Tish Ballance To Open Clinic in Waynesville, NC October 2008

After much discussion on what the heck happened to Tish Ballance and her Access West dental clinic that was supposed to open in Asheville, NC in July 2008 I thought it was time to just go find out for myself.
So I took off to Asheville to check things out.  There is no sign of her Access West Clinic in Asheville and the number you find of the Internet is no longer in service, nor is there a current phone number for Access West, so hopefully we stopped that theivin dentist in Asheville.
However and this is a big however!  She is opening up a clinic in Waynesville, NC about 25 miles northwest of Asheville close to Maggie Valley and Cherokee, NC.  It's a beautiful little town nestled at the foot of the mountains.  A good place for a crook to hide out.
Her new clinic's name is Carolina West Dental Clinic and will be located in Waynesville Plaza shopping center in the old Family Dollar building.  It appeared the plumbing is in for all the dental stations but not one stud has been put up in the huge building. 
I asked the construction guys about the place and they directed me across the parking lot to a small tan building housing a construction company's office who builds log home among other things.
I spoke with the gentlemen in the office and they told me the place should be ready to open at the end of October, so we still have some time left to stop this clinic from opening as well. 
Evidently times are hard for Tish as her contractor seems to be also acting as her human resources person.  I say this since I presented my self as looking for a job and the new clinic and he insisted that I could get my resume together and leave it with him and he would see to it that it got to the right person.
But there seems to be no sign of her greed little hands in Asheville unless she used some other name to open her clinic other than Access West or Carolina West Dental.
It's time we warn the good citizens of Waynesville what kind of person is about to start treating the children in this small quaint town.

Small Smiles In New Albany Still Treating and Mistreating Children; Collecting Medicaid Dollars Once Again!

New Albany Small Smiles Clinic Still In Business. The sign simply says Dentist Clinic, but the new name actually is Albany Access Dentistry as I've reported on here before.

Thank goodness more parents are suing Forba/Small Smiles! Their Legal Eagles of King and Spalding should be quite busy right about now.

Of course Forba is going to say they no longer own this clinic but that simply is an out right lie. They know they own it, I know they own it and others know damn well they own it!

If you do a 'who is' for who owns and administers the Albany Access Dentistry website you will see that it's FORBA. Yeah, they registered that name just days following the Albany clinic being shut out of the medicaid program in NY.

Anyone who reads this blog knows that Small Smiles/Forba always seems to find a way to skirt the laws of every state in which they operate. But something tells me this is all coming to a swift end very soon. These reports are not going away, and I certainly am not going away, not as long as Forba insists on abusing children for profit!

Shotty Toothbrushes Sent Home With Patients At Small Smiles, Smile Starters and other Forba Owned Clinics

Little did I know the response I would get when I posted about the toothbrushes imported from China by Brad Padula.  These toothbrushes were supposed to be FDA approved or at least that's what it said.

However, from massive amounts of emails I've received I seriously doubt it, unless the FDA approved toothbrushes loaded with stains on the bristles, crumbing handles that left your mouth full of bristles and pieces parts.  Not that I would expect a quality brush sent home, they want those teeth to rot, right?!

Anyway, if they give you one of those toothbrushes that are not a brand name, take it home and throw the damn thing in the garbage.

Dr. Letitia (Tish) Ballance Update

I'm getting conflicting reports as to whether Letitia (Tish) Ballance opened her new state of the art "Access West" dental clinic is Asheville, but am getting a strong report she's opening a clinic in Waynesville, NC, located in Waynesville Plaza.

However I did do a little search to see if maybe Tish had ever been licensed in Colorado, and sure'nuff there she was.

License number 8153.  She was first licensed in June, 2000 and let it laspe in February 2006.  Her licensing method was 'credentialing'.  No actions are on file for her. 

I would hope that the dental board has her name red flagged in case she were to ever try and get her licenses there again.  In fact when she, along with Michael DeRose were fined that $10 million last year, didn't the dental board say something about how this would following them no matter where they go, well yeah, it's following them alright.  Following them right along to opening more clinics, bilking (I mean, billing) medicaid and straight to the bank.

When I find out for sure if she opened that new clinic in Asheville, I'll update it here.

Small Smiles Pays School District To Advertise

According to an article in The Colorado Springs Gazette (see here) Small Smiles paid the El Paso County school district 11 $7,000 to advertise on buses, to send post cards home with students in 2004.

This was just prior to the state enacting very strict guideline on papoosing a child for dental work.  The state had to enact this rule due to all the complaints it received from parent about Small Smiles torturous treatment practices.

Michael DeRose didn't speak at the hearing when this new rule was being read however Sen. Maryanne Keller said, "To Voluntarily restrain another individual against their will is the seond worst thing we can do to them."

I bring this up now to show that as far back as 2004 the DeRose's, Forba, Small Smiles and all of it's affiliates knew that people felt this was wrong on so many levels but did they stop before laws and regulations had to be passed?  NO!

Colorado didn't tolerate this behavior for very long   So what did Small Smiles do, they ventured out to other states to find more children to papoose, abuse and traumatize and they've yet to stop!

First I think there is just something wrong with companies being able to solicit their wears to young school children, dental, coke, pepsi, or whatever.

Second, it's clear, unless a state pass regulations that prohibit Small Smiles and those like them to stop abusing children they will continue!  It's 2008 and they are still at it in those states that do not have regulations!

So, States!  What are YOU going to do to stop these people?

FYI: Brad Padula; US Agent Importing Toothbrushes From China

Brad Padula, pictured above is US Agent for FDA Approved Toothbrushes imported from a company in China called Shanghai Songyang Import and Export Company, LTD. See document from zapconnect.com

One might ask, so who cares? What's Brad Padula got to do with any of this anyway?

Well, I'll tell ya. I can connect him directly (can't show you that just yet, but I will) with Smile Starters in North Carolina. That's the Michael DeRose company that was fined the $10 Million dollars back in April for Medicaid fraud, over treating children (16 stainless crowns in one sitting..and more). Remember Michael DeRose is part owner of Forba/Small Smiles (on the board of directors too).

He's the upper management that Arcaptia Bank, out of Bahrain, just outside of Saudi Arabia is doing business with in all these Small Smiles Clinics across the US.

It's uncle Adolph (Rudy) Paula's (Brad's dad, Michael and Dan's uncle) that puts his licenses up in various Small Smiles clinics across the US even though he's not seen a mouth of teeth in years!

A word about Songyang (China International Intellectech Corporation, Shanghai Songyang Import & Export Co., Ltd). As you might know all heavy industry and agriculture in China (The Peoples Republic of China) is State owned. Some large western companies such as General Motors have opened plants in China. These are joint ventures where the State owns the land and GM might own as much as 49% of the joint venture. Only mom and pop size retail establishments can be said to be owned privately. Songyang is State owned. Songyang was established by the State to market the production of the State owned businesses. Add to that the fact that manufacturing labor cost in China is 1/8th (one eighth) that of the United States or Europe.

More on Todd Cruse and His Testimony In Sen. John Ford Trial.

I thought I would post this since it gives a little background on just where Todd Cruse (divorced) actually came from and how he ended up at Forba. Something tells me someone on here just might need this info and find it useful.

Todd should be considered as SVP of Smooth Operations.  Since he certainly is a "smooth" operator.  He can almost make you believe what he is saying and buy what he is selling.  But it doesn't take long to smell what he is stepping in either....

Was Todd or Dan DeRose for that matter given some kind of deal to testify against Sen. John Ford?  We will probably never know.  I sure hope that was not the case.

At the time all this went down Don Sundquist was governor of Tenneesee and Toad (...LOL...sorry I mistyped then decided to just leave it,..sorry, Todd) Cruse was a top official in Sundquist's administration.
From Commercial Appeal:

By Richard Locker (Contact), Memphis Commercial Appeal
Monday, July 7, 2008
NASHVILLE — NASHVILLE -- The lobbyist for a network of children's dental clinics told jurors this afternoon John Ford was the only Memphis lawmaker he spoke with who would not help his company in its fight with Doral Dental Services to open a clinic in Memphis and that when he asked Ford for help, "He chuckled a bit and said, 'No, they call me Mr. 15 Percent'.''
That exchange between Todd Cruse, a top official in former governor Don Sundquist's administration and later a government relations executive with Forba Dental, occurred in 2003 outside the P.F. Chang's China Bistro in Memphis, Cruse testified.
Prosecutors are trying to prove that Ford used his influence as a powerful member of the state Senate on behalf on Doral Dental Services, with whom he had a consulting arrangement that the government claims paid him more then $400,000, through a firm called Managed Care Consulting Group in which Ford was the lead partner.
Cruse went to work for Forba in January 2003 after the Sundquist administration left office. He first worked on Forba's behalf through a lobbying firm called Public Strategies, and then moved directly to Forba's employment.
Soon after he left state government, Forba became embroiled in a bitter fight with Doral after Doral rejected Forba's efforts to join Doral's network of dental providers across the state that would allow Forba to serve -- and get reimbursed for -- TennCare recipients, primarily children.
That denial, Cruse said, occurred on the day in the spring 2003 that Forba had opened its first Tennessee clinic in Memphis at Knight-Arnold Road and Perkins. That turned out to be the only day it was open, Cruse said, because its business model was to exclusively serve low-income children who were covered by government-paid health insurance programs.
Up until that time, he testified, Forba believed it was en route to being approved by Doral, TennCare's sole contractor to administer dental benefits to TennCare recipients, for inclusion in its network of dental providers. Its dentist and the Memphis facility had been certified by Doral. The only reason Doral gave for the rejection was that its network in Tennessee's urban areas was "adequate."
Cruse said Forba launched a "multi-faceted" campaign to reverse the decision, meeting with black legislators whose constituents were Forba's primary patients, attempting to rally support among ministers and meeting with TennCare officials. That effort included at least two meetings with Ford, in his office and at P.F.Chang's, and a brief conversation in the Legislative Plaza hallway in Nashville.
Cruse said that House Speaker Pro Tem Lois DeBerry, state Rep. John DeBerry, and then-legislators Roscoe Dixon and Kathryn Bowers, all of Memphis, were generally supportive of Forba's efforts. But Ford was not. In the meetings, Ford attempted to lay blame on state TennCare officials rather than Doral.
After the meeting in Ford's office, Cruse testified, he said that Ford's general response was that "the whole situation was silly; it can't be Doral's fault, it was on the back of the TennCare Bureau. It was left open (at that time) whether he would do anything."
But at a later meeting in Memphis, at the restaurant, Cruse said he and other Forba executives told Ford that Forba was seriously considering filing a lawsuit against Doral. "He said it wasn't Doral's problem. It was TennCare's problem," Cruse testified.
Cruse testified the conversation continued as he, Ford and Forba executive Dan DeRose drifted out into Chang's parking lot and Cruse made a last-ditch effort to win the senator's help:
"I said we could really use his help, that the situation was dire. He chuckled a little bit and said, 'No, they call me Mr. 15 Percent."
Cruse testified later under cross examination by Asst. Federal Public Defender Isaiah Gant, Ford's defense attorney, that that remark stood out in his mind. "When a legislator tells you he is known as Mr. 15 Percent, it sticks with you."
Although there was no attempt made to explain the meaning of the statement, Gant attempted to discredit the phrase, getting Cruse to acknowledge that it did not "stick" with him enough for him to report it to authorities. But Cruse said that he had never heard another legislator make such a remark.
In his direct examination by Asst. U.S. Atty. Eli Richardson, Cruse said that at no time did Ford ever let him know that he was doing consulting work for Doral or had any sort of financial arrangement with Doral. He said that would have been good to know as he approached him for help on behalf of Forba, which was fighting Doral.
But under cross examination, Cruse acknowledged that there was no law requiring Ford to notify him that he was working for anyone.
In the final testimony of the day, Doral executive Robert W. Lynn testified how he first learned of his company's consulting contract with Managed Care Services Group -- in late 2004 as Doral was being acquired by DentaQuest Dental Services and Lynn was assigned to assess all of Doral's consulting contracts with an eye toward cutting costs.
Under cross examination, Lynn acknowledged that the firm had consulting contracts for business development in several states and that he was not aware whether Ford's work occurred inside or outside of Tennessee. One of the defense's arguments is that Ford's work was outside of Tennessee, which would apparently not have been illegal.
Under re-direct questioning by Asst. U.S. Atty. David Rivera, Lynn said that to his knowledge, none of the other consulting contracts were with sitting state senators.

Forba To Participate In Study; Shouldn't They Be Doing Something Else With All Their Spare Time!

OH, Dear Lord Above, Please Protect Us From More Forba! Amen.

560 unlucky patients to be recruited for Forba experiment, I mean 'study'!
PEARL Network-Practitioners Engaged in Applied Research and Learning; Forba and the words 'applied research and learning' all in the same paragraph cause one to choke, does it not?

1. Who is funding this?
2. You would think a company needs to be of much higher quality than Forba/Small Smiles before they get into research. And Forba/Small Smiles going to 'study' 'treatment' of anything whatsoever is beyond me believing!
3. Let me 'examine' some 'treatment'!
4. What makes them think they are going to be in business long enough to complete any study!
5. Let me see, isn't Forba the one being 'studied' ...oh say by.... all kinds of State and Federal Agencies!!!!!!!!
6-100. What's wrong with people?
101. Shouldn't a company have qualified dentists to actually participate in a 'study'?!
103. If  PEARL ever had any credibility at all it's gone now!
104.-200. What's wrong with people!

FORBA-Managed Dental Centers to Participate in PEARL Network Study
Multi-year study will examine treatment of deep caries
July 22, 2008 - Nashville, TN – The lead dentists of three FORBA-managed dental centers have volunteered to recruit patients for a multi-year study conducted by The PEARL Network (Partners Engaged in Applied Learning and Research) that will examine treatment of deep caries nationwide.
Management of deep caries close to the dental pulp presents a challenge to both clinician and patient because the prognosis for recommended treatments is not well documented. The PEARL Network study, called Complete versus Partial Removal of Deep Caries: A Comparison Study of Treatment Outcomes (Deep Caries Study), will attempt to shed light on the most effective treatment options.
“The working relationship between FORBA and the PEARL Network will allow for a broader base of clinical studies to include a wider consideration of the population,” said Dr. Frederick Curro, New York University College of Dentistry’s Chief of Pharmacotherapeutic Investigations, who is conducting the PEARL study.
In a survey of PEARL Network members, 80 percent of dentist practitioner-investigators reported removing all caries from deep lesions and 20 percent reported that they only partially remove caries. Based upon this survey’s results and the recent publication of a report that found outcomes of both treatment approaches produced similar outcomes, the PEARL Network designed this effectiveness study to assess treatment outcomes for both procedures in PEARL Network practices.
The specific aims of this research are to:
• Compare the effectiveness between complete and partial caries removal in deep Class I lesions for maintaining tooth vitality at one year post-treatment.
• Assess the effects of deep caries treatment on patients' Post-Operative Hypersensitivity (POH) and Oral Health Related Quality of Life (OHRQoL)
• Evaluate cavity lining and bonding techniques for non-vitality outcome trends in order to design a follow-up prospective intervention study.
The study, currently in its early phases, will recruit 560 patients who will be monitored at 6 and 12-month intervals to examine treatment efficacy.
“FORBA provides dental care to a unique population which provides an opportunity for the PEARL Network to be more inclusive of its clinical studies,” said Dr. Curro. “The synergy between Forba and the PEARL Network will be manifested in the breadth of the patients considered for the clinical studies and in translating the clinical data to all socioeconomic levels.”
Contact: Don Meyer
(202) 898-0995
# # #

Knott The Dentist

Ya know, all of this crap just burns my butt to no end. I just can't talk about it enough.
Let's take Kenneth Eugene Knott, Dentist At Large.
I'm using him as an example, he certainly isn't the only one doing this for Small Smiles or Kool Smiles either for that matter. There are bunches and bunches of them out there! Rudy Padula, (Adolph Padula), Robert Andrus, Michael DeRose, the list just goes on and on.

On Delta Dental's PPO list he's listed as a dental provider for the Small Smiles in Fort Wayne, IN. If you made an appointment with that clinic I can tell you with 100% certainty that you would NOT see Dr. Knott, nor is he in the building and probably never has been.
He's listed as the dentist at the Small Smiles in Washington, DC, the ones in Cincinnati, and in Kentucky and in Oklahoma and on and on...Arizona, New Hampshire...more and more.

Now look, Dental Boards, what the matter with you people?
If there is a dentist who is applying for a licenses in a state he clearly does not live it that should raise some enormous red flags and I just don't get how it's gotten this outta hand.
It's time to clean this mess up! And I'm not talking about next meeting time either, I'm talking last week.
We all know Kenneth Eugene Knott does not practice dentistry in all of these states, well unless he has one of those cool magic red capes like Superman!

Small Smiles Takes Advantage of Grieving Mother To Patient Shop

You gotta luv Forba and their hired (public relation) gun, Don Meyer of Rubin-Meyer, formerly with Hill & Knowlton.

They've gone and got themselves their very own blog with Don Meyer as its author. (guess they are trying to fight fire with fire)

I know but please stop laughing. I understand it's hard but give it a shot.

It's not much of a blog. It started in May with 1 post and has one or two posts in each month since.

Not much they can say, most of the 9 posts talk in general about dental care to the under served.

One post is about them hiring Dr. Steve Adair, the papoose board expert who at one time warned against using the papoose board and wrote an article outlining how it should be modified in order to ensure the child could get oxygen and breath.

The other posts are reprinted news articles about clinic openings etc. None of the news articles after these clinics have been in operation in a community are posted.

The latest post is the most horrible of all.

It's about this lady who lost her son and holds an event each year that hands out book bags, this year she is teaming up with Small Smiles to offer free dental screenings during her event.

How HORRIBLE that Small Smiles would take advantage of this woman's goodness to patient shop!

This woman and her good graces and grief are being exploited for the gain of Small Smiles and it's a disgrace!

Clearly she knows nothing about Small Smiles operations, fraud, and investigation into these practices by various government agencies.

I'm not going to post the address, but I will say they use one of their big 'buzz' words in the title and it's hosted at blogspot.

Forba, is there nothing you won't do?

Kool Smiles Law Suit Help Requested

We've got a person who is suing Kool Smiles and is looking for others who have been victims or possibly current or former employees to help with information or possibly make a statement.

If you can help this family please email me at cckaddie@yahoo.com or better yet, lisanrj04@yahoo.com.

FORBA's Todd Cruse of Nashville, TN Donates To New Mexico Congressman

Call me stupid. Ok, wait, you would have to get in line to do that but anyway...

Wonder why Todd Cruse in Nashville would contribute a mere $250 to a congressman's campaign. Especially knowing how they work and all, surely he wouldn't expect much in return for that.

But the bigger question is:

Why would Mr. Cruse donate to Ben R. Lujan, a New Mexico Congressman.

You can see for yourself here.

Click

Oh wait! Here it is, straight from Ben's website:

Commissioner Luján has also fought for improved health care for New Mexico consumers by investigating the health-insurance industry's denial practices and spearheading development of legislation that expands access to insurance and closes loopholes. The industry had been using these loopholes to unfairly deny medical claims and void policies.

"Closes Loopholes" ROTF LMAO ROTF LMAO

Think about that a minute, the King of Loopholes, donating to a guy who boasts he 'closes them'. LMAO!

OMG, not a day passes I don't get some kind of 'pee' my pants hearty laugh with this group!

And get this Michael Lindley, FORBA's CEO donated to Ben as well. I guess Mikie makes more than Todd, because Mike donated $1, 000.

I guess Mike and Todd want to join the fight and help close all those 'loop holes'! LMAO!

Next thing ya know, Todd will be on the witness stand again.

But here is the REAL reason: A loan from the state of New Mexico to open a Small Smiles there.

Click Here for the story.

Related:

Mario Burgos: Bahrain Investors Collect New Mexico's Tax Dollars

Dr. Robert Andrus Does NOT Really Own Any Small Smiles Clinics In The Sense They Want To Project

This article had been reprinted here before but I felt it was worth reprinting it again along with the link to the original article.

Click here for original.

Anyway, it's important because it's talking about the Small Smiles opening in Roanoke, VA and how it's owned by Robert Andrus and FORBA only manages it for him.

Well, that simply isn't true. Robert Andrus works (or should I say worked, he's no longer with them according to recent reports). On an document that was sent to me listing all employees at FORBA, their phone numbers, email address and their job title Robert Andrus is listed as Senior VP West Region.

In fact he and Kenneth (Ken) Knott, SVP Central Region are listed as being owners as several Small Smiles clinics, especially in states where dental clinics have to be doctor owned. (I guess being doctor owned is subjective as to what percent of ownership isn't it, 1% or 100%?)

If you check phone books of various cities where Small Smiles is located you will see Dr. Robert (Bob) Andrus' name listed on several of them as being the owner and providing services to clients. He is (was) nothing more than a FORBA employee, it's just that simple.

Small Smiles defies traditional system - Low-income children haven't been welcome at most dental practices in the region, at least not without tight restrictions

Dentists suffer with a toothache of sorts over treating patients on government programs. The reimbursement is low, and the hassle is often high. Dentists prefer patients with private insurance or cash, on whom a stable, profitable practice can be built.

But a new Roanoke dental clinic has turned the standard business model on its head.

Four dentists courting the business of low-income children in Western Virginia have opened a practice at Crossroads Mall. Small Smiles caters to children age 20 and younger enrolled in any of the state's health insurance programs: Medicaid, FAMIS and FAMIS Plus. Low-income means people at or below 200 percent of the poverty level, which is $40,000 for a family of four.

It has drawn a huge response, with 2,100 patients booked for appointments before it opened July 31, drawn only by TV commercials and a postcard mailing.

"I think it's going to be successful," said dentist David Jones, who closed his private Roanoke practice to work at Small Smiles. There's so much work, "we could probably keep another clinic like this one afloat."

If the niche sounds unusual, it is: Low-income children haven't been welcome at most dental practices across the region -- at least not without restrictions that close access to new patients when the dentist feels he or she can no longer afford to treat any more.

But last year, Virginia lawmakers intervened. They increased reimbursement for dentists who treat Medicaid-insured children and chopped away red tape for both patient and dentist. Attention was directed at reducing missed appointments; people on Medicaid and related programs miss up to 50 percent of scheduled dental appointments.

National companies that cater to those on government programs have been setting up shop in Virginia. The Small Smiles group, from Pueblo, Colo., has opened 46 practices across the country, including in Roanoke and Richmond. A similar enterprise, Kool Smiles, based in Decatur, Ga., has 17 sites nationwide, including four in Virginia, its Web site said.

"We have a business model that works because this is all we do five days a week, 12 months of the year," said Todd Cruse, speaking for Small Smiles in Roanoke. "We typically average somewhere around 72 to 75 patients a day."

Cruse is chief development officer at FORBA LLC, a dental practice management company in Pueblo, Colorado.

FORBA manages the Roanoke practice for its owner, Colorado dentist Robert Andrus.

Terry Dickinson, executive director of the Virginia Dental Association, was wary when he first heard that a for-proft, corporate dental practice focused on the poor was preparing to operate in Richmond this past spring.

It appeared to be a low-margin business dependent on moving a high volume of patients through, Dickinson said. Might Small Smiles be a "mill" providing the least acceptable care, Dickinson wondered.

So he met with Small Smiles officials. "We made it clear if they chose to come into the state that we would have our eyes on their operation," Dickinson said. Company officials pledged to give quality care and invited state dental industry leaders to drop by unannounced.

Now that the Richmond practice has been up and running for several months, Dickinson is satisfied that Small Smiles is meeting the needs of Virginians, he said, adding there haven't been any patient complaints to his association.

"We are very pleased with what they're doing," Dickinson said.

Another Small Smiles Business Partner Settles Medicaid Fraud Charges

I hardly know where to begin on this entry. What a mess we have here. It might help if you read the entry about the "Tangled Web" before reading this one.

Well, earlier this month we had Doral Dental implicated in the bribery charges of former Tennessee State Senator John Ford. During the trial FORBA/Small Smiles top dogs, Todd Cruse and Dan DeRose even had to take the stand.

Doral Dental execs were so guilty they admitted if they took the stand they would plead the 5th as not to implicate themselves.

Now we have Amerigroup settling the largest ever false claims Medicaid Fraud case in American history at a whopping $225 Million dollars. (somehow no jail time has been imposed)

After WJLA TV's investigation aired about the horrible treatments of children at Small Smiles clinics and the medicaid fraud in and around Washington DC, Amerigroup announced it was requesting Doral Dental to do a thorough investigation of these allegations. (aren't you just about choking right about now?)

Amerigroup contracts with the state

Doral Dental contracts with Amerigroup

Small Smiles contracts with Doral Dental

...to provide dental care to children enrolled in medicaid in Maryland, District of Columbia, Ohio and Georgia.

Don't forget just a few short months ago Dr. Michael DeRose the co-founder of FORBA/Small Smiles paid a $10 million dollar settlement in North Carolina for medicaid fraud.

Something tells me that FORBA/Small Smiles was not exactly shaking in their boots when they were made aware Amerigroup was having Doral Dental look into their business practices, what do you think?

Buying and Selling of Your Medical Charts: Is this legal?

This post is a bit off topic but thought it deserved some space on my blog.

Recently I was reading a message board and a discussion came up relating to 'buying charts'.

It was about a young dental practice wanting to know how much they should pay per chart if they purchased them from a retiring dentist. (which means there was an offer from the retiring dentist to sell them in the first place right?)

Now something about that just bothers me. I thought my medical charts (dental or otherwise) were somehow a bit more protected than that. The idea that they can be bought and sold really burns my butt not to mention all the HIPPA issues I see that could arise.

Imagine your dentist retiring, soon you get another dentist peddling his services via your mail box or home phone from the info he just bought from your retired dentist.

During this conversation another professional came back and said that you can't really buy charts but you can take over custodianship of them. He advised not paying a dime for them but to offer the retired dentist to take over the charts saving the retiring dentist from having to store, make copies to send to his old patients, sorting them all out etc.

Does the fact that your private medical information, of any kind, can and is bought, sold or traded? Of course I don't guess this is much different than if a professional sold his practice is it? In selling that practice wouldn't the buyer get your charts?

Two Doral Dental Opinions: Both raise questions

When asked about signing up to be a Doral Dental Provider here are a few of the responses:

mc2001 says: I have mostly good things to say in Virginia. The rates are reasonable (reimburse at approximately 60-70% of my practice fees depending on the codes). I collected $2.8 million last year with 8 chairs running 5 days a week.

I get a $30,000-$45,000 check every 9-12 business days, very few claims get denied and they cover most ADA codes that a pedodontist uses. Additionally, I am a participating provider with Delta and once the participating provider adjustment is done, I often find that Medicaid reimburses at a higher rate than Delta.

Sounds like to me this guy (or gal) is saying they get more money from Doral Dental and it's Medicaid reimbursements, then through private pay Delta Dental. Do other dentists know about this, since they argue they won't take medicaid patients due to the low reimbursement rates?

Of course I did take note that is was all about the 'coding' used. Wonder what coding one uses to get that high of a percentage of reimbursement? Creative Coding maybe? Like coding on Oral Hygiene instruction which is telling a two year old to brush his teeth twice a day, (can't tell his parents, they are locked in the waiting room at many clinics) wonder how much that pays?

Of course there are two sides to the flattest pancake so here is another opinion from nanham22:

Run away AS FAST AS YOU CAN. Doral manages Kansas Medicaid and it is the reason we absolutely refuse to see Medicaid patients - we don't get paid on time - MAYBE six months later, if we are lucky; and then, minimal reimbursement.
You can never get anyone to help you with claims. Finally, we had to call the governor's office and our state rep to get claims paid that were over a year old.
Pitiful.

Adventure Dental and Vision, yep vision too

Before going any further, I want to warn you that the owner of these clinics worked for and was trained by FORBA and Drs. Michael and Ed DeRose and Dan DeRose as well as Michael Roump of the infamous Small Smiles clinics that mistreat and abuse children and have been accused of medicaid fraud.

Looks like there's yet another dental clinic on the rise catering to low income Medicaid children only this one is going to take care of eye care as well. (I bet FORBA hates they hadn't thought about this new cash cow!)

Adventure Kids Dental and Vision (yes vision is being added I suppose unless there is something about seeing with ones teeth that I'm not aware of).

This place started out in Colorado Springs, CO (yep, Colorado again) as Academy Kids Dental and is the brain child of Ronald (Dr. Ron) Brandon Montano once again another former Small Smiles dentist, like Dr. Tran and Dr. Pham of Kool Smiles being former Small Smiles (Ed and Michael DeRose trained) dentists.

As of right now there is a clinic in Colorado Springs, Colorado another in Greenley, Colorado and one on the east coast in Brockton, Massachusetts and two in the DC area.

This clinics theme is cartoon action hero with the main character being "Captain Smiles". see captainsmiles.com

And the 'management company' for Adventure Kids Dental, sometimes referred to as Adventure Dental, is Hero Management. (an email address on one of the websites is cathy@hero-management.com)

So what's the deal with every dental clinic needing it's own personal management company anyway?

Another of it's websites is: adventuredentalandvision.com

The staff at the Colorado Springs clinics includes Drs. Ron Mantano, Mario Montanez, Melissa Montano and Steven Gould.

The Greenley dentist is Dr. Amy Jorgensen

No one is listed in the Brockton office so it might not be open yet, who knows.

Anyway there are two now opening in the Washington, DC hotbed:

1253 West Pratt Street
Baltimore, MD
410-727-4746

and

1305 Rhode Island Avenue NE
Washington, DC 20018
202-269-4746

..both 4746 wonder what special meaning those numbers have to Dr. Ron?

We can only hope that complaints don't come flying in for Adventure Dental. Hopefully Dr. Ron learned what NOT to do while working at Small Smiles in Colorado Springs. I heard he was let go, so that's a good sign since Small Smiles/FORBA doesn't keep dentists who are patient and nice to children.

Time will tell.

Anyway it's looking like the Washington DC, Maryland, Virginia area of the country needs it's own fully staffed task force, complete with a SWAT team to keep a close eye on all the dental clinics for the poor.

Dr. Kenneth Knott: Owner or Front Man?

Recently I checked out a Small Smiles yellow page ad in a city to be named later.

They ad read in part:

Care Provided by OH Licensed General Dentists
-Dr. Kenneth E. Knott & Dr. Robert Andrus, Owners

I just don't believe that is true.

They do not provide the care as it would lead you to believe and they don't 'own' the clinic either. Neither of these dentists have touched a mouth full of teeth in years.

Dr. Kenneth Knott is listed as FORBA's Senior Vice President-Central Region according to their internal employee list.

Dr. Knott has licenses in Kentucky, Ohio, Nebraska, New Hampshire, Oklahoma, South Carolina, Virginia and others. Dr. Robert Andrus is licensed in all these states as well.

So is being a 'senior vp for FORBA really mean, you go from state to state in your region, take some tests if any, hopefully pass them, apply for and obtain licenses so that we can hang them in the rogue clinics. So I guess that makes one a "professional licenses obtainer", right?

Doral Dental Execs Would Invoke 5th In John Ford Trial.

From My Fox Memphis

Defense Rests in John Ford's Corruption Trial

Judge: Key Ford Witness Doesn't Have to Testify

Last Edited: Wednesday, 16 Jul 2008, 2:58 PM CDT

Created: Wednesday, 16 Jul 2008, 1:16 PM CDT

NASHVILLE, Tenn. (WHBQ FOX13 myfoxmemphis.com) -- The defense rested in the John Ford corruption trial after a federal judge shot down attempts to get two crucial witnesses to testify on behalf of the former state lawmaker.
U.S. District Judge Todd Campbell on Wednesday said the former CEOs of two TennCare contractors have the right not to incriminate themselves on the witness stand.

Campbell's ruling left Ford without the benefit of testimony from Osbie Howard, former CEO of Memphis-based OmniCare, and Craig Kasten, co-founder and former CEO of Doral Dental, based in Mequon, Wis.

It is not clear whether the two could also be charged in the case.

(They darn well should be along with Dan DeRose and Todd Curse who no doubt paid Doral Dental to let Small Smiles open up shop in Tennessee)

Ford, 66, is accused of taking more than $800,000 to use his position as a senator to advance the interests of the two companies. Ford has maintained he was being paid for work he did outside the state of Tennessee.

Ford's attorney, Isaiah "Skip" Gant, has said Kasten made sworn statements in a deposition that would vindicate Ford.

Kasten took the witness stand Wednesday without the jury in the courtroom. Asked whether he would be willing to answer questions about the business dealings between Doral and Ford, Kasten said, "I would refuse to answer on the grounds that my answer might tend to incriminate me."

(Incriminate him and a few others I propose)

Previous testimony has shown that Doral paid Ford's consulting group about $1.2 million.

Last week, Gant asked the government to grant Kasten immunity from prosecution in exchange for his testimony.

In considering the request, Campbell asked prosecutors whether the government intended to charge Kasten and if he was the target of a probe.

The prosecution's answer to Campbell's questions was filed under seal and Campbell denied the request for immunity.
Howard, the former OmniCare CEO, took the stand after Campbell advised him to get a lawyer before testifying.

With Nashville attorney Jodie Bell by his side, Howard repeatedly invoked his Fifth Amendment right not to answer Gant's questions.

Gant told Howard he wanted to ask about his personal and business relationship with Ford. He also asked if Howard would answer questions about Managed Care Services Group, a consulting group that Ford and Howard were in together.
"If I were to ask you questions in that regard, would you answer those questions?" Gant asked.

"No," Howard said. "I would invoke my Fifth Amendment rights."
In ruling Howard should not be compelled to testify, Campbell said Howard's concerns about incriminating himself were "substantial and real."

(Substantial and Real, well you bet it is!)

Closing arguments were set to begin Wednesday afternoon.
Ford is serving a 5 1/2-year prison sentence for a bribery conviction in the unrelated Tennessee Waltz sting.

Remember Doral Dental is the company saying it's doing an investigation in Maryland concerning the barbaric treatment of children by Small Smiles/FORBA Dentists.

Dentist Able To Treat Patients Too Soon

It just amazes me how easily a person can attend dental school, graduate and immediately be given the opportunity to tear into a person's mouth, especially a child's.

No wonder so many go to dental school instead of medical school or take the time to attend another couple of years of college to actually become a pediatric dentist.  And explains why dentistry has become such a joke, which it shouldn't be since oral health is so important.

In medical school it's years before you are allowed to attack the care of a patient on your own, to become a dentist and treat patients is a piece of cake in comparison.  No, I'm not saying it's easy by any means nor do I think I could do it, however from what I've heard many Small Smiles dentist are doing I'm not so sure my 5 years old grandchild might not do a bit better job.

What bothers me is the fact these dentist pass a test, (yes they actually do have to do some work on actual teeth before graduation but so does a cosmetologist so that doesn't mean a whole heck of a lot) then left to roam from state to state simply applying for a licenses to practice and after a few questions from state dental boards are granted those licenses.  And unless there are complaints (and a whole lot of them and sometimes this mean little) they are left to run loose.  This is why filing complaint is so important!  If not you, then who? 

I know from doing all my research into this very few dentists licenses are actually revoked and in most instances one state will slap them on the wrist, maybe even two slaps, the next state knows this but will grant them a licenses anyway as if there is some dentist shortage or something.

This just seems wrong to me.  There is a bit of oversight of dentists.  But nothing near enough when looking at how places like Small Smiles, Kool Smiles and the like have been allowed to open renegade dental offices.  Many of these clinics have licenses hanging in their offices of dentists the staff have never seen or heard of, let alone any of them actually working on patients.

Of course many of the staff don't understand why these licenses are hanging there (it's to skirt the laws of particular states) but I encourage them to report this behavior to your state dental boards.  If there is a dentist licenses hanging in your office and you've never seen this dentist this should raise some red flags and I hope that you ask yourself why.

Anyway, states need to be taking a much closer look at their dental laws, rules and regulation and put a high powered microscope on their dental boards.  It's time for individuals to take some action here and let your law makers know there is a python in the wood pile and clean up this mess.

That is one thing I can thank companies like Small Smiles for, their tyranny bringing to light much that is wrong and what needs to be cleaned up and I don't mean tomorrow, I mean last week.

Another Child Abused At The Hands of Dental Staff.

This is Ginny's story:

Recently I took my 5 y/o son to a Pediatric Dentist in Overland Park, KS. I begged for something before hand for him, knowing that he would be very scared.

They called in Valium 10mg, 30 min before his appt. He was needing 2 fillings that were side by side. They also advised me before hand that Nitrous gas was going to be used.

Once the gas started, he began to get a combative, screaming, and kicking. He begged for me to help him. It felt like a dagger to the heart.

They said that they would need to use a papoose board, with my permission, so that they didn't drill into his cheek or gum. I advised them that he was a little claustrophobic and wouldn't like it.

They said they needed to finish the procedure. He was screaming no no no and was asking them to wait because he had to tell me something, ("kids try using all tactics", is what I was told).

I kept talking calmly to him telling him it would be over soon, and it was ok and mom was here. When they turned it into a safety issue, you think you are doing the right thing.

Watching your child be strapped down, with a 130-140# tech laying over them, screaming, nearly throwing up, you feel like a criminal & a failure as a parent.

He kept saying he couldn't breath, and the tech kept telling him that if he was crying he was breathing. I am a RN, and would never treat my patients like this. You are trained safety first, but he is my child and I knew that they couldn't leave his procedure half done.

I asked several times if they had used lidocaine, they said that he wasn't hurting he was just mad. He was never given local anesthesia.

I was told by a tech that if I felt that it would help they could try it but it may interact with the Valium, and cause a worse issue than what we had.

I try not to let office staff know when I go somewhere what my profession is because then they seem to treat you differently. When it was all over almost 45 minutes later, he was soaked in sweat from his head to his socks.

The doctor was calm during all of this and never raised her voice once. The techs though had this look on their faces like they were going to control this child, the first one yelled out the door for help then two more came in.

Over all there was the dentist, and 4 techs in the room. He is very very strong and kept getting his hands out of the restraint and pinched them. He was asked not to pinch because it wasn't nice. I wanted to tell them put yourself in his shoes, I would be scratching your eyeballs out of your head if you were holding me down, so get over it!

Never again will anything like that happen again to any of my children. My daughter went 1 1/2 years ago and had a baby eye tooth pulled that wasn't ready to come out but because all of her perm teeth were being twisted, had to be pulled. That was a different doctor same facility.

I fired that doctor from seeing my children because of her treatment. It took me over a year of talking and reassuring my daughter that the next experience would be better, for her to return to the dentist.

And after my sons appt. and not using lidocaine, I was discussing it with my husband and I truly do not think that she was ever given lidocaine or any other anesthesia except for nitrous gas.. I am appalled.

I am calling Monday morning to ask what her anesthesia was for that appt. She is 9 and is to start braces in 2 months at this facility. If I find that she wasn't given local when they pulled her tooth, I will make a decision to turn them in to the ADA and also to transfer care.

It is up to us to protect our children and I have failed both of them in this department. If anyone feels that it is wrong, it probably is and they need to remove their child from the situation.

I will never be afraid to cause waves again. If we don't protect them who will?

Dr. Robert F. Andrus-Still Small Smiles Front Man?

According to Beta Health Association Complete Specialists Directory (not dated so I don't know how "updated" this actually is) Dr. Robert F. Andrus's specialty is Pedodontics (children's dentistry). Of course as with anything to do with Small Smiles, this simply isn't the case. His current Colorado licenses lists him as a General Dentist.

Of course I knew this was probably BS since this same list has Michael DeRose's Specialty as Pedodontics as well and we know that simply 'ain't so'.

Why do I mention Dr. Robert F. Andrus, DDS you might be asking yourself? Well, on this same list it says that Dr. Andrus works in the Michael DeRose office located at 1022 Liberty Lane, Pueblo, Colorado along with Drs. Ed DeRose, Michael DeRose, Jim Mobley, Randy Ellis, Hate Haerr.

Of course there are hundreds of dentist associated with Small Smiles/FORBA and Michael DeRose but this guy seems to stand out a bit since he's applied for and received dental licenses in Kentucky, Nebraska, New Hampshire, South Carolina, Virginia and Kansas just to name a few.

So how does this associate him with Small Smiles? Well, there is an article on glsennca.org called "Small Smiles defies traditional system". In this article it says that Terry Dickinson was wary of corporate dentistry coming to the state of Virginia and would be keeping an eye on Small Smiles.

It also says that Todd Cruse, chief development officer for FORBA would be managing a Small Smiles clinic owned by a Colorado dentist, Dr. Robert Andrus. This same article says a Dr. David Jones, DDS (not of the Monkees fame) closed his private practice to come to work for Small Smiles in Roanoke (bet he regrets this move by now).

Anyway I don't know if Dr. Andrus still is fronting for Small Smiles, using his name on licenses and such but he sure did at one time and he's all but held hands with Micheal DeRose and I'm not sure they've not done that as well.

After the first Small Smiles Report

Over the course of a few months, after Roberta's first report, there were a lot of follow-ups and communications between a lot of organization and state agencies and FORBA, now known as Church Street Health Care Management.
November 2007:
At that time, Maryland had 3 companies that managed their dental program.

1. Amerigroup who contracted out to Doral who contracted with FORBA (this drives me insane!)
2. United Healthcare - Mid-Atlantic Medicaid Plan (United Medicaid/UHCMA) who contracted with Dental Benefit Providers, Inc.
3. JAI Medical Systems

All these companies started investigating Small Smiles clinics Nov. 9 and Nov. 12, 2007.

November 9, 2007 Mike Lindley tells employees there would be audits that they estimate may take 30-45 days and during which time they could not seek reimbursement, but they had made the decision to continue to treat patients.  (because they felt so strongly about taking care of the underprivileged, all services would be "at no charge". 

[Am I the only one who doesn't think they knew how things would end and they could float these clinics for a couple of months, no problem]

Oh What A Tangled Web

Doral Dental is a Third Party Administrator (TPA) of Government Medicaid Dental Programs according to answers.com.

My first question is why in the world does any agency (Medicaid) need a THIRD party anything. Wouldn’t first party or second party at most be plenty?

Amerigroup is a Medicaid Managed Care Organization (MCO) but following along the thinking of Doral's designation, I guess Amerigroup would be considered a Second Party Administrator.

Your state Medicaid services would be the first tier I suppose.

So your state gets your hard earned, and taken away from you, tax dollars allocated to them to spend on the poor and those in need for medical treatment, called Medicaid. (In some states they give it a local name such as in Massachusetts it’s called MassHealth, in Tennessee it’s called TennCare, but it’s just Medicaid.)

Evidently the states don’t know what to do with the money, they need experts to distribute it so they hire companies like Amerigroup to spend your tax dollars for them.

In Maryland they have hired 7 of these companies, one isn’t enough I suppose. Amerigroup is one, AmeriChoice, Coventry Diamond Plan, Helix Family Choice, Jai Medical, Maryland Physicians Care, and Priority Partners are the others.

All of these companies then find it overwhelming to do the job so they hire Third Party Administrators such as Doral Dental. Doral Dental then goes out and gets contracts and hires the actual providers, your dentists and dental clinics such as Small Smiles.

Some of the Second Tier companies such as Jai Medical contract directly with the providers, Small Smiles, so I guess hats should be off to them for by passing those Third Party Administrators. Getting rid of the middle middle men I suppose. (more money for them to keep right)

However even the Third Tier companies like Doral find it overwhelming to spend all that money and will hire companies to help them decide where to spend it as they did in Tennessee by hiring Managed Care Services, a company who just happened to be owned by a state senator, John Ford, now on trial. (Amazing how many “consulting” firms are needed to decide where to spend all those Medicaid dollars isn’t it.)

Honestly, we have management companies managing management companies who hire consulting firms to help manage the management.

Well, evidently the rival firm of Doral, FORBA which just happens to own Small Smiles that are Doral Dental providers in other states wanted to sue Doral for Doral not letting them in on the TennCare Medicaid dental pie. This brought to light Senator Ford’s involvement and everything hit the fan and federal charges were filed but so far only against Senator John Ford, why no charges are being filed against FORBA and Doral for offering the bribe money is beyond me. I mean aren’t the ‘johns’ of hookers also charged?

Well anyway this brings me to Doral overseeing Small Smiles clinics in Virginia, Maryland, Ohio, Kentucky and a host of other states for those Second Tier Administrators like Amerigroup.

Doral says it’s conducting internal investigation of all the allegations on the mistreatment of children and fraudulent Medicaid billing, but what good is that exactly. I mean Doral sends it’s patients to Small Smiles in several states, yet is in competition with Small Smiles own management, FORBA in other states. (Head spinning yet? Mine sure is.) And the icing on the cake, Doral who is looking into these allegations is in deep doo doo in Tennessee for bribing a state senator! Don't think any kind of 'clean bill of health' Doral was to give Small Smiles would mean a whole lot, what do you think?

When pressed Doral will just throw the responsibility back to Amerigroup, saying they are the ones who push for all these children to be mistreated, (clearing throat) I mean money to be made, Amerigroup says it’s Small Smiles, and Small Smiles throws up it’s hands and says they don’t know anything about children being mistreated or Medicaid being ripped off.

And do you think the states know, well heck no. They don’t even seem to be smart enough to manage the Medicaid dollars in the first place and they have hired a umpteen packs of Foxes to watch one hen house.

But when all said and done there really is no competition or rivalry. They are all in the same bed, using the same horrible methods to steal millions and millions of your dollars and mistreating and abusing innocent children to get the job done and sending at least some of the huge profits to an Islamic bank is Bahrain that must not be making enough money of oil prices.

And let us not forget this same scenario is happening with United American Healthcare and it’s Third Tier Management group Omnicare. (As Doral Dental is to Amerigroup, Omnicare is to United American) FORBA/Small Smiles is also a dental provider for Medicaid enrollees of United American Healthcare in various states just like they are for Doral Dental and Jai Medical.

United American Healthcare, through it’s OmniCare company was paying Senator John Ford $8500 a month for his services in getting key legislation through the Tennessee assembly. Legislation that would greatly benefit FORBA/Small Smiles as well as it’s own interests. (You can read about this at various places on the net, so I’m not getting into all of those allegations here)

Point is United American Healthcare did nothing to curtail Small Smiles treatment of children in Maryland. Doral Dental terminated 4 individual dentists and is ‘investigating’ (chocking on that word) Small Smiles practices before it sends more of it’s enrollees to Small Smiles and in November Jai Medical Systems sent a letter directly to Todd Cruse putting Small Smiles on probation and requiring Small Smiles to allow parents to go back with their children, make sure all personnel are licensed BEFORE they treat children, not go to school while practicing, and were going to do surprise visits and random patient surveys.

In light of the recent allegations of United Healthcare and Doral Dental being in hot water up to their eyeballs for bribing a state senator, I don’t think either of these companies should be ‘overseeing’ or ‘investigating’ wrong doing of Small Smiles or any other company, do you?

Partial List of Small Smiles/FORBA Corporate Office Staff

updated 4-1-2009

Al Smith (President, COO), Adam Snell, Alicia Sandovel, Amanda Greenhood, Amanda Skelley, Anna Casarez, Arnie Carlsen, Bob Andrus-FIRED Fall 2008, Brad Gardner, Brad Williams, Brandon Dyson, Cha Jones, Chante Green, Chanthalay Onevathana, Chase Trivett, Chris Gallina, Chris Hatch, Chris Pershin, Christian Diehl, Christine Peasron, Daniel Dunn, Donnie Watson, Dorothy Vigil, Jacob Kochenberger, Jake West, Jeff Osterman, Jenna Kochenberger, Jody Kay McFarland, John Fujishiro, Juliana Johnson, Kallene West, Kathy Morales, Ken Knott-FIRED with Bob Andrus, Kevin Reilly, Kimberly England, Lara Lott, Linda Zoeller (she's the one who files all those many many state corporate filings), Lisa DeRose, Lisa Mullinix, Liz Tran-FIRED March 2009(wonder if she's related to the Tran who opened Kool Smiles), Lizz Lown Krummel, Lori Bland, Lorri Stelner, Mark Oreskovich, Marla Grossman, Marschelle Chatman, Melissa (Missy) Green, Michael Lindley, Michele Campbell, Mike McDulla, Phyllis Brown, Rodney Cawood, Shari Reed, Skye Lown, Stephanie Pena, Steve Nitchen, Suzy Selgenthaler, Tammy Green, Tim Richter, Todd Cruse, Trevor Blazer, Vince Benfatti, Vinny Branchael.

All these people are listed as employees of FORBA either at the Nashville Office or the Colorado Office that located within DDMarketing (Dan DeRose Marketing)

If you are on this list and no longer employed with Small Smiles, let me know and I will note it.

Small Smiles Old Consent Form v. New Consent Form

Small Smiles Old Consent Form that says there is no known danger in strapping a child down in a straightjacket/papoose board.

See Here

Small Smiles New Consent Form telling parents a dentist, not assistant or hygienist but a DENTIST must inform the parents how, when and why a straightjacket/papoose board needs to be used as well as informing them their child could die if they use one.

See Here

Changes Made In Maryland Due To Small Smiles Abuse of Children

Changes are being made for children needing dental care in Maryland, in part to ABC 7 I-Team's Small Smiles investigation.

The changes will affect tens of thousands of families who've had a tough time finding quality care. The overhaul will bring greater oversight and encourage more dentists to accept Medicaid families.

Most dentists won't treat children on Medicaid because it pays less than private insurance. The I-Team's investigation showed Small Smiles made up for low fees with high volume. Beginning the first week in July, Maryland Medicaid officials will begin pumping an additional $14 million dollars into the program to encourage more dentists to participate.

"The state is concerned overwhelmingly about two things: We want to make sure we have enough dentists who can provide services to the children, and we want to make sure that those services are of high quality," said John Folkemer with the Maryland Department of Health.

Before, Small Smiles would keep parents waiting in the lobby, and had no special training for dentists who routinely used restraining devices while treating young children.

"We have required them to do some corrective actions," said Folkemer, "and to change some of the policies."

Folkemer says parents must be allowed to stay with their children and dentists now receive training on how and when to use so-called papoose boards.

Also consent forms were changed which had falsely told parents that restraints posed "no known risks" to children. Small Smiles now warns parents of potential "serious consequences" of these restraints, including "physical or psychological harm even death."

"And we [also] will now have one organization that we can deal with to handle any such problems as have been raised as to the quality of care or access," said Folkemer.

Dan DeRose Takes the Stand in Ford Trial

by:Marc Perrusquia

NASHVILLE -- Only one or two top executives at a TennCare contracting firm knew details of then-state Sen. John Ford's secret consulting job for the firm, according to witness testimony and documents presented by prosecutors Tuesday.

The closely held secret of Ford's $190,000-a-year job for state contractor Doral Dental began leaking out in late 2004 after the Wisconsin-based firm was sold to its current New England owners.

Ford, 66, is on trial in federal court here on six counts of corruption connected to payments he received from Doral and another state contractor.

Steven Pollock, Doral's current president, testified that he and others found out around the time of the sale that Ford was involved with two partners in Managed Care Services Group, a firm set up to help Doral win a contract with TennCare, Tennessee's expanded Medicaid program.

Doral started paying Managed Care $40,000 a month -- 40 percent of it going to Ford -- weeks after Doral won a lucrative TennCare contract in 2002.

Pollock said he began asking questions in November 2004 when Ford and his two partners traveled to Milwaukee in hopes of saving their Doral consulting deal, which had come under internal review.

"I asked (an employee) to check whether Sen. Ford was a sitting state senator,'' Pollock told jurors.

Asked why he did that, Pollock replied, "Obviously, as a government contractor, there's typically prohibitions (against) working directly with state officials.''

Pollock said Doral eventually terminated Managed Care's consulting contract, but not before the news media began reporting on Ford's connection. Doral severed the contract in February 2005, just a few days after The Commercial Appeal first reported that Ford was receiving hundreds of thousands of dollars through Managed Care -- income he didn't report to state regulators.

Although he was then Doral's general counsel and vice president of market development, Pollock said he didn't know what Managed Care did for the firm. A succession of Doral executives, including senior vice president Robert Lynn and former chief financial officer Lisa Sweeney, testified similarly over the past two days.

Pollock said that two top executives -- Doral founders Craig Kasten and Greg Borca -- had authority to enter consulting agreements. Neither has testified. Testimony on Monday indicated that Managed Care was formed after Ford and Kasten began discussing a potential TennCare contract.

On Tuesday, prosecutors introduced a 2005 spreadsheet listing Doral's consultants that characterized Managed Care as "a political organization, (with) public officials tied to this organization including Senator Ford. ... Greg (Borca) worked out the relationship.''

The spreadsheet went on to say that when a rival firm had threatened to sue Doral, "MCSG intervene(d) and no suit was filed. Well connected and influential.''

The passage appears to be a reference to FORBA, a Colorado-based manager of Medicaid-funded dental clinics for poor children. Two current and former FORBA officials have testified that they built and briefly opened a clinic in Memphis in 2003 but were forced to shut down after Doral would not let them into the TennCare dental network.

Dan DeRose, FORBA's former CEO, testified Tuesday that Ford had tried to discourage him from suing Doral. Echoing testimony from a lobbyist a day earlier, DeRose also said Ford tried to solicit payments from him for his legislative influence.

"He asked me if I knew what his nickname was. I said no. He said, 'They call me Mr. 15Percent,''' DeRose said. Prosecutors asked DeRose if he had asked Ford what he meant by Mr. 15Percent. DeRose responded that he had, saying, "His response was 'I can take care of your problems.'''

DeRose stood his ground when defense attorney Isaiah "Skip" Gant suggested he had made inconsistent statements regarding the Mr. 15Percent comments.

"I'll always remember it,'' DeRose said on redirect. "It was startling. ... I'd never been solicited for money like that.''

The very idea that Dan DeRose is on the witness stand trying to say his hands are clean in this just blows my mind!!!!

FORBA's Todd Cruse on Witness Stand In Tennessee Senator Trial: No Big Surprise Here

In my opinion Todd Cruse is no better than Senator Ford. I've been trying to tell my readers for months that FORBA, Todd Cruse, Michael DeRose, Doral Dental and the whole bunch associated with FORBA are crooks!

I'm looking forward to other senators to get nailed from doing dirty business with FORBA in the near future.

How many children did Small Smiles/FORBA and Doral Dental, who manages the management of FORBA, abuse to give Senator Ford his 1.7 million dollar cut. Let's see, at $220 per baby root canal that's close to 8,000 teeth just for one senator's payoff.

As you can clearly see, FORBA/Small Smiles just can't seem to keep their asses out of the spot light now can they?

July 8, 2008
Contact Chris Echegaray at 664-2144 or cechegaray@tennessean.com

Former state Sen. John Ford and his business partners were paid roughly $1.7 million in consulting fees from a TennCare contractor, according to a key government witness who testified in federal court on Monday.
Ford, 66, is accused of receiving consulting fees from two TennCare contractors, Memphis-based OmniCare and Wisconsin-based Doral Dental, from 2002 to 2005 while he served as a state senator on the general welfare committee and the TennCare oversight committee.
Ronald Dobbins, a Pennsylvania businessman who was one of Ford's partners in the consulting firm Managed Care Services Group, testified that the Memphis Democrat received 40 percent of the consulting fees from Doral Dental and the other partners got 30 percent.
Dobbins initially worked for United American Health Care, the parent company of OmniCare.
He testified that after leaving the company he created the consulting firm, Managed Care Services Group, in 2001. He said the initial consulting partnership was between Ford and him.
Then he found out that Ford had invited Osbie Howard, the chief executive officer of OmniCare, to join them. Howard handled the money, Dobbins told the jury.
Dobbins testified that he collected around $300,000 from Doral Dental over three years for doing little to no work.
Dobbins testified he had no knowledge of what Ford was doing on Doral's behalf.

'Mr. 15 percent'

Todd Cruse, a lobbyist for Forba, which operates dental centers for low-income children, was trying to get work through TennCare in Tennessee through Doral. Cruse sought out legislators in the districts where the dental centers were being opened, he testified. He sought out members of the black caucus, including Ford.
Cruse testified that after a dinner at a PF Chang's in Memphis, he approached Ford about Forba having a shot to work in the state.
"He chuckled," Cruse said. "And he said, 'They call me Mr. 15 percent.' When a legislator says he's known as Mr. 15 percent, it sorta sticks with you."
In cross-examination, federal public defender Isaiah Gant attacked Cruse for not reporting the 15 percent comment to anyone.
Gant also noted that Dobbins was initially the subject of the investigation into wire fraud. Dobbins received immunity in exchange for his testimony and cooperation with the government.
Ford is charged with two counts of wire fraud and four counts of making false statements on official documents. The wire fraud charges carry a maximum penalty of 20 years. The maximum sentence for each of the four other charges is five years.


I would like to say that Todd Cruse may at one time been a Lobbyist for FORBA, I don't know where he crawled in from, but he's now listed as:

Senior Vice President of Development tcruse@forba.com 615-986-1709

New Small Smiles Papoose Board Consent

In FORBA/Small Smiles' Policy and Procedure Manual the consent for papoose use (stabilization) it said there was "no know risk to the immobilization procedure". It's evident FORBA/Small Smiles knows that is an out right lie since they are now using another consent form, I'll explain:

Recently another consent agreement says otherwise.

When you look at the form, at the lower right corner it says it was updated 1/31/2008, however it sure wasn't the consent form handed to me as part of the initial paperwork prior to treatment at Small Smiles just one month ago. (May 2008)

I asked myself why this particular form has now surfaced in at least two clinics that I'm aware of then it hit me. It's being used at those clinics who have been/are under the media microscope, but I'm wondering if it's being used in ALL clinics.

So, for all those employees who visit here regularly shoot me a line and let me know if this is the form you are using in your clinics. Email Me

Click here to see the Consent Form that has been updated. In this one, at the bottom, it will tell you that using it could cause death to your child among a host of other things that no parent would want to happen to their child.

To compare them, here is a link to see the consent I was handed in May 2008.

Small Smiles Denial Of Owning Clinics In Kansas Debunked

This is a repost from March 2008

The Wichita Eagle

March 15, 2008

• Original The Wichita Eagle article:

A Wichita dental clinic that serves mostly low-income children is drawing criticism from some parents and other dentists, in part for using procedures that the critics say traumatize its young patients.

They say Small Smiles Dental Clinic of Wichita routinely restrains children during treatment, does not allow parents to accompany their children to treatment and does work that doesn't seem necessary.

In addition, the dentists are concerned that Small Smiles tries to give the impression it is staffed by dentists who are specialists in children's care. And, they say, it is corporate dentistry, a practice not allowed in Kansas.

Small Smiles dentist Reza Akbar, in an e-mailed statement, said, 'We are proud of the high-quality, compassionate care we provide.... Last year, we served more than 11,000 children, and the feedback I have received has been overwhelmingly positive. I am unaware of any concerns raised by parents.'

Akbar is the owner of the clinic, according to a Small Smiles spokesman.

Small Smiles, which opened in 2005, turned down requests for interviews or visits. An out-of-state spokesman for Small Smiles, who asked not to be named, said by e-mail, 'This is a concerted effort by the company to focus on patient care in the midst of recent scrutiny.'

In November, ABC News and an affiliate ran stories about Small Smiles offices in the Washington, D.C., area. The stories told of frightened children, the use of restraints and the prohibition of parents in the treatment area -- the same concerns echoed by parents and dentists in Wichita in interviews with The Eagle.

Many Medicaid clients

Small Smiles' advertising notes that it serves Medicaid and HealthWave children. The Small Smiles spokesman said 98 percent of Small Smiles' Wichita patients have Medicaid or HealthWave, programs that provide medical and dental coverage for low-income children and some others who meet income guidelines.

Many dentists do not accept Medicaid patients or accept only a few because the reimbursement for their care is less than what is paid by private insurance. But Crystal Walker, a pediatric dentist, said four of the five pediatric dental practices in Wichita do accept Medicaid patients. Some general dentists also take those patients, and dental care is offered to Medicaid patients at GraceMed and some other clinics.

In 2007, Small Smiles got more than $4.5 million in Medicaid and HealthWave dental payments from the state, according to the Kansas Health Policy Authority. The clinic declined to say how many dentists it employs.

The clinic uses what amounts to assembly-line dentistry, some say.

'They go in, they do the cleaning, they do the diagnostic, they get everything done that they can in one day,' said pediatric dentist David Brown.

'It was like an assembly line,' said Shelbi Meisch, whose daughter was a Small Smiles patient. 'There was just nothing about the experience that felt like you were getting good care.'

Restraining patients

Though parents said they were not allowed to accompany their children into the treatment area, the Small Smiles spokesman said that's not policy: 'Parents decide in consultation with their dentist whether or not to be present during their child's care,' his e-mail said.

Jeff Davis said he and his wife were asked to sign a consent form giving Small Smiles permission 'to do everything from yell at the child to physically restrain them to tie them down.'

Meisch, as well as Delicia Akbar, whose children also were Small Smiles patients, said uncooperative children -- including theirs -- are immobilized in a 'papoose board.' Akbar isn't related to the Small Smiles dentist.

The Small Smiles spokesman provided a copy of a consent form used at Small Smiles in Rochester, N.Y., and said the one in Wichita is similar.

It asks parents to agree to 'protective stabilization,' described this way: 'The child is wrapped in the device and placed in a reclined dental chair.' Pictures on the form show a child with what looks like a blanket and a shaped back piece.

Medical suppliers describe a 'papoose board' as a rigid board with wide fabric straps that have Velcro fasteners. Separate straps hold limbs inside the wrap, providing a snug-fitting restraint that immobilizes the patient.

The Small Smiles spokesman said, 'Our records indicate that protective restraint was used in fewer than 3 percent of all patient visits in Wichita last year.'

Akbar took her three children to Small Smiles. She read and signed the consent form 'but my understanding of the restraint was not something.. to strap them down.' She said the papoose board was used on her 9-year-old.

'I didn't even think anything negative until the kids came out

Copyright © 2008 The Wichita Eagle, All Rights Reserved.

____________________________________________________________________________

Thanks to a heads up from one of my readers, here is an article where Mike DeRose admits they own and operate clinics in Kansas:

Gazette, The (Colorado Springs), May 9, 2004 by CARY LEIDER VOGRIN THE GAZETTE

Dr. Michael DeRose describes himself as "just a simple little Pueblo kid that wanted to help poor kids."

DeRose, 47, is a third-generation dentist, following in his grandfather's and father's footsteps.

Bruno DeRose graduated from dental school in 1928; Edward DeRose started practicing in 1961. Michael DeRose went to dental school at his father's alma mater, Creighton University in Omaha, Neb., returning to his hometown to practice in 1982.

Michael DeRose said his dad had the heart to treat low-income children, explaining how the family got into the Medicaid business.

"He opened his doors for every patient," he said.

He and his father practiced together and became known to kids around Pueblo as "Spaghetti Eddie and Meatball Mike" because of their Italian heritage, DeRose said. Business grew when they opened a second clinic in Colorado Springs in 1995.

The DeRoses have built something of a dental dynasty, having a financial stake in clinics in eight states: Colorado, New Mexico, Arizona, Indiana, South Carolina, North Carolina, Georgia and Kansas.

"It's really a family-owned business with Dr. (William) Mueller," he said, referring to a Denver dentist who has a financial interest in some clinics.

DeRose said his brother, Dan, provides marketing and management services, and an uncle, Adolph Padula, has a financial interest in some clinics. Neither responded to a request for an interview. Mueller did not respond to a registered letter sent by The Gazette.

The clinics have done well. Michael DeRose bought a home last year in Pueblo West overlooking Lake Pueblo for $3.4 million -- a record price in Pueblo County for what the Assessor's Office terms "a nonagricultural based residence."

The family has a stake in 21 clinics across the nation staffed by about 70 dentists, according to Michael DeRose. Dental offices most recently were opened in Kansas City, Kan., and Florence, S.C., he said.

Plans are under way for expansion.

"We think that there's more places in Georgia that could really use our help," DeRose said. "We've looked at Oklahoma as a consideration. They have a lot of need in the Oklahoma City area, maybe Tulsa."

The clinics are "well-received" because they fill a need, DeRose said.

Small Smiles in Colorado Springs, for example, is in an area where 26 percent of people age 17 and younger live in poverty, according to census statistics.

"There is an epidemic in the United States, and it's hard to believe we can put a man on the moon and yet there are thousands and thousands of poor children that cannot find dental treatment," DeRose said.

It's common at his clinics, he said, to see children with severe decay.

During an interview at the Pueblo clinic, DeRose offered a tour. Treatment rooms are painted with kids in mind: There's a blue- andorange "Broncos" room and another with an "Austin Powers" theme. For younger children, rooms are decked out with "Scooby Doo" and "Blue's Clues."

The dentists go by kid-friendly names, wearing shirts that read "Dr. Mike" and "Dr. Nate."

Edward DeRose is retired from practice but still has a large office at the Pueblo clinic.

Michael DeRose said business has "grown beyond our dreams," but money isn't the motivator.

"Sure, business, if you can make money at it, that's great," he said. "But when it's dual purpose and you can make money yet help people -- that's the best thing you can do."

DeRose said he's had no problems finding dentists for his clinics.

"There's a lot of dentists that have the heart to treat poor children. A lot of doctors really would like to do this but they just feel like they can't make money at it," he said. "We can provide them an opportunity to do something that's their dream. It's the best of both worlds.

"There really is something to be said about sleeping good at night." (I bet he's not sleeping so well at night right now.)

Copyright 2004
Provided by ProQuest Information and Learning Company. All rights Reserved.

____________________________________________________________________________

I have already posted on this blog the campaign contributions that Dr. Mohammad Reza Akbar, of Pueblo, CO had made to a Kansas politician in the name of Small Smiles.

Plus if you guys could see an in-house company directory you would see the Small Smiles in Kansas listed as part of the company.

So Kansas, is corporate dentistry like this now legal or are they going to be shut down. It's not like Small Smiles accidentally opened up these clinics. They blatantly broke your laws with intent to defraud your medicaid system.

Small Smiles in Chapel Hill, NC

This add came from UNC Dental Alumni Associations Website. Click Here

Name: Small Smiles Dentistry
Owner: Private
Location: Chapel Hill, NC

Job Description:
Small Smiles Dentistry SEEKING DENTISTS to join our great staff. Rewarding work environment with state-of-the-art equipment. We are the nation's largest and most experienced provider to underserved children and young adults with 70 locations.

Contact:
Jenna Kochenberger
415 N Grand Ave
Pueblo, CO 81003
Phone: 7195624462
Fax: 7195847696
Email: jlkochenberger@smallsmiles.com

WOW, now this is an interesting ad.

First: (to get this out of the way) Wasn't the last contact person Jacob D. Kochenberger in the ads at aftercollege.com. I just can't say it enough when I say FORBA (Michael DeRose) sure keeps it all in the family, I wonder if Jenna and Jacob (sounds like brother and sister doesn't it) are more cousins like Brad Padula.

I also notice that the address is DD Marketing's address in Pueblo. Oh, that infamous 415 N. Grand Ave, that crops up as the address for all sorts of DeRose businesses.

Second: Let's get this out of the way, I sure wish they would stop using the word underserved as one word. I know I make a lot of typo, leave of a lot of 'ing's and 'ed's etc but dog gone it, I just wish they would say they serve "under served" and not 'underserved'.

Third: FORBA (Michael DeRose) has gone to great lengths saying he's basically out of the state of North Carolina. (ran out on a rail pretty much). He says he sold SmileStarters to Raf Rivera and it's under new management. (Yeah, Right! Managed by Root Dental Management, who is DeRose's accountant! Plus who loaned Raf Rivera that kind of money to purchase clinics who were just fined 10 million dollars and headed down the tubes, well one Michael DeRose would be my guess.

But look, North Carolina, he's baaaaack! Him and FORBA are right back dipping their lilies right back into Medicaid pot of gold. Who manages your dental medicaid service anyway? Dumb and Dumber?

Sounds just like Tish Ballance sticking her grubby little fingers back in with her Access West Clinic is Asheville doesn't it. (I guess she's still opening that clinic, I've not heard otherwise)

What's it going to take to shut these criminals out of North Carolina anyway?

What are you going to do this time! Monitor them some more! A lot of good that does!

Conflict of Interest at Department of Medical Assistance Services-Virginia

I just find it totally amazing that Dr. David Strange of Kool Smiles is on the Dental Advisory Committee of the Virginia Department of Medical Assistance Services. He may have a licenses there but I bet you he's never touched a patients mouth in Virginia, yet he wants to be an adviser!! What is he planning to give advise them about.

It's that like the fox watching the hen house. He is in business with Dr. Tu M. Tran and Dr. Theim Pham who originally trained and worked with Drs. Michael and Ed DeRose at Smile High Clinic which morphed into Small Smiles. Want to take a guess where Tran, Pham, and Strange are from, Colorado!

Not only this, but Dr. Harry M. Joseph is an employee of both Small Smiles and Kool Smiles according to Doral's May 2008 Handbook, so what gives with that.

I think there is a clear conflict of interest here!

Dental Advisory Committee Members (updated) 2008

Dr. David Strange (from the Kool Smiles website)

Dr. David M. Strange, Chief Dental Officer
Dr. David M Strange is a board certified pediatric dentist. He received his Doctor of Dental Surgery degree from the University of Colorado Health Sciences Center along with his certificate of Pediatric Dentistry from the Children's Medical Center in Dallas, TX and his MS from the Baylor College of Dentistry. Dr Strange was formerly an Associate Clinical Professor at the University of Colorado Health Sciences Center and also served as the President of the Colorado Academy of Pediatric Dentistry. He previously served on the Constitution and By-Laws Committee of the American Academy of Pediatric Dentistry and is currently serving on the Council for Dental Benefits of the American Academy of Pediatric Dentistry. Dr Strange is also a member in good standing with the American Dental Association, the American Academy of Pediatric Dentistry, the Colorado Academy of Pediatric Dentistry, the Georgia Dental Association and the Southwestern Society of Pediatric Dentistry. His three children and wife live in Atlanta after relocating from Denver, Colorado.

United Health Care Removed Dental Search from Website

On 6-17-2008 I was able to go to United Health site and visit this page

https://www.myuhcdental.com/presence/release/MemberDentistList.asp

or here and choose a state plan and search for a dentist who accepts medicaid. They would tell me the clinic name, Small Smiles for example as well as the name of the dentist at that clinic.

By the next day I could still go there but each and every search for a dentist under any plan and any search criteria would end up with zero results. The first time I did it, heck I could even get the list emailed to me. Now you can't find a recommended dentist from United Health to save your soul.

So I have to ask why that is.

1. They don't want the public to know they are recommending it's members to visit Small Smiles.
2. They are protecting themselves from lawsuits because they continue to recommend it's members take their children to Small Smiles even though Doral Dental has suspended them, in several places anyway, or
3. The dentists they listed as being employees of Small Smiles threw a fit because they are so embarrassed of being associated with Small Smiles. (let me say here I know this to be true from the emails I received...)

Anyway I'm glad I had my lists emailed to me and they came from the following email address:
dentalproviderlist@yourdentalplan.com

The subject was: Custom Dental Provider Directory List

I don't know who's cheatin' who here, but there are some really embarrassed people out there because of their association with Small Smiles, including major HMOs.