Massachusetts Dentists Support Independent Practitioners

13 Sep 2018 Jill Tanzi, DDS

Todays Dental News

Most dentists in the United States have not heard of the Massachusetts Dentists Alliance for Quality Care. We are a group of dentists who are passionate about private practice and maintaining an excellent standard of care in our profession and for our patients.

In recent years, many of us have felt that organized dentistry’s advocacy for private practice has declined. In all fairness, not every dentist is in private practice. Many are working for dental service organizations (DSOs), academia, insurance companies, and other fields. The ADA and state organizations represent all dentists, not just one special interest group.

Last year, several dentists in Massachusetts decided to seek legal advice and petition our Attorney General in response to a contract received from Delta Dental of MA (currently called Total Choice PPO). Not only did we raise enough money to file a formal petition with the Attorney General, but we also formed a group that has grown to more than 60 members today.

In July, we voiced our concerns to the Division of Insurance at a hearing regarding a “new fee methodology” proposed by Delta Dental that would automatically decrease reimbursements to the entire network of Premier providers in the state. To date, we continue to educate our legislators and advocate for private practice dentists, as well as mentor students and recent graduates.

Although Delta Dental’s new for-profit Total Choice PPO was approved in our state, Delta continues to sell the non-profit Premier plan (96% of dentists in Massachusetts are Premier providers). In June of this year, it was announced that our state dental society decided to make a deal with Delta Dental of MA to cut all of the Premier dentists’ reimbursements by 10%.

This 10% “recalibration,” a euphemism for lower reimbursements, will affect that 96% of dentists in our state. Conversely, the Total Choice plan that offers a larger 30% discount has not been less popular with employers in Massachusetts and has far fewer contracted participating dentists.

Many dentists in our state understand these subtleties and were extremely upset by the decision of the leadership of the Massachusetts Dental Society, while other dentists may not be paying attention to these small details or fear retribution for getting involved.

Now is not the time to sit back and let others figure out the details that affect the future of our profession. Do you recall what has happened to primary care physicians? Not only have they been forced to work increasingly faster by insurance companies, but the quality of patient care also has suffered as a result. This is especially important for the younger generation of dentists to understand, as they will need to work faster and longer hours to try to make a living with ever decreasing reimbursements and huge amounts of student loan debt.

It is our hope that organized dentistry in our country will learn from the mistakes of the American Medical Association and try to slow the corporatization of dentistry and the reliance on dental benefit companies. We would like to see more support for the private practitioner members who, in fact, serve most patients in our country.

The Massachusetts Dentists Alliance for Quality Care is continuing its work on behalf of our profession. We believe that by educating our legislators, we will have a stronger voice in our state government. We also believe there is hope for our future and welcome as many dentists who are interested in becoming part of this movement to join our group.

Stand up, fellow dentists. It is time to make your voice heard. The time to make a difference is now!

Dr. Tanzi, a graduate of the University of Maryland School of Dentistry, has more than 18 years of private practice experience. She started The Dentist at Hopkinton in Hopkinton, Mass, 15 years ago near the starting line of the Boston Marathon. Passionate about issues facing dentists and private practice, she is also a founding member of the MA Dentists Alliance for Quality Care, which advocates for private practice dentistry and high quality dental care for patients. She can be reached at jilltanzidds@hopdent.com. 

Related Articles:

Massachusetts Dental Society Strikes Delicate Balance in Delta Dental Discussions

Massachusetts Dentists Continue Battle Against Delta Dental

Emerging Advocacy Groups Support Small Business Dentistry

Krista Szewczyk Posed as Dentist for 7 Years. Prosecutors and Dental Board Fail

Szewczyk was first accused of illegally performing dental procedures in 2012.  The District Attorney at the time decide not to pursue charges citing a conflict of interest since her husband was a Deputy Sheriff in Paulding.

Apparently, Szewczyk posed as a dentist through her mini-DSO, County Dental Providers. She also is reported to have performed dental procedures in the homes of patients.

At least one patient was sent to the hospital due to an abscess in his throat the size of a tennis ball.

People Magazine website reports:

In an interview with Atlanta TV station WGCL, Szewczyk said: “It’s definitely a personal vendetta” by the prosecutor. She added, “Sad situation … and I’m confident it will be handled in a timely manner.”

The investigation into Szewczyk dates to 2013, when the Georgia Board of Dentistry alerted the district attorney’s office to complaints about Szewczyk, who ran a business called County Dental Providers starting in 2011 that contracted with independent licensed dentists to come in and work on patients, Donovan says.

The state board’s 2013 alert prompted a criminal investigation at the time that led to a single charge in Paulding County accusing Szewczyk of performing dental services without a license, the district attorney says. But on the DA’s recommendation, Szewczyk was enrolled in a pretrial diversion program that did not require her to enter a plea, and instead allowed for the charge to be dropped if she successfully completed the program.

“This was the only instance of which we were aware at the time, so we just said, ‘Don’t do this anymore,'” says Donovan. “I got a notice saying she had completed the program about the same time I heard from the Board of Dentistry that she was back at it again.”

There are indications Szewczyk is associated with Heartland Dental on her LinkedIn page which has been removed. Additionally her picture appears on Group Dentistry Now blog.

Heartland Dental Winter Conference, January 2018.

Related:

The Atlanta Journal-Constitution-Woman accused of posing as a dentist also under investigation in Cobb

Why Picket Aspen Dental?

Why Picket Aspen Dental?

by Linda Reynolds

What is B.A.D.?

B.A.D. is the acronym for Boycott Aspen Dental. We are a cause that primarily seeks to give a voice to the Aspen Dental victims who are not strong enough to speak out on their own. Alone we are faceless along with all the other Aspen Dental victims, but as a group we have a BEAUTIFUL face of courage with a BOLD name.  We desire to help victims of Aspen Dental because we too are a handful of victims that have been hurt; some of us worse than others.

Why has B.A.D. been created?

B.A.D. was created after experiencing my own personal Aspen Dental horror story, and after reading endless so it seems, online negative reviews about similar Aspen Dental experiences. I saw a need to create a centralized website so people can see the magnitude of thousands of voices screaming out the injustices of Aspen Dental; people who have never had their dental horror story told much less appropriately addressed by the company who caused the damage (ADM). B.A.D. is not about one individual; B.A.D. is a cause that seeks to bring Aspen Dental Victims together. We are one voice and one face: Boycott Aspen Dental.

How did you hear about Aspen Dental?

My insurance had limited options, and Aspen Dental was one of them. I searched the actual dentist for negative reviews, and couldn’t find any. Dr Mark Habermeyer was new at Aspen Dental, but he had several years of prior experience. It was just a simple crown replacement, so I made the appointment asking myself, “How could I go wrong?”

Unfortunately that one visit will cost $5000 to fix the errors made by the staff that day.

I’m still getting treated for this issue that was caused April/May of 2017, so I’m not sure if more will be added to that figure later.

Did Aspen Dental attempt to compensate for your pain and trouble?

They refused to refund my money at the time of the incident, which was when www.twothirtydentalcaution.org was created. Not a word was heard from Aspen Dental

until June of this year when I received a call from a staff member at Aspen Dental to say they’ve decided to refund my money. What? Over a year later they are doing this? So I get the check for $408, and then another call comes in a few weeks later to offer a settlement. Unfortunately they chose a figure I put out there a year ago, and which no longer covered all that I had gone through. Aspen Dental knew B.A.D. was soon to be revealed, and this apparently was their first vain attempt to stop it.

What do you mean by “vain attempt”?

They showed absolutely no concern whatsoever for all the pain I’ve endured. They attempted to entice me with a low ball offer, but what they failed to consider is I  already had concluded and accepted that I wouldn’t be getting any money from Aspen Dental. The plans for B.A.D. were in place (March 2017 is when the idea was conceived), so I was very suspicious when I received the first call that came a year afterthe incident with no previous attempts on record made by Aspen Dental to rectify this.

After they realized I wasn’t going to take the bait of the second call with the low ball offer, three ladies from Aspen Dental Management Corp offices in Syracuse, NY called me again to attempt to convince me to take the low ball offer. When that didn’t work, they hired an attorney with threats to close us down, and yes that low ball offer was included once more.

What about the threat of a lawsuit?

The day Aspen Dental sues its victim is the day the world will know that Aspen Dental is guilty of all they are accused of doing and more. This victim will never shut up. They don’t have the power to destroy B.A.D. like they would like us to believe. For example, if by chance they were able to have our websites removed with their money, well there was a day we didn’t have the Internet and word still traveled about upcoming events. We will revert back to sending telegrams if we have to, but B.A.D. will be around for months, years and decades to come. Aspen Dental we are not going away until you stop hurting innocent people.

Does Boycott Aspen Dental have an attorney?

We are suiting up for battle, let’s leave it at that.

What is on the agenda of B.A.D. for the short term?

Please visit our website www.boycottaspendental.com to learn of our current goals as we are planning our grand opening October 6, 2018. That’s when we will reveal our first fundraiser for an Aspen Dental victim to be chosen by member voting. We will also have our first Aspen Dental picket on that day (locations to be announced).

What is on the agenda of B.A.D. for the long term?

To tell as many people who will listen, Stay Safe; Stay AWAY from Aspen Dental!

To have an annual picket at every Aspen Dental location until Aspen Dental STOPS preying on innocent people, often times low income seniors, people with disabilities and children of low income families. If you are an Aspen Dental Victim or know someone who is, please consider joining B.A.D. today!

FLOSS Dental owner had questionable dental past before closures

August 16, 2018 AUSTIN (KXAN) — A lawsuit filed within Travis County details allegations against Dr. Clinton Herzog from FLOSS Dental, including that he is not a licensed dentist.

Plaintiffs claim Herzog collected hundreds of thousands of dollars from investors to open multiple locations for his dentistry in Austin, then never bought them and left the city. They also say the State Board of Dental Examiners suspended his license in 2015, but allowed him to practice under certain conditions.

In 2016, Herzog voluntarily surrendered his license to practice, which the plaintiffs said they were not aware of. According to Texas State Board of Dental Examiners records, Herzog was accused of advertising that his offices had multiple "elite" providers for Invisalign services, but he was the only "elite" provider. Herzog is also accused of advertising dental services that "were free or discounted without disclosing the prices of associated services," according to his non-disciplinary remedial plan.

FLOSS Dental workers on Fifth Street in Austin told KXAN Herzog "left town" and they could not get a hold of him…

See report and read entire article here.

---

  

Is this the same Clinton Herzog? You decide.

Clinton Herzog – January 5, 2018 Charged with Driving While Intoxicated and Possessison of PG1 (Penalty Group 1*) Controlled Substance

*Penality Group 1(usually Heroin, Meth or Cocain) Possession of less than one gram is a State Jail Felony which may result in confinement in a Texas State Jail Facility for a minimum of 180 days and maximum of 24 months along with a fine up to $10,000.

Related:

Clinton F. Herzog, DDS - Order of Tempoarty Suspension, April 28, 2016

The Happy Hour dentist who offers patients free booze before a cleaning, May 2011

Dazzling Smile Care PC and Dr. Shahrzad Haghayegh-Askarian Indicted on Medicaid Fraud Charges

August 7, 2018
Boston — A Quincy-based dentist who was banned from the state’s Medicaid program has been indicted in connection with an alleged scheme to fraudulently bill MassHealth under another dentist’s name, Attorney General Maura Healey announced today.

Dr. Shahrzad Haghayegh-Askarian, age 43, of Norwell, was indicted by a Statewide Grand Jury on charges of Medicaid False Claims (2 counts) and Larceny over $1,200 (2 counts). Haghayegh-Askarian’s company, Dazzling Smile Care PC, located in Quincy, was also indicted on the same charges. 

An audit by the State Auditor’s Office uncovered Medicaid fraud committed by Dr. Haghayegh-Askarian. Following that audit, Dr. Haghayegh-Askarian agreed to a $300,000 settlement with the AG’s Office in 2015 and was terminated from participating in the MassHealth program. The settlement stipulated that she could only re-enroll with MassHealth if she met standards of compliance and instituted a monitoring program mutually agreed upon by Dr. Haghayegh-Askarian and the AG’s Medicaid Fraud Division.

The AG’s office alleges that, despite her termination from MassHealth, from April 2014 to December 2017, Dr. Haghayegh-Askarian continued to treat MassHealth patients and billed those services under the name and identification number of another dentist, without his knowledge or authorization. That dentist contacted the Office of the State Auditor to report this alleged fraudulent activity when he learned of it in September 2017. 

“I commend my staff and the staff of Attorney General Healey for their work to bring charges against Dr. Haghayegh-Askarian,” said State Auditor Suzanne Bump. “Her license should be immediately revoked, and her continued, brazen abuse of MassHealth should be punished.”

“This matter illustrates the commitment of all agencies to combat medical billing fraud which affects all citizens,” said Anthony DiPaolo, Chief of Investigations at the Insurance Fraud Bureau of Massachusetts. “The IFB places a high priority on fighting this type of insurance fraud. The collaboration in this matter is unprecedented.”

All of these charges are allegations and defendants are presumed innocent until proven guilty.
The matter was investigated by Assistant Attorneys General Jay McCormack and Kevin Lownds, Investigations Supervisor Lisa Bailey and Investigators April Waterhouse and Deborah ElMajdoubi, all of Attorney General Maura Healey’s Medicaid Fraud Division, with assistance from MassHealth, the Insurance Fraud Bureau of Massachusetts, the State Auditor’s Office, and Massachusetts State Police assigned to the AG’s Office.

Boycott Aspen Dental Day–October 6, 2018

For more information click here

Kool Smiles featured on CBS Whistleblower Series

 

Benevis/Kool Smiles Response to CBS Report:
Dr. Greenwald and Dr. Rai blew the whistle on Kool Smiles after they say they witnessed unnecessary dental procedures performed on children. CBS reached out to the company for a comment and they provided the following statements:

Statement from Kool Smiles:
"Our patients and their safety are our top priority and we will continue to work toward our mission of ensuring every child in America has a dental home. The settlement reached in December 2017 addressed treatment provided between 2009 and 2011, and was unrelated to the quality of dental care provided to patients. The company's compliance and quality assurance programs lead the dental industry and we continue to implement ongoing measures to ensure every patient receives the best care."

This past December, 2-year-old Zion Gastelum died four days after visiting the Kool Smiles office in Yuma, Arizona. Zion's death occurred just days after the Whistleblower suit was settled. The case had been in litigation for almost a decade.

Statement from Kool Smiles regarding death of Zion Gastelum:
"Kool Smiles treatment protocols follow the guidelines and best practices established by the American Dental Association and the American Academy of Pediatric Dentistry. Treatment is provided only after conducting a consultation and obtaining the informed, written consent of the patient's parent or guardian. Our dedicated dentists, anesthesiologists and the rest of our Kool Smiles family mourn this tragic loss."

Dr. Behzad Nazari, D.D.S., ET AL. v. The State of Texas; Xerox Corp; and Xerox State Healthcare, LLC, f/k/a ACS State Healthcare, LLC, n/k/a Conduent Business Services, LLC

Despite all the claims, counter-claims, third, forth and fith party claims, here is the the short version:

Texas withheld reimbursement from several dentists due to a high suspicion of Medicaid fraud. Dr. Nazari, his clinic Antoine Dental and others argued they needed and deserved their money for all the honest and much needed work they had done on so many children with terrible orthodontic deformities and rotten baby teeth. They were the saving grace to the underserved population as they saw it.

Being royally pissed, Nazari suesTexas and Xerox (NYSE:XRX) (ACS) demanding his money.

The Feds (that is us, the US taxpayers) says “Hey Texas, we pay 50% of all you spend on Medicaid, and we want our money back!

Texas says, “We really have that kind of cash to hand back, we spent it already. But we will try to get it from Xerox. They ran the show down here for years. In fact we knew nothing about this until Byron Harris did a series of reports for WFAA in Dallas. We learned about it on the local evening news!”

Texas sues Xerox, under whatever name Xerox was using at the time. The suit ends up at the Texas Supreme Court.

Texas tells the Texas Supreme Court justices, it was no seeking actual damages from Xerox in a civil Medicaid fraud suit in a civil Medicaid fraud suit accusing the company of signing off on $1.1 billion in claims for orthodontic services without properly vetting them, and therefore the remedies it has sought aren't subject to proportionate responsibility calculations.

Xerox says that it is wrongly facing sole liability in the matter, despite the fact it trained paid employees to basically rubber stamp “Approvals” as fast as they could. Additionally, in early testimony it was learned they trained the dentists how to game the systems.

Yesterday, June 22, 2018, the Texas Supreme Court handed down its decision. Xerox, it is all on you guys. Pony up the $2 Billion!

Now, doing business as Conduent Business Services (CNDT) reports are that Conduent’s “benefit wallet” is empy and they will probably settle for $500 Million. 

Related:

Dentist the Menace blog posts on this matter

Case Details and Documents

Opinions posted on the SCOTX Blog

December 6, 2017 Oral Arguments Video

Emerging Advocacy Groups Support Small Business Dentistry

20 Apr 2018 Michael W. Davis, DDS

Small business dentistry is increasingly establishing advocacy groups designed to address specific issues. Areas of concern range from protecting the doctor/patient relationship against the intrusion of the insurance industry and corporate dentistry to honest evaluation and solutions for the public’s “access to care.”

These associations are springing up in a variety of different states. Because of their distinctive smaller sizes, they are highly attuned to specific predicaments unique to a given state. Larger national groups may have multiple and conflicting agendas, which too often grind effectiveness to a standstill. These smaller spearhead organizations often serve as the initial testing ground for addressing and solving challenges. Many times, state dental associations will later pick up the banner and carry forth with their added weight and power of membership.

Three organizations that exemplify this movement are the Concerned Dentists of Texas (CDoT), the Concerned Dentists of Washington State (CDWS), and the Massachusetts Dentists Alliance for Quality Care (MDAQC). Each of these relatively small associations is free to examine problems unique to its specific state and discover optimal mechanisms for local problem solving. They aren’t handicapped by the political or economic motivations of a faraway distanced leadership. They aren’t bogged down by neverending and do-nothing committee meetings. And, they lack multiple layers of leadership hierarchy, which often hinders effective action…

Read Dr. Davis’ entire article here.

Southern Dental Alliance and Sale to Pouschine Cook Capital

Keep in on your radar.

Sept 2017:

Deloitte Advises Southern Dental Alliance on Sale to Pouschine Cook

Deloitte Corporate Finance acted as exclusive financial advisor to Atlanta-based VSM Management d/b/a Southern Dental Alliance on its sale to Pouschine Cook Capital Management and its co-investor group.

Southern Dental is a multi-specialty dental service organization in the Southeastern U.S. with 32 clinic locations across eight brands.

“DCF’s assistance was indispensable for us throughout the transaction process, offering both expertise in the space and extensive resources. We are excited about our future growth prospects and the new partnership with Pouschine Cook,” said Mark Lakis, CEO of Southern Dental.

Tom Harbin, managing partner at Source Capital, echoed the sentiment, “DCF’s deep knowledge of the dental space was invaluable and helped lead to a successful transaction. We could not be more pleased with the outcome.”

http://www.abfjournal.com/dailynews/deloitte-advises-southern-dental-alliance-on-sale-to-pouschine-cook/