiple states’ attorney generals. However, corporate dental management is evidently far more concerned with negative fallout of crowd sourced branding, versus presenting truth in the public marketplace. 




To further counter the negative public impression of corporate dentistry generated by crowd sourced branding, numbers of corporate dental chains market the misrepresentation of doctors, and not faceless Wall Street types, as owning dental practices. The reality is very different and highly disturbing. 
Numbers of dental chain corporations establish specific individual doctors to act fully as sham-owners, who have no control of management, the sale of “their” asset of the dental practice, or control of clinic bank accounts. In fact, these shame-owner dentists have no idea how the funds generated by “their” dental clinics are allocated; depositions in the Small Smiles mass action lawsuit made that abundantly clear.





Other corporate dental chains establish a group of dentists acting as sham-owners, via the accounting mechanism of a professional corporation (PC). Again, these doctors have no true and valid ownership privileges of dental practices, as beneficial ownership passes to non-doctor corporations, often private equity investment firms. Some of the world’s largest and most well-known private equity firms currently are or formerly have been the beneficial holders of corporate dental chains, which direct patient dental care. Examples include Morgan Stanley11, Valour Investments Ltd.12, Carlyle Group13, American Capital Strategies13, FFL Partners14, Gryphon Investors15, MSD Capital (holdings of Michael Dell  family)16,17, etc. 

Tuesday, November 22, 2016

DentaQuest Back in the Texas Medicaid Business?

Is DentaQuest back in the Texas Medicaid business?

Apparently so.

According to DFW Dental Team, who operates out of the newly licensed (Sep 2016) DFW Children’s Surgery Center dentist can “refer” patients and right there on their very interesting website is a link to DentaQuest forms.

161122-DFW Dental Team - DentaQuest screen shot

 

 

 

There is so much more to this story so expect an indepth look VERY soon.

Just for a sneal peek, let’s just say it involves a couple of Harvard grads (Brian Walker and Jonathan Jardine),  some Brigham Young University grads, a very proud Harvard professor and a bunch of dentists whom I would say are ethically challenged; a former Kool Smiles dentist, Dr. Diaa Zora and another “owner” dentist,  Dr. Ketan Sukkawala, being just two of the many.

It involves several business names such as:

North End Health Care http://www.nehc.com/ (Note the Harvardesque logo)
North End Capital, LLC Eagle, Idaho
Blue Cloud Pediatric Surgery Centers http://txcpa.lookupbook.net/blue-cloud-pediatric-surgery-centers-llc-houston-tx
HCDC Professionals, PLLC
San Antonio Children’s Ambulatory Surgical Center http://sachildrenssurgical.com/
SACS Professionals, PLLC
San Antonio Dental Team http://sadentalteam.com/ (ignore the statement that the surgery center is owned separtely)
DFW Children’s Surgery Center http://dfwchildrens.com/
DFW Dental Team http://dfwdentalteam.com/ (ignore the statement that the surgery center is owned separtely)
Referral Care, Inc http://www.nehc.com/affiliates.html

If you can’t wait you can check out:

North End HealthCare: Pediatric Ambulatory Surgery Center Expansion Strategy (don’t miss the disclaimer on page one)

Oh, and at the end (Strategic Decision) where Brian is asking himself questions..the answer is not only no, but hell no!

Friday, November 18, 2016

Broken Arrow, OK: Mother questions dentist's decision to cap, fill more than a dozen baby teeth at Super Smiles Dental

BROKEN ARROW - A Broken Arrow mother reached out to 2 Works for You after a popular Broken Arrow dental practice presented her with an estimate for more than $5,000 to fix her toddler's baby teeth.

Sarah Powell said she felt like she had failed her three-year-old son, Jaxon, when a dental practice told her he had 13 cavities in his temporary baby teeth.

"I was mortified," Powell said, "I couldn't fathom how he could have that many issues and no pain."

Powell said the dental assistant at Super Smiles Dental Office in Broken Arrow rattled off a list of work Jaxon needed and numbers Powell needed to call, then stopped and said, "Oh, you have private insurance. This is going to be expensive," according to Powell.

Because Powell said she had been regularly brushing Jaxon's teeth since they popped up, and that she took him for regular check-ups since he was 18 months old, she sensed something had to be wrong.

Read entire story here


Super Smiles - Broken Arrow-OK-logo

 

Despit Super Smiles logo, it doesn’t seem to be exactly a “Fun Place For Teeth”, does it?

Wish I could report EVAN D CLOTHIER DDS, was some sort of corporate dentistry thug, but I can’t. I guess he’s just a thug.  His Oklahoma dental license is current and there are no reported sanction listed. But that doesn’t mean much since so often they are never reported by the dental board.

EVAN D CLOTHIER DDS-Super Smiles-Oklahoma

Tuesday, November 15, 2016

TEXAS: 10.45% Reduction in Medicaid Reimbursement to Ambulatory Surgery Centers Likley To Be Catastrophic for Pediatric Dental Patients

On Wednesday of this week (November 16, 2016) at 1:30 there is to be a public hearing held by Texas Health and Human Services (THHSC) in the Brown-Heady Building, 4900 North Lamar Blvd, Austin, TX. The purpose of the public hearing is to receive comments related to a 10.45% reduction in reimbursement to Ambulatory Surgical Centers for Dental Rehabilitation and Restoration. My sourse says this reduction is spear headed by the Dental Service Organizations (DSO') whose target patients are children on Medicaid and is to take effect January 1, 2017.

(Why aren’t these “hearing” held at a time when the actual public or interested parties are available? It shall be interesting to see who is there to offer “public comments”.  THHSC website indicatged the hearing will be webcast and available to watch here: http://legacy-hhsc.hhsc.state.tx.us/news/webcasting.asp.)

The source states the long term plan is to reduce the number of licensed pediatric dentists and oral surgeons from accepting children who currently require sedation for treatment, whereby those dentists will drop out of the program thereby limiting the access to quality care for the children. This is outrageous!

I’m told the DSO's plan to hire young new graduates carrying loads of student debt general dentists to perform these procedures, The source hinted a system is already in place to make sure all children meet the qualifications to require sedation.

As it was told to me, it is planned to be much like the orthodontic scam that took place in Texas just a couple of years ago whereby nearly all children suddenly qualified for braces and the per-authorization process was to rubber stamp and approve every child!

(Let’s not forget how dentists were trained on how to scam the system by Dr. James (Jim) Orr and attorney Robert (Bob) Anderton, in Anderton’s private office.  Orr, at the time was Dental Director of the claims agent for Texas. In sworn testimony before the State Office of Administrative Hearings (SOAH) witnesses stated Orr and Anderton taught them how to “utilize” the HDL scoring system in place to qualify children for orthodontic braces. In addition the processors, who worked from home, were paid $50 for each approved application! For more on there click here.)

No doubt the Ambulatory Surgical Center’s are not going to complain too much about a reimbursement rate reduction when they expect their patient volume to skyrocket. Win, Win for everyone, right?  Well except the children who are needlessly sedated for what is likley to be unnecessary dental procedures, like 4 year old Navaeh Hall who was left brain damaged or Daisy Lynn Torres or 3 year old Marvelena Rady who both died this year.

For the public who would like to make comments by mail:

Health and Human Services Commission
Attention: Rate Analysis, Mail Code H-400
P.O. Box 149030
Austin, TX 78714-9030

Overnight mail, special delivery mail, or hand delivery:
Health and Human Services Commission
Attention: Rate Analysis, Mail Code H-400
Brown-Heatly Building
4900 North Lamar Blvd.
Austin, TX 78751
Phone number for package delivery: 512-730-7401
Fax: Attention:  Rate Analysis at 512-730-7475

 

Related Links:

November 16, 2016 Hearing Briefing Package
Link to Webcast page

Thursday, November 10, 2016

Thursday, October 27, 2016

57 children who underwent baby tooth root canals, or pulpotomies, at Children’s Dental Group have been hospitalized

CHOC given $150,000 to treat children sickened in dental clinic infection outbreak
By COURTNEY PERKES / STAFF WRITER
Contact the writer:
cperkes@scng.com 714-796-3686
So far, 57 children who underwent baby tooth root canals, or pulpotomies, at Children’s Dental Group have been hospitalized at CHOC with confirmed or probable mycobacterial infections, said Dr. Jasjit Singh, a pediatric infectious disease specialist at the Orange hospital. About 21 patients need to take a tightly regulated drug typically used to treat leprosy, she said.
Ordering the oral antibiotic, clofazimine, from the Food and Drug Administration requires a lengthy approval process for each child. CHOC will be expanding a part-time nurse’s hours to full-time to oversee the process.
“It’s a much more rigorous process than writing a prescription for an antibiotic,” Singh said. “That process requires some administrative and logistical work. It requires filling out those FDA forms.”
…“This is a nightmare,” Morales said. “I stay awake at times picturing her with a hearing aid or with kidney problems. That’s why I asked the nurse what would happen if we didn’t give this to her. She said she could die.”
READ THE ENTIRE UPDATE HERE

In related news, Christine Curtis brought her three children to Children’s Dental Group of Anaheim and says dentists perfromed up to 11 baby root canals on her children, all while they were strapped down and restrained.  Curtis now believes the work was unnecessary and along with a growing number of parents has contacted Texas Attorney, Jim Moriarty for help.
Wayne Dolcefino, President of Investigative Communications firm, Dolcefino Consulting spoke with Moriarty:
“This assembly line dentistry uncovered in at Children’s Dental Group smacks of Medicaid Fraud,” says Moriarty. “A Full state and federal investigation is owed to U.S. taxpayers.  I believe Children’t Dental is over treating these childdren to make a buch using higher cost stainless steel crowns, and falsifying the need for baby root canals to increase the cost of taxpayers.”
“I beleive the infection outbreat in California could lead to proving Children’s Dental Group is systematically abusing children.”
Moriarty was the legal architect behind the groundbreaking lawsuit against the Small Smiles Dental chain, and now represents the family of 4-year old Neveah Hall, the little girl left severely brain damaged by a bad dentist.

Related Links:
Law Offices of James R. Moriarty Facebook
Law Offices of James R. Moriarty Website







The many schemes of four dentists accused of defrauding MetroHealth

image

 

 

 

By Eric Heisig, cleveland.com
Follow on Twitter
on October 26, 2016 at 9:36 AM, updated October 26, 2016 at 4:10 PM

CLEVELAND, Ohio — The schemes described in a federal indictment against former MetroHealth executive Edward Hills and three former hospital dentists undertook were complex, intertwined and lasted for years.

They also involved about $250,000, much of which was taxpayer money. Meanwhile, Hills was being paid increasingly larger six-figure salaries for his work at the hospital system.

The U.S. Attorney's Office laid out its accusations in a 93-page indictment unsealed Tuesday, following the arrest of Hills and dentists Sari Alqsous, Yazan Al-Madani and Tariq Sayegh. The charges say the men steered MetroHealth clients and resources toward their private businesses and forced prospective residents to pay them bribes in exchange for preferential treatment.

All four entered not-guilty pleas at their arraignments.

The case is the culmination of an investigation that lasted more than two years and was headed by the FBI and IRS. It involves a series of cooperating witnesses. Federal prosecutors have not said whether others will face charges.

READ ENTIRE STORY HERE

 

Related:

FBI raids former MetroHealth System's executive's home, businesses

Sunday, October 09, 2016

Unlicensed Dental Hygiene Practice as a Business Model

 

Dr. Michael Davis
Dr. Michael W. Davis maintains a general dental practice in Santa Fe, NM. He serves as chairperson for Santa Fe District Dental Society Peer-Review. Dr. Davis also provides a fair amount of dental expert legal work for attorneys. He may be contacted via email: MWDavisDDS@comcast.net

 

 

Unlicensed Dental Hygiene Practice as a Business Model

The unlicensed practice of dental hygiene is unlawful in all 50 states. In reality, enforcement is lax to nonexistent. In the infrequent event of violators charged, the bigger the violator, the more lenient the penalty. State regulatory dental boards have generally failed to address this problem, and their inaction has enabled and emboldened violators. Dental practices which conduct their business affairs within the rule of law are at a distinct marketplace disadvantage, to dental practices which engage unlawful dental hygiene practice as a business model.

Traditionally, only doctors were lawfully permitted to own dental practices and supervise the practice of dental hygiene within their businesses. Today, a dental practice may only be “owned” by a dentist(s) as a nominee figurehead. An outside corporation may truly beneficially own and manage the dental practice and the practice of dental hygienists. These beneficial owners (often private equity investment companies) pull the strings on the doctor/patient relationship, as well as the practice of dental hygiene in their clinics via dental service organizations (DSOs).

Jesus Villegas, DDS MS

Dr. Villeges, a pediatric dental specialist with clinics in Milford and West Haven, CT, settled with the US government for $1.3 million for his alleged actions of utilization of uncertified dental assistants in taking dental radiographs.1 These patient services could only lawfully be delegated to certified dental assistants or licensed dental hygienists. This dental Medicaid fraud case was notably prosecuted in Connecticut, as were earlier federal and state criminal actions against Dr. Gary Anusavice2 and later Dr. Mehran Zamani3, who operated a chain of dental Medicaid clinics, also in CT.

Phillip M. Coyne, Special Agent in Charge with the US Health and Human Services- Office Inspector General stated, “Dentists must ensure that only certified staff provide services to their patients. Cutting corners could jeopardize the safety of patients and the integrity of the Medicaid program.  Working with our law enforcement partners, our agency is dedicated to protecting patients and the government health care programs designed to serve them.”1

US Attorney Deirdre M. Daly added, “Health care providers must utilize properly certified individuals to treat patients, and the failure to ensure such proper care for patients will have serious consequences.”1

Douglas Macko, DMD MS

In the case of State of Connecticut versus Douglas Macko, the decision awarded $717,000 to the plaintiff, for Dr. Macko’s violations to the Connecticut Unfair Trade Practices Act.4 Dr. Macko unlawfully employed unlicensed personnel to provided dental hygiene patient services to pediatric dental patients. The court’s decision went into length on Dr. Macko’s efforts misrepresent facts of the case. The court also determined unlicensed staff falsified statements of fact in affidavits to support their employer. Like the aforementioned legal case of Dr. Jesus Villegas, this legal action involved a specialist pediatric dentist, and primarily dental Medicaid fraud.

Thomas P. Floyd, DMD MS

Similar to the previous cases, Dr. Floyd was a pediatric dental specialist mostly serving a children’s Medicaid population. However, his case was prosecuted in Florida, not Connecticut. In Florida, dentist violators are far more likely to receive regulatory wrist-slaps and large chain DSOs no investigation whatsoever (similar to most states).

Thursday, September 22, 2016

Colorado Dental Association Responds to “Toxic Troika for Dental Patients”

 

September 21, 2016

Dear Author and Editor:

Among a number of misportrayals, Michael W Davis’ August 2016 blog post entitled “Toxic Troika for Dental Patients” wrongly implies that Dr. Jason Ehtessabian engaged in unethical behavior by testifying on behalf of the Colorado Dental Association on SB16-009. This accusation borders on defamation and could not be further from the truth.

Dr. Ehtessabian was asked to testify on SB16-009 as an official representative of the Colorado Dental Association, and did not testify of his own interest. While Dr. Ehtessabian once worked for Comfort Dental – the party who advanced SB16-009 – nearly 10 years ago, Dr. Ehtessabian has reported that he had a personally difficult relationship with the franchise. He declined to take an ownership stake in the company when offered the opportunity, and certainly does not have any personal interest in advancing their cause. He does not have any current or ongoing financial connection with the franchise. Contrary to the insinuation of the article, Dr. Ehtessabian actually took the high road in overcoming his personal history to testify on this bill, because the bill had broader helpful implications for the entire Colorado dental community. To imply otherwise is wrong and irresponsible.

As previously shared with the author, the Colorado Dental Association participated with SB16-009 to ensure that Colorado’s fee splitting regulations continued to be as stringent as possible, while also addressing a recent Colorado court case that would have potentially prohibited dentists from paying for basic business services like accounting services, payroll, website hosting and more.

Allowing dentists to continue to engage business consultants is necessary to the efficient operation of our members’ practices, and was never the intended subject of the precursor Section 12-35-129 (1)(v) of Colorado’s Dental Practice Act. A court extension of the intent of this section required a bill to prevent disruptions to all types of dental practices – from large to small. Federal and state anti-kickback prohibitions continue to protect the public from inappropriate marketing and recruiting schemes, as does the revised section of the Dental Practice Act.

The Colorado Dental Association specifically asks that a formal correction to the article be published stating that Dr. Jason Ehtessabian is not affiliated with Comfort Dental and that the following statement be retracted:

“Dr. Ehtessabian is also affiliated with Comfort Dental in the company’s arranged franchise capacity. No one seemed concerned about Dr. Ehtessabian’s or Mr. Bear’s obvious conflict of interest. No representative of small business dentistry attended. No independent representative of the CDA attended, who wasn’t affiliated with corporate dentistry. Obviously, the fix was in against the public welfare in favor of corporate dentistry, corrupt government, and sold-out organized dentistry.”

We also understand that in conversations subsequent to the article, Dr. Davis has accused Dr. Ehtessabian of violating Section 4.E. of the ADA Code of Ethics by testifying on SB16-009. This accusation is completely out of line. First, Section 4.E. of the ADA Code of Ethics defines “fee splitting” to be directly tied to inappropriate marketing and recruiting schemes, such as kickbacks and rebates. Section 4.E. does not at all address payments for business management services and consultants, the issue addressed through SB16-009. SB16-009 and resulting Colorado Statute continue to prohibit the inappropriate advertising, marketing and recruitment schemes considered in Section 4.E. of the ADA Code of Ethics. There is nothing in the ADA Code of Ethics that explicitly addresses payments to franchises or business consultants, which was the topic of SB16-009. Likewise, an accusation that SB16-009 conflicted with Section 4.E. of the ADA Code of Ethics is inherently out of line. Further, even if Section 4.E. of the ADA Code of Ethics was applicable to this situation, Dr. Ehtessabian testified in an official capacity as a CDA representative, so any accusation of an ethical violation would need to be levied against the organization and not the individual.

We further request that Dr. Davis also issue a formal apology to Dr. Ehtessabian, a representative of small business dentistry, based on the errors in the article and cease making ethical accusations against him as outlined above.

Sincerely,

Greg Hill, J.D., CAE
Executive Director,

Colorado Dental Association