Oh where, oh where has Small Smiles gone, oh where, oh where can it be…

February is “National Children’s Oral Health Month”. Normally Small Smiles Dental Centers lead dentists (or fake owner dentists) slither from under their rock and hit local morning TV talk shows, claiming they are having free services that very morning for a couple of hours. So far, I’ve not seen hide nor hair of them in 2013. Kool Smiles Dental centers at least announced they gave away toothbrushes this year. (Geez, I hope they weren’t those chemical-laden ones from China that leave blisters in your mouth.)

Small Smiles “free services day” were a sneaky ploy. The dentists would appear on local talk shows about 6 AM announcing they were having free services that morning; from 9AM-11AM for example. They would invite the public, telling them they needed to call for an appointment; failing to mentioning the schedule was already packed tight as sardines – as they were everyday.

It was last year about this time they were preparing documents to file bankruptcy in Nashville’s Federal Court and closing several clinics (updates on that coming soon). By June the OIG forced them to divest in at least one clinic; personally I think it was more than one, Manassas, Virginia clinic for sure. (Let’s just say, whoever took over Manassas, also took the Pueblo, Colorado clinic as well. See: Violations of Corporate Integrity Agreement Triggers Divestiture Action by HHS OIG.

“It is clear that the defendants’ actions constituted more than just malpractice.” –Judge John Cherundo, Onondaga County Superior Court

By August 2012, Small Smiles Dental Centers were taking serious hits in the malpractice cases file against them. In 2011, families of at least 75 children had filed lawsuits in New York against the Small Smiles Dental Centers. Judge John C. Cherundo denied the companies request to dismiss the cases saying, “This intentional misconduct was part of the of the alleged scheme to generate revenue as quickly as possible”. 

Dental health reform on the horizon for New Mexico

John Schmidt | Staff Writer | 0 comments

A bill that could potentially improve New Mexico’s bleak dental health issues if approved will be reviewed on Feb. 23.

New Mexico currently ranks 49th in the United States when it comes to the number of dentists per 1,000 residents ratio. The Dental Therapist-Hygienist bill that could help change this poor position has been unanimously passed by the House Health, Government and Indian Affairs Committee and will go to the House Business and Industry Committee this Saturday, Feb. 23.

“We believe that everyone should be able to get quality, affordable dental care in their own communities,” said Barbara Webber, executive director for Health Action New Mexico.

Kids Care Dental–Sacramento, CA Now Private Equity Owned

CNN Money is reporting Sterling Partners has invested in Kids Care Dental Group located in California.

The listed owner of Kids Care Dental is CDC Dental Management Co., LLC – Aaron P. Reeves,DDS president.

 Sterling Partner Team

---

Sterling Partners has invested an undisclosed amount of private equity into Kids Care Dental Group, a pediatric dental care practice with six office locations in the Sacramento, Calif. area. www.kidscaredentalgroup.com

Systemic breakdown attributes to massive fraud

I’m not sure where the breakdown is, but there is no doubt a breakdown; a big one!  Either agencies are failing to report, or the OIG is failing to add criminals to their list. Which ever the case, the free flow of tax dollars from your pocket to fraudsters bank accounts goes unchecked.

In checking to see if Dr. Robin Lockwood is at least excluded from defrauding taxpayers from any more money for her employer, Ocean Dental, I find she still has access to our tax dollars; she’s not on the governments List of Excluded Individuals and Entities (LEIE). 

According to the OIG, if a criminal conviction is related to – Fraud, Obstruction of an investigation or misdemeanor conviction relating to controlled substances and should be reported as soon as the defendant is sentenced - even if appealed - there is supposed to be a “Mandatory Exclusion”. Maybe mandatory means something difference in government-speak.

Mandatory exclusions: OIG is required by law to exclude from participation in all Federal health care programs individuals and entities convicted of the following types of criminal offenses: Medicare or Medicaid fraud, as well as any other offenses related to the delivery of items or services under Medicare, Medicaid, SCHIP, or other State health care programs; patient abuse or neglect; felony convictions for other health care-related fraud, theft, or other financial misconduct; and felony convictions relating to unlawful manufacture, distribution, prescription, or dispensing of controlled substances.

The sources who are supposed to report to the OIG are the USAO’s, MFCU’s (Medicaid Fraud Control Units), Local Prosecutors, State Medicaid Agencies and Licensing boards and should include the judgment, plea agreement, final actions, indictment information, investigative report or narrative, aggravating factors, mitigating factors, and a cover letter with a brief summary.

There are numerous acts under which the government should stop the massive fraud, one being under the Social Security Act 1128(b)(4), where Michael DeRose, DDS and William Mueller, DDS the founders of Small Smiles Dental Centers are listed.

Senate Panel Backs Bill That Targets Medicaid Fraud

The Senate Health and Human Services Committee gave its endorsement Tuesday to legislation that tackles Medicaid fraud and could save the state millions of dollars.

Senate Bill 8 will “reduce the epidemic levels of fraud waste and abuse that are plaguing our health and human services,” said Sen. Jane Nelson, R-Flower Mound, the author of the bill and chairwoman of the Senate health committee. She added that “no amount of fraud is tolerable, but given our recent budget challenges it is inexcusable” that the Office of Inspector General has identified more than $6 billion in fraud from 2004 to 2011 tied to Medicaid, the state health program for poor residents.

The legislation will now go to the full Senate.

The committee approved a substitute of the original bill. The approved measure would set up a data analysis team within the Texas Health and Human Services Commission to detect trends in Medicaid claims and take a proactive approach to identifying potential fraud; ensure providers found guilty of Medicaid fraud in Texas or other states would be barred from participating in the state’s program; strengthen prohibitions against directly soliciting Medicaid patients for treatments; and reduce transportation fraud by adding medical transportation services to managed care and setting up a relationship between the Texas Department of Transportation and the Health and Human Services Commission to verify the eligibility of a Medicaid patient for transportation services.

Dr. Kristie Ayn Liebau-Grassi receives 4 month in federal prison, 8 months of house arrest and 3 years of supervised release

February 14, 2013

How many more mommy’s are going to go to the slammer before they stop participating in the fraud at dental clinics across the country.

GoEarie.com is reporting Dr. Kristi Ayn Liebau-Grassi is going to be spending 4 months in federal prison, 8 months of house arrest then 3 years of supervised release. She admitted guilt to defrauding Medicaid out of $289,000 between 2008 and 2011. 

After the Medicaid fraud in Pennsylvania, suspiciously, Kristi moved her family to Texas to practice dentistry. Did she hear that’s where to make the big bucks in Medicaid dental fraud? She ended up working for Pacific Dental’s Sienna Modern Dentistry in Missouri City, Texas.

I bet she would like to go back and rethink all those decisions she made back then, don’t you?  It’s not just the fine, the restitution, the prison time, etc., it’s the pain and stress of her entire family which will continue well past the time her supervision ends, something in 2017.

Counting the 3 years of waiting for the Feds to come knocking, it will be a total of 7 years by the time this is tragedy can even begin to heal. Her children’s lives where thrown away, for $289,000!  

What a shame Kristi didn’t think about her children, all under 7 years old including a 2 year old who has a serious heart problem, BEFORE, she decided Medicaid fraud was the path to wealth.

It’s ironic she tried to use the needs of her own children to stay out of prison, when screwing over other people’s children sent her there. 

 

 

Dentist gets 4 months in prison, plus house arrest, for fraud in Erie

By ED PALATTELLA, Erie Times-News
ed.palattella@timesnews.com

A 40-year-old dentist who defrauded Medicaid while treating children in the Erie area asked a judge to consider her own children at her sentencing.

The judge took Kristi Ayn Liebau-Grassi's concerns into account on Wednesday as he ordered her incarcerated for four months, followed by eight months of house arrest.

Liebau-Grassi, a married mother of five children who now lives near Houston, faced a recommended sentence of a year to 18 months in prison under the federal sentencing guidelines.

What does Scientology and Muslim Extremist have in common? It appears the answer is Texas Medicaid $ and Juan Villarreal, DDS

Texas Dentists for Medicaid Reform (TDMR) testified before the Texas Senate Finance Committee recently. The group was "singing the blues", saying all the reports of any such fraud taking place in Texas are lies. .

Despite recent reports of $1billion dollars in Medicaid monies being recovered by the Texas Attorney General’s office in the last 10 years, the group’s attorney, Greg Ewing, all but called it hogwash at the hearing.

Their press release contained the mother of all Freudian Slips and guess who was lucky enough to find it?  

The original link to their website contained in the press release read “Texas Dentists for Medicaid Fraud.” In that entire press release there were two truthful statements: the speaker was in fact Greg Ewing and their mission is Medicaid Fraud

Within three days after this blog pointed it out, the PRWeb press release had been changed.  Now there is only one honest statement, Greg Ewing’s name, and that might be in question at this point. Do they read this blog, you bet!

This group has the fingerprints of savvy political operatives all over it.  You know what I mean; call it one thing even though it’s something else.

Their name gives the illusion they are for “reform”.  I suspect in reality they are for “fraud”, as their “fraudian” slip (above) indicated.  Their actions indicate the only reform they support is for the Texas OIG or AG to disband any investigations in to Medicaid fraud.  See their January 2013 testimony in front of the Texas Senate Finance Committee.

Anyone want to take bets on whether their web presence will appear they are middle of the road, trying to fix what’s broken, etc.?  Truth is, they don’t want what’s broken fixed at all!

Texas orthodontist, Dr. Michael Goodwin to fork over $1.5 million beside fine and facing prison.

I bet Dr. Richard Malouf’s ears perked up yesterday when he heard good ole Dr. Goodwin had to fork over $1.5 million, beside a fine of $250,000 and facing up to 10 years in prison. But come to think of it, Malouf has already agreed to pay up over $1M to settle fraud charges. Hmm…

February 12, 2013

Amarillo orthodontist must forfeit $1.5M

By Jim McBride

jim.mcbride@amarillo.com

An Amarillo orthodontist must forfeit $1.56 million he fraudulently gleaned from the Texas Medicaid program by billing for dental work he never performed, an Amarillo judge has ruled.

In a preliminary order issued Monday, U.S. District Judge Mary Lou Robinson said the government presented “credible evidence” Michael David Goodwin, owner of Goodwin Orthodontics, 3629 Wolflin Ave., reaped $1.56 million in ill-
gotten gains between 2008 and 2011.

Goodwin, 63, pleaded guilty in December to one count of health care fraud. He faces up to 10 years in federal prison and a fine of up to $250,000 when he is sentenced. Under the plea, Goodwin agreed not to challenge the forfeiture.

Prosecutors allege Goodwin frequently billed for work he never performed and scheduled up to 100 patients daily. Employees and patients likened the scheme to “herding cattle,” court documents show.

A phone message Tuesday at Goodwin Orthodontics said the office was temporarily closed.

Dr. Kristie Liebau-Grassi Sentencing

Tomorrow is supposed to be the big day for Dr. Kristie Liebau-Grassi, who pled guilty to Medicaid fraud in September 2012.

She has agreed to pay restitution of $289K and faces 12-18 months of time in federal prison.  Maybe Dr. Robin Lockwood has a bunk in her cell for Dr. Kristie.

We shall see tomorrow.

Raven Maria Blanco Foundation Patient Survey

This 35-question survey is intended to measure patient attitudes and knowledge regarding the level of medical emergency preparedness in dental offices.
A general dentist (also called a family dentist) is a primary dental care provider that provides a wide range of dental services such as check-ups, exams, cleanings, fillings, crowns/caps, dentures and possibly other dental services. Many general dentists treat children as well as adults.

Please answer the questions based on your experiences with your current general dentist.

 

https://www.surveymonkey.com/s/rmbf-patient-expectation-survey

Dr. Thomas Floyd arrested again, this time for Medicaid Fraud and more.

Pam Bondi’s Office Arrests West Palm Beach Dentist on Medicaid Fraud and Grand Theft Charges

By: Eric Giunta | Posted: February 8, 2013 2:27 PM

Florida Attorney General Pam Bondi has announced that her office has arrested a West Palm Beach dentist -- Dr. Thomas Floyd, 61 -- on charges of Medicaid fraud, grand theft, and employing a person to perform duties outside the scope of their license.

“Employing a person to perform duties outside the scope of their license and billing Medicaid for those services is endangering patients and stealing from the Medicaid program,” Bondi said in a press release.

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