Thanks

When given the opportunity to do what is right, correct a wrong, and end the child abuse, how do you explain not taking it? You can't, not really.

I'll be giving thanks this holiday season for all those who take the opportunity they have been given.

Smith and Lindley

 11-1-2011
I heard Al Smith and Michael Lindley are no longer President and CEO of Church Street Health Management/Small Smiles dental.

True? I don't know.

update:  11-10-2011
Confirmed!
Michale Lindley is "no longer with the company"

Still working on ole Alford Joseph.

update: 11-18-2011

I hear Todd Cruse has been put in charge to guard the hen house, taking Lindley's place.
Still not sure about Smith.

Stockton, California 4 year old, dead after dental surgery

 

RECORD Net

By Joe Goldeen

Record Staff Writer

November 16, 2011 12:00 AM

STOCKTON - On Friday, Dominique Smith brought her son Jermaine, 4, to a dentist in Oakland. She later left him with the Alameda County coroner.

Something went wrong after Jermaine was given an oral anesthetic to calm him down and subdue any pain caused by the dental procedure intended to remove some rotten teeth and cap some others. The family wants some answers.

Jermaine died after doctors unsuccessfully attempted to revive him, administering chest compressions for up to 45 minutes, his family said.

On Aug. 6, 2007, in Stockton Jermaine Lee Harrison was born with a hole in the wall that separates the right and left ventricles of his heart. He required open-heart surgery and, about 12 months later, he had a pacemaker installed. Three years later, he was thriving and healthy, his family said.

"He was playful. He never wanted to stay in the house. He was a jolly little boy, a happy little boy," said his grandmother, Pamela McElroy of Stockton, who accompanied her daughter and grandson to Children's Hospital and Research Center Oakland last week where the dental procedure was scheduled.

Children's Hospital Oakland was familiar with Jermaine's medical history, the family said, because that's where his initial open-heart surgery was and where he returned every six months for a cardiology checkup.

The family is at a loss on what to do next. An autopsy report on the cause of death from the Coroner's Bureau of the Alameda County Sheriff's Office is not due for about a month, according to a coroner's spokesman who said it is standard procedure.

A spokeswoman for Children's Hospital Oakland said late Tuesday neither she nor hospital staff could speak about any aspect of the case without written consent from the family, which they are working on obtaining.

Anyone wishing to contact the family may call McElroy at (209) 271-3401.

Contact reporter Joe Goldeen at (209) 546-8278 or jgoldeen@recordnet.com. Visit his blog at recordnet.com/goldeenblog.

---

STOCKTON, Calif. (KCRA) -- A 4-year-old Stockton boy who survived three open-heart surgeries died Friday while having his teeth capped.

The boy’s grandmother, Pamela McElroy, said she watched as he was taken into an operating room. She never saw him alive again.

The cause of death remains a mystery, and an official at Oakland Children’s Hospital – where the dental surgery was performed Friday – said an investigation is underway.

“I just want to know what went wrong,” McElroy said.

Strange visitors indeed

Over the last 5 days there has been an increase in web traffic here.  Some of the search terms used are:

Todd Cruse
Forba Nashville Closing
Stockton 4 year old death
Eight dental office closed over billing news 8
Smile Starters Complaints
Heartland Dental Complaints
Neta DeRose Obituary

Xerox owned company contributing to dental Medicaid fraud; Fraud from the dental office to the billing processor exposed

It’s apparent to me that neither private companies or government operated health care can operate and deliver healthcare to American’s for a fair price, since theft of taxpayer dollars is part of the business plan.  I’ve said all along that people who think Obama Care will solve the problems are so wrong.  Some seem to think the government will actually operate it—which somehow would be better.  But that simply isn’t the case folks.  The government will hand out contracts to greedy corporations to oversee and operate.  The same corporations who donate and lobby our lawmakers.  All I can see Obama care doing is giving the government the ability to add their favored companies to the free-for-all raiding of the taxpayer money pot. 
 
 
Byron Harris
November 11, 2011

DALLAS - Claims procedures discovered in a News 8 investigation of "Your tax dollars aren't working," said a former claims specialist, one of several News 8 has interviewed. "You're paying for [dental] services that shouldn't be paid for."the Texas Medicaid Dental program may apply to the whole country, because of the payment process employed by a major government contractor.
In a series of investigative reports over the last several months, News 8 discovered hundreds of millions of dollars in Medicaid billing for orthodontics. Now it appears the problems, which have triggered a federal audit, may be linked as much to the way the claims are approved, as they are to the individual dentists involved.
It turns out that the claims examiners are paid by quantity, and not
Employees who might have been making $20 per claim two years ago, now are making $10 per claim. To take home the same pay, they have to push nearly twice as many claims through the system.

"People didn't know how they were going to make their mortgage payment, their car payment, pay their babysitter because every time they turned around, their pay was being reduced again because corporate felt they were making too much money," a former employee said. necessarily quality, under a program called Activity Based Compensation, or ABC. The more claims they process, the more money they make, creating a strong incentive not to take too much time with each one.
"Your tax dollars aren't working," said a former claims specialist, one of several News 8 has interviewed. "You're paying for [dental] services that shouldn't be paid for."

Latest Small Smiles Job Postings

Wait a minute, I thought Church Street Health Management was simply a “management company” contracted with dental centers to manage day to day operations.  (sarcasm) Hmmm… 

They aren’t even telling folks this is to work at their Small Smiles Dental Centers.

If anyone reading this ad has a brain cell one left, do NOT call Jacob!  It’s a trap you don’t want to be caught up in…  I promise! But if you are here at this website, you likely already know that, don’t you?

Here’s a current job posting:

Lawsuit on behalf of 23 Smile Center patients was filed sued by parents

Wednesday November 9, 2011
WOIA TV


Reported by: Brian Collister
Email: BrianCollister@woaitv.com
A chain of dental clinics here in San Antonio is hit with a massive lawsuit filed by parents who took their children to The Smile Center.

The court action is more fallout from my investigation into the clinics and allegations it did unnecessary work at taxpayers expense.

The lawsuit filed Wednesday on behalf of 23 children alleges the Smile center would routinely recommend unnecessary and excessive dental services.

The lawyer filing the suit says this is the first of many to come as they prepare to file on behalf of one-hundred children.

“The lawsuit alleges and we intend to prove with substantial evidence that a lot of the dental care received by these children was unnecessary and improper”, says Attorney Tom Crosley.
Read the entire story at WOIA TV
If your child was injured due to dental treatment received at The Smile Center, Kool Smiles or other Medicaid dental centers in San Antonio contact attorney Tom Crosley for a free case review at:
Crosley Law Firm P.C. Free Case Review
Injured Smile Center Patients Information
Attorney Tom Crosley named Texas Super Lawyer for 2011

I think Kool Smiles Dental press releases about “new jobs” is very misleading

Over the past several days Kool Smiles Dental (NCDR, LLC) has published press releases about their expansion, growth and plans to hire from 80 to 100 jobs in various states. i.e. South Carolina to get 100 new jobs, Virginia blessed with 100, Indiana 88 new jobs.
Using buzz words and phrases such as “expansion”, “bright economic outlook” “provide jobs” leaves the reader feeling warm and fuzzy about Kool Smiles doesn’t it?  Heck they are providing dental treatment for underprivileged children and children whose parents have fallen on hard times due to the poor economy and bleak job outlook.  As the cherry on top they state they are providing jobs for states and local communities. 
FANTASTIC!
Shoot, they even have lawmakers commenting about the fabulous news:

Just saying...

The only thing worse than bad people doing bad things is good people doing nothing.

North Carolina Dental Board nixed Heartland Dental’s attempt to take root, taking the bull by the horns.

It looks like North Carolina is taking the lead to put an end to the corporate take over of dentistry.  Now, if they would just look into the Smile Starters agreement with Root Dental Management, and the sales agreement between Dr. Rivera and Dr. Michael DeRose another income flow to the DeRose family might be cut off. 

If you want to understand how the corporation do business, you should read this.  It lays it all out for you.

North Carolina State Board of Dental Examiners (NCBDE)

vs.

Heartland Dental Care, Inc
d/b/a Heartland Management, Inc
Gary Cameron and Associates, P.C and';
Gary L. Cameron, DDS

Case 11-CVS-2343

Heartland Dental Permanent Injunction

The NCBDE filed a complaint in Superior Court, Randolph County, North Carolina in September accusing Heartland Dental of implementing a series of transactions, contracts, documents and agreements to which Dr. Gary Cameron, DDS of Asheboro, North Carolina unlawfully transferred to Heartland Dental; Ownership, Management, Supervision and Control of his dental practice, Asheboro Dental Care..

Dr. Cameron was selling his dental practice to a corporation, “an unlicensed individual or entity.”

Heartland denied Dr. Cameron transferred ownership or management to anyone and maintained Dr. Cameron merely sold certain assets to Heartland then entered into a lawful management agreement with Heartland.

This violates North Carolina’s Dental Practice Act (N.C. Gen. Stat. 90-22) and the Management Arrangement Rule (21 N.C. Admin. Code 126X.0101).

Heartland Dental denied the allegation that Dr. Gary Cameron transferred ownership or management to anyone and maintained Dr. Cameron merely sold certain assets to Heartland Dental then entered into a lawful management agreement with Heartland.

[I’m seriously trying not to roll on the floor while laughing at Heartland’s position]

However, in 2009, Dr. Cameron hired Roger K. Hill and Company to assess and valuate his dental practice and provide him with a valuation of $2,350,800.00.  I’m not even going to get into what was likely done to make sure the the clinic had a high value.

By December 1, 2009 Dr. Cameron and Heartland agreed on a price of $2,450,000.00 PLUS the value of his accounts receivable and entered into a “Letter of Intent to Acquire Certain Assets”.  In this letter of intent it listed the “assets of the Seller” to be:

”All operating assets, leasehold improvements, office equipment, dental equipment, supplies, inventory, trade receivables, licenses, contracts,
trademarks, and other tangible and intangible property necessary to the operation of the Seller”

In January 2010 Dr. Cameron established a new company called Gary Cameron and Associates, P. C. with him being the sole owner.

Is this Kool Smiles way of pretending they are paying back the millions defrauded or trying to head off some bad publicity in the works?

Can you consider  “patient shopping” a donated service?  Here is their Press Release for today:

Kool Smiles Donates $12.5 Million in Dental Services to Underserved Communities and Launches Facebook Campaign to Donate a Toothbrush for Every "Like"

ATLANTA, Nov 4, 2011  Kool Smiles is proud to announce that so far this year it has donated over $12.5 million in free dental services to underserved communities. In celebration, they are launching a new Facebook page. In addition to keeping the community engaged in its vision and efforts to increase accessible dental health nationwide, the page allows individuals to have an impact on the wellbeing of children in need. For every "Like" the Kool Smiles Facebook page receives, a toothbrush will be donated to an underserved child.

Quality dental care at a young age plays an important role in both the physical and psychological well-being of children and adults. Now, Kool Smiles is empowering every person who "likes" its efforts by donating a free toothbrush and is prepared to provide up to a million toothbrushes for a million healthy smiles.

Dr. Tung Thai Nguyen Pleads Guilty To Health Care Fraud-Greensboro, NC

  NC Dental Board Action 2009

Silva and Silva DMD Pllc 
(used to be Nguyen, Silva and Silva, P.A. D.M.D –dissolved 1-12-2011)
Silva and Silva, LLC
Dr. Enrico Silva
Dr. Ha Hguyen Silva
1505 West Lee Street
Greensboro, NC  27403
336-510-2600

November 4, 2011
From WMFY News

Greensboro, NC-- A Greensboro dentist has admitted to health care fraud. 

Thursday, the US Attorney's Office accepted a plea deal with Tung Thai Nguyen. Nguyen pleaded guilty to health care fraud charges in connection with false claims submitted to Medicaid.

Dr. Nguyen, 40, pleaded guilty, in A Winston-Salem federal court room,  to two counts of violating health care fraud and one count of violating 18 false entries in a matter involving a health care benefit program.

According to documents filed in Court, Dr. Nguyen submitted claims to the Medicaid program for dental restorations not actually performed. Dr. Nguyen also submitted a claim to the Medicaid program for the installation of one type of partial denture when he actually furnished a less expensive and different partial denture to the patient.

Nguyen will be sentence in February 2012. He faces the maximum possible penalty for a health care fraud violation, which is not more than ten years imprisonment, a maximum fine of $250,000, and a term of supervised release not to exceed three years. The maximum possible penalty for a false entry violation is not more than five years imprisonment, a maximum fine of $250,000, and a term of supervised release not to exceed three years.

The Court may also order the defendant to pay restitution to the health care benefit program.

The case was investigated by the Health and Human Services Office of Inspector General and the North Carolina Attorney General's Medicaid Investigations Unit and prosecuted by Assistant United States Attorney Robert Hamilton.

So why are there no Medicaid dental mills in Florida?

Florida ranks near the bottom in access to dental care.  So why are the dental mills staying away; other than the denture places like Aspen? I’d like to hear your thoughts on why Florida is spared.
cckaddie@yahoo.com or post in the comment section.

5TH Circuit Court of Appeal Declares Florida Medicaid Fraud Statute 409.920(2) (A) Unconstitutional
from South Florida Health Care News 

This case deals with two very important subjects: The ability of Healthcare providers to market using practice management companies as well as reaffirming the principle in Florida that one cannot be criminally liable for filing a false claim by accident , error or negligence

Facts

In 2001, two Miami dentists contracted with a dental management company to open a dental office in Orlando Florida. The management company agreed to provide a turn-key dental facility. In addition, the dental management company would manage the business and marketing aspects of the practice including marketing the dental practice to Medicaid eligible recipients. In return the management company is paid between 42% and 43% of the compensation received by the dentists for their services.

In 2003, the state filed a 130 count information against appellees Sonia Guzman and Ana Maria Mendez and three co-defendants John Rubio, Ileana Martin-Fernandez and Gustavo Fernandez. Counts I and 2 charged all defendants with racketeering and conspiracy to commit racketeering in violation of section 895.03, Florida Statutes. Counts 3 — 55 charged various defendants with Medicaid provider fraud in violation of section 409.920(2) (a), Florida Statutes. Counts 56 — 129 charged various defendants with patient brokering by engaging in a split-fee arrangement in violation of section 817.505, Florida Statutes. Count 130 charged all defendants with violating the White Collar Crime Victim Protection Act, section 775.0844, Florida Statutes.

Assess, Communicate, Decide; guidelines impossible for dentists working for corporate dental mills

The American College of Dentists (ACD) produces a card for the wallet that contains on one side the Core Values, which guide the ethical behavior of Fellows of the ACD, and on the reverse a list of questions called the ACD Test for Ethical Decisions, following the ACD acronym.

Assess
Is it true?
Is it accurate?
Is it fair?
Is it quality?
Is it legal?

Communicate
Have you listened?
Have you informed the patient?
Have you explained outcomes?
Have you presented alternatives?

Decide
Is now the best time?
Is it within your ability?
Is it in the best interest of the patient?
Is it what you would want for yourself?
This is a simplified but excellent reminder.

PC Holder = Owner Dentist

Just saying...

Sugar plums can dance in one's head.

Just Saying…

per·ju·ry [pur-juh-ree]
noun, plural -ries.
to lie like a dog; the willful giving of false testimony under oath or affirmation, before a competent tribunal, upon a point material to a legal inquiry

• Elements:
• Oath - person must be under oath during his testimony;
• Intent - you lied and you knew you were lying like a dog;
• Falsity - must have made told or more lying statements, and;
• Materiality – the lie could or would influence the legal proceeding

Section 1621 and 1623 of Title XVIII of the United States Criminal Code sections 1621 and 1623 deal with the crime of perjury.

Title XVIII of the US Criminal Code section 1623, makes it a Federal offense to knowingly make a false statement about a material matter while under oath before a Federal court.

State laws on perjury:

Kentucky CHAPTER 523 PERJURY AND RELATED OFFENSES

523.020 Perjury in the first degree.
(1) A person is guilty of perjury in the first degree when he makes a material false statement, which he does not believe, in any official proceeding under an oath required or authorized by law; or
(2) When he makes a material false statement which he does not believe in a subscribed written instrument for which an oath is required or authorized by law, with the intent to mislead a public servant in the performance of his official functions when such person is subscribing a warrant accusing his spouse of an offense under KRS Chapter 510.
(3) Perjury in the first degree is a Class D felony.

Kentucky Class D felony- not less than 1 year nor more than 5 years per charge  or in the case of perjury, per lie.

523.030 Perjury in the second degree.
(1) A person is guilty of perjury in the second degree when he makes a material false statement which he does not believe in a subscribed written instrument for which an oath is required or authorized by law with the intent to mislead a public servant in the performance of his official functions.
(2) Perjury in the second degree is a Class A misdemeanor.

Class A misdemeanor – 3 to 12 months in jail per charger or in this case or perjury, per lie.

523.040 False swearing.
(1) A person is guilty of false swearing when he makes a false statement which he does not believe under oath required or authorized by law.
(2) False swearing is a Class B misdemeanor.

Class B misdemeanor – usually no jail time

523.050 Inconsistent statements.
(1) When a person has made inconsistent statements under oath, both having been made within the period of the statute of limitations, the prosecution may proceed by setting forth the inconsistent statements in a single charge alleging in the alternative that one or the other was false and not believed by the defendant. In such case it shall not be necessary for the prosecution to prove which statement was false but only that one or the other was false and not believed by the defendant to be true.
(2) The highest offense of which a person may be convicted in such an instance shall be determined by hypothetically assuming each statement to be false. If perjury of different degrees would be established by the making of the two statements, the person may only be convicted of the lesser degree. If perjury or false swearing would be established by the making of the two statements, the person may only be convicted of false swearing.

 

Perjury

A. Perjury is the intentional making of a false written or oral statement in or for use in a judicial proceeding, any proceeding before a board or official, wherein such board or official is authorized to take testimony, or before any committee or subcommittee of either house or any joint committee or subcommittee of both houses of the legislature. In order to constitute perjury the false statement must be made under sanction of an oath or an equivalent affirmation and must relate to matter material to the issue or question in controversy.

Just Saying…

There just has to be a very special place in HELL as well Jail for those who choose to conspire and lie to cover-up the heinous abuse of children.

Just saying…

Marissa Kingery death settlement

This report says the Executive Director of the Ohio Dental Board “approved” the settlement.  What is God’s name did she have to do with anything, other than some responsibility into Marissa’s death in my opinion. 

How did such a conversation go anyway?  Did she say, “yeah, that’s a fair price”!!!

 

By Jack Shea Fox 8 News Reporter

6:14 p.m. EDT, October 28, 2011

LORAIN, Ohio—

The family of a Lorain County girl, who died while undergoing oral surgery, has settled a wrongful death lawsuit against the dentist who performed the surgery.

On December 21, 2010, 13-year-old Marissa Kingery, of Elyria, stopped breathing while having teeth removed at the Lorain office of Dr. Henry Mazorow.
An autopsy later concluded that Marissa's death was accidental, the result of complications from anesthesia administered before the surgery.

The lawsuit filed by the girl's family was settled by Dr. Mazorow's insurance company for one million dollars, to be shared by her parents and their civil attorney.

The Ohio State Dental Board helped negotiate the settlement, and then approved it.

Dental Board Executive Director Lili Reitz told Fox 8, "Our job is to ensure that dentists who are not safe, or who pose a threat, either remediate in the areas where they're deficient, or no longer practice."

[It’s a damn shame Ms. Reitz didn’t feel the same when Mazorow killed the other patient in 1997.  Sounds real noble Ms. Reitz, but your words are empty!]

On September 1, after consulting with the dental board, Dr. Mazorow agreed to retire at the age of 81.

[It took from December 2010 until September 1, 2011 for Mazorow to be forced into retirement?!  Also after 5 years, his record will be wiped clean as Ms. Reitz pointed out earlier this year!]

The case of Marissa Kingery was not the first time Mazorow had been sued for wrongful death. In 1997, 57-year-old Rosemary Johnson died from similar complications while undergoing surgery at the doctor's office. The case was settled out of court for $550,000.

Fox 8 News tried to talk to Dr. Mazorow about what happened to Marissa Kingery and Rosemary Johnson, but were unable to reach him.

Reitz said says the case illustrates the difficulty of regulating dentistry.
"What I have a hard time accepting is our limitations, and our limitations are the license of the individual, and whether or not that person should be, to hold a license, and if so, what needs to be done to ensure that they're safe."

[What’s so damn difficult about it, Ms. Reitz? ]

Lessons to be learned from 1992 dental malpractice and murder case

$1.6 Million Awarded to 13 Patients of Convicted Dentist

October 08, 1992|MARLA CONE | TIMES STAFF WRITER

Thirteen patients of a Costa Mesa dentist who was convicted in 1984 of murdering three patients were awarded $1.6 million in damages Wednesday to be paid by a state insurance association, according to their attorney.

Dr. Tony Protopappas was convicted of three counts of second-degree murder after two women and a teen-age girl died during a five-month period from lethal doses of general anesthesia he administered during routine dental work. He is serving a 15-year term at a state prison.

The $1 million in damages and $600,000 in interest awarded Wednesday is in addition to $500,000 the plaintiffs were awarded from insurers in 1987, said their attorney, William Humphreys of the Santa Ana law firm of Horton, Barbaro & Reilly.

After Protopappas' arrest, his dental firm as well as his insurance company went bankrupt, so the claims were sent to the California Insurance Guaranty Assn., which is a statewide fund created by insurers to handle claims of companies that go bankrupt.

SHOCKING! Ethics in dentistry has declined.

A study published in the October issue of the Journal of Dental Education reports ethics has declined in dentistry.  Shocking!  In fact, what actually qualifies as “ethics” education seems to have changed.  Shocking!  This information was developed by the authors, listed below and administered by the American Society for Dental Ethics.  American Society of Dental Ethics!?  Who knew?! 

I’m wondering if this “Ethics Society” was the impetus to the decline in and redefining of ethics education.  Wonder what kind of influence the dental mills and the Dental Group Practice Association (DGPA ) (see below) have of the ethics curriculum?  Ethics is something the mills certainly do not want practiced, it hinders production!

Jurisprudence must be in worse shape than ethics, considering all the illegal dental mills openly operating these days!  I wonder if there is an American Society of Dental Jurisprudence?

This study was done with data from 2008.  2011 is damn near over!! 

Now on with the abstract of the Study:

Abstract:
The survey was sent to the individual who directs the ethics curriculum at the fifty-six U.S. dental schools that had a full complement of enrolled pre-doctoral little time is devoted to ethics instruction in the formal curriculum.classes as of January 2008.

All fifty-six schools responded to the survey. The data suggest that, in general, little time is devoted to ethics instruction in the formal curriculum. The mean number of contact hours of ethics instruction is 26.5 hours, which represents about 0.5 percent of the mean clock hours of instruction for dental education programs reported in the most recent American Dental Association survey of dental education. While the amount of time devoted to ethics instruction appears not to have changed much over the past thirty years, what has changed are what qualifies as ethics instructionwhat has changed are what qualities as ethics instruction, the pedagogies used, and the development and availability of norm-referenced learning outcomes assessments, which are currently used by a number of schools.

Oklahoma–18 year old Jonathan Adams dies from infection after root canal

KOCO
HARRAH, Okla. -- Former Harrah football player Jonathan Adams died Monday, Oct. 10, 2011 after he developed a rare infection following a root canal, his family told Eyewitness News 5.
When Adams, 18, first developed a sore throat and fever, doctors thought the Northeastern State football player had strep throat. However, his family now believes he had a serious and rare bacterial infection that led to further complications and his eventual death.
“The main reason we wanted to (speak to the media) is so nobody else has to do this because if I can keep another parent from going through losing their child at 18, I did my job," said Johnie Adams, Jonathan's mother.
Adams was a 280-pound redshirt freshman on the Northeastern State University football team. His father, David Adams, said he hoped to have a future in football after he graduated from college.

Real dentists sharing real thoughts about sealants, dental mills, waste and fraud

   
Dentist 1:

It’s all designed to fool the taxpayer.  Politian's get into trouble for overspending.  They cut services, in this case Medicaid reimbursement fees for dental treatment. To keep the special interest happy, they agree to cover another procedure, everyone’s happy.

I work in an office (corporate mill) that takes Medicaid- MassHealth-in my state. which covers sealants on primary molars.  In my opinion, I think sealants on second primary molars (first primary, very rare) are beneficial in only a small percentage of cases; high risk, deep grooves, ability to obtain good isolation, etc.

Here's what I find troublesome and wasteful from a taxpayers point of view.
- We routinely seal all primary molars up to the age of 8, even on low risk patients with shallow grooves
-  90% of the time dental assistants place them alone with poor isolation.
I only do sealants when I have good isolation.  95% of the time I use my Isolite.  
With my criteria, I rarely seal primary molars. 
The dentists who do treatment plan sealants on a 3 year old, that will not even remain still for an exam or cleaning are wasting tax dollars in my opinion.  I do see pressure for assistants to do them from the corporate headquarters.  Corporate heads want a “sealant” report daily.  That irks the hell out of me.  It irks me even more when the dentist is not busy at all and still let's the assistant do them alone!

A buyers assistance program I could sink my teeth into

If only there could be a dental mill clinic crises.  Like the one in the housing market; saturated with empty dental mill clinics. Now there is a buyers assistance program I could support.

As one dentist recently said, “When the money for general dentists doing the small kids disappears, the mills will be gone. There are 4 dentists on every corner. Being a practice broker is where the money will be when these mills close down.”

I can dream.

“Owner Dentists” banded together and won $130 million

Had I read this in 2007 or even 2008 I might have believed the whole scenario laid out in the lawsuit between Park Dental Group and American Dental Partners. But knowing what I know today I think it’s a case of “owner dentists” going rogue, but I could be completely wrong. 
In 2007 a Minnesota jury awarded a group of dentist $130 million dollars.  The group alleged American Dental Partners, Inc. had overstepped its bounds when it came to the treatment of their patients.  Disappointingly, the jury failed to address the claims of a corporation/non-dentist practicing dentistry without a license.  However I suspect one could say the monetary award spoke volumes.

I guess it could be a case of the smaller dental group decided to become their own “management” company and screw the Wall Street folks. But as long as dentists own the clinics, are making the decisions and delivering the treatment I don’t see a need for real concern, do you?

Star Tribune
December 13, 2007

In a landmark verdict likely to draw praise from those opposed to the growing corporate presence in medicine, a jury ordered a Massachusetts company to pay $130.6 million to a group of Twin Cities dentists who claim the company interfered with their delivery of care to patients.

A Hennepin County jury ruled Wednesday in favor of PDG PA, a professional association of 115 dentists who operate the Park Dental and Dental Specialist clinics. The dentists had accused American Dental Partners Inc., a public company to which they had outsourced most of the administrative side of the business, of overstepping its legal authority and granting itself grossly excessive fees.

[I’m wondering exactly what that grossly amount was, 100% as with CSHM]

The ruling and the mammoth award will have far-reaching implications for thousands of clinics and hospitals nationwide that in recent years have outsourced the management of their business operations to corporations that aren't owned by medical professionals, industry analysts said.

"It puts in sharp relief the tension that exists in the health care industry over who controls the practice of medicine and dentistry," said Joseph Anthony, an attorney with Anthony, Ostlund & Baer, which represented the dentists. "Will it be the doctors or will it be non-doctor-trained service providers?"

After a month long trial, American Dental and a subsidiary were found liable for, among other charges, breach of contract, breach of good faith and defamation. Late Wednesday, the jury ordered the company to pay $88.3 million in damages, then added $42.3 million in punitive damages on Thursday.

American Dental, based in Wakefield, Mass., said in a written statement that it is evaluating the verdict. Officials did not return repeated telephone calls. Shares of the company tumbled Thursday to $4.62 a share from $14.34 a share a day earlier.

The verdict stems from a dispute over a 1996 agreement in which an American Dental subsidiary, PDHC Ltd., agreed to provide the dentists with money for expansion as well as "non-dental administrative services," such as accounting, lab services and equipment maintenance. In return, the dentists agreed to pay a portion of their billing revenue to American Dental in the form of a "service fee."

[Honestly, I’ve got to give a huge thumbs up to whom ever “spun” this one.  There are lessons to be learned here, I’m sure]

Dentistry Whistleblower DEAD

Remember last year when it was revealed a VA clinic in Ohio was using less than sterile conditions.  There was an uproar!

Well, the dental lab technician who blew the whistle on died Saturday in a one car accident.

By Thomas Gnau, Staff Writer Updated 10:37 AM Sunday, October 16, 2011

BEAVERCREEK — A dental lab technician who helped call attention to poor infection-control practices at the Dayton VA Medical Center last year was killed in a one-car accident in Beavercreek Saturday morning.

Wallace “Ray” Perdue of Fairborn was killed after the car he was driving left the road and struck a tree in the 2200 block of Kemp Road, just west of Beaver Valley Road, at 11:54 a.m. Saturday, according to Beavercreek police. He was 45. Police said he died at the scene.

His wife, Sherry Perdue, was also in the car. She was examined at Miami Valley Hospital after the crash, then discharged on Saturday, a hospital spokesperson said.

The Perdues, along with a third whistle-blower, told VA inspectors in the summer of 2010 about dentist Dr. Dwight Pemberton’s failure to sterilize instruments and change latex gloves between seeing patients.

In the aftermath of the Perdues’ allegations coming to light, the VA closed its Dayton dental clinic for three weeks and offered testing for hepatitis B, hepatitis C and HIV to 535 former patients of Pemberton’s.

Small Smiles Dental Centers Continue SLAPP’ing Grandma of 9

Demonstrating their ruthless style of business-preying on the most vulnerable of citizens-Church Street Health Management is continuing to SLAPP a Kentucky grandma  for voicing her continued dislike of the company’s business practices,

In 2008 Church Street Heath Management, LLC- then known as FORBA Holdings, LLC- brought a first amendment lawsuit, referred to as a Strategic Lawsuit Against Public Participation (SLAPP) against one of their many critics.

In January 2010, Church Street Health Management agreed to pay upwards to $30Mil to settle allegations of abusing children, overtreatment and Medicaid Fraud.  CSHM was also forced to sign a “Quality of Care” “Corporate Integrity Agreement” with the Department of Health and Human Services. 

Being the “low hanging fruit”, CSHM and their corporate owners, the Carlyle Group, First Islamic Bank-now known as Arcapita Bank and American Capital Strategies, have once again brought this unrepresented grandmother of 9 back to court in Western Kentucky. 

On October 17, 2011 at 10AM a hearing will be held in Federal Court.  CSHM has motioned the court to find grandma in Contempt of Court; asking the retired grandma to be fined $10,000 and pay an exorbitant amount of legal fees.  In their court pleadings, CSHM mentions possible jail time as a remedy to satisfy their intent to suppress grandma’s 1st Amendment rights to free speech.

CSHM also wants the court to force grandma to reveal the identity of current or former employees with whom she has had contact.  Doubtful it’s to pat any of those person’s on the head for doing such a good job in keeping them honest.

 

November 2008 Original  Complaint - FORBA v Hagan
December 2008 -CSHM's 1st request for Santions  2008(denied)
April 2009 – CSHM’s Motion to Dismiss (granted) 

July 2011 CSHM Motion for Sanctions
July 2011 Declaration of Todd Cruse
July 2011 Memorandum in Support of Sanctions

September 2011 Grandma's Combined Response to CSHM’s Motion for Sanctions and Motion to Dismiss
September 2011 Grandma's Memorandum in support

Church Street Health Management, LLC is located in Nashville, Tennessee at:618 Church St # 520
Nashville, TN 37219-2457
(615) 750-0306

 Members and Officers of the Church Street Health Management, LLC are:

Officers:
Michael Lindley-Chairman & CFO
Rodney Cawood-EVP & Chief Financial Officer
Al J. Smith- President, COO and Secretary

Members:
Dr. Steve Adair
Bret Bero – American Capital.
Scott A. Buschmann – Arcapita Bank
Stockton Croft – Arcapita Bank
Charles L. Griffith – Arcapita Bank
Susan B. Kasser- Carlyle Group
Douglas Kelley – American Capital
Michael G. Lindley – Small Smiles Holding, LLC
William C. Miller, Jr – Arcapita Bank
Al J. Smith – Small Smiles Holding, LLC

 

Arcapita Bank is headquartered in Bahrain, while the Carlyle Group is the third largest private investment group in the world with assets of $150 billion dollars. In March 2008, Carlyle Capital Corporation defaulted on about US$ 16.6 billion of debt as the global credit crunch brought about by the subprime mortgage crisis worsened for leveraged investors. (Wikipedia)

American Dental Partners Lawsuits thru June 2011

From EDGAR online

American Dental Partners, Inc. ( NASDQ: ADPI) Lawsuits thru June 2011

Stockholder Litigation

On or about February 22 and 23, 2010, Special Situations Fund III L.P., Special Situations Cayman Fund, L.P., and Special Situations Fund III Q.P., L.P. excluded themselves from the class action settlement resolving consolidated actions entitled “In re American Dental Partners, Inc. Securities Litigation,” civil action number 1:08-CV-10119-RGS, and filed an opt-out complaint in the United States District Court for the District of Massachusetts, against us and certain of our executive officers, entitled “Special Situations Fund III, L.P. et al. v. American Dental Partners, Inc. et al.,” civil action number 1:10-CV-10331, which we refer to as the Opt-Out Action.

The Opt-Out Action complaint (i) asserts that the plaintiffs purchased over 500,000 shares of our common stock during the period of February 25, 2004 through December 13, 2007; (ii) alleges that we and certain of our executive officers violated the federal securities laws, in particular, Section 10(b) of the Securities Exchange Act and Rule 10b-5 promulgated thereunder, by making allegedly material misrepresentations and failing to disclose allegedly material facts concerning the lawsuit by Park Dental Group against our subsidiary, PDHC, Ltd., entitled PDG, P.A. v. PDHC, Ltd., Civ. A. Nos. 27-CV-06-2500 and 27-CV-07-13030, filed in the Fourth Judicial District of Hennepin County, Minnesota on February 3, 2006 and conduct at issue in that action during the period of February 25, 2004 through December 13, 2007, which had the effect of artificially inflating the market price of our common stock; (iii) asserts control person claims under Section 20(a) of the Securities Exchange Act against the executive officers named as defendants; and (iv) claims that certain of the alleged misrepresentations also violated Section 18 of the Securities Exchange Act.

The plaintiffs seek an unspecified amount of monetary damages, costs and attorneys’ fees and any other relief the Court deems proper. We are unable to provide a range of potential damages with respect to this action.

On June 11, 2010, we and the other defendants filed a motion to dismiss the Opt-Out Action. On March 31, 2011, the Court denied the motion to dismiss with respect to the Section 10(b) and Section 20(a) claims, but granted the motion to dismiss with respect to the Section 18 claim. We intend to defend ourselves vigorously with respect to this matter.

Youngstown, Ohio Small Smiles Dental Center Dentist Has Hair Pulled by Patient

October 12, 2011
By JOE GORMAN - reporter (jgorman@tribtoday.com) , Tribune Chronicle | TribToday.com

YOUNGSTOWN - An Idlewood Avenue woman reportedly unhappy with work on her tooth was arraigned Tuesday in Municipal Court on accusations that she pulled her dentist's hair and wouldn't let go.

Cassandra Allen, 21, was arraigned on two counts of assault. Judge Elizabeth Kobly set bond at $10,000, as well as ordering that Allen have no contact with the Small Smile Dental Center on Mahoning Avenue or any of its employees.

Police reports state that Allen went to the office about 9 a.m. Monday, upset over some work done on her tooth. A dentist tried to help her, but several times during the process, Allen complained, the report states.

Connecticut dentist paying the price for Medicaid fraud–Dr. Kristi Rossomando

Dentist pays for making false claims to Medicaid

WTNH TV
Updated: Tuesday, 11 Oct 2011, 4:42 PM EDT
Published : Tuesday, 11 Oct 2011, 4:42 PM EDT

New Haven, Conn. (WTNH) - A New Haven dentist is paying over $200,000 for making false claims for services provided at her dental office.

Kristi Rossomando, D.M.D and her dental practice, The Children's Dental Group, P.C., located at 825 Grand Avenue, have entered into a civil settlement in which they will pay $212,000 to resolve allegations that they violated the federal and state False Claims Acts.

NYC dentist, Dr. Elan Kaufman, maxed out family’s dental benefits for the entire year of 2011 when he hadn’t seen any of their children. None! It gets worse, much worse.

Also, the high profile dentist and Chief of Pediatric Dentistry at St. Luke’s Roosevelt Hospital, Dr. Elan Kaufman billed the family’s insurance company for 5 visits on their 3 year old child whom he has never seen. Dr. Elan Kaufman had never looked inside the child’s mouth-he should not even have a chart or medical record of any kind on this child.  Parents say the child had not been past the waiting room!

Records say in 2009 he did 6 filings on the child- when the child was only one year old.  According to all the bills submitted on the child he had never seen the 3 year old had been seen 5 times and should currently have a total of 14 fillings.  He also billed for cleanings and fluoride treatment. 

Fox 5 took the child to another prominent dentist for examination.  Not only did the child have NO fillings, she had NO cavities.  Troubling to me is the fact the dentist wanted his identity to remain a secret.  Typical and 99.9% of the problem in my opinion.  Everyone wants to remain anonymous!!

Dr. Kaufman blames the “mistake” on staff, calling it a “clerical error”.  HA!

Anyone want to guess what procedures he billed out in 2011, that caused the family to max out it’s benefits with Delta Dental?

It was the “soup of the day”- Pulpotomies (Baby Root Canals) and Stainless Steel Crowns.  I know, I know…

Wednesday September 28, 2011
Fox 5 reporter Arnold Diaz

Dr. Elan Kaufman’s Other reported Credentials:
Director of Children’s Dentistry and Orthodontics in Brooklyn
Teaches at Columbia University – Columbia says he no longer teaches there.
President of the non-profit Children’s Dental Foundation (CDF)

Complaints About New York City Dentist: MyFoxNY.com

UK Ombudsman names and shames dentist

The serious problems with the dental community is not limited to the US.

GDPUK

The Health Service Ombudsman, Ann Abraham, has named a Staffordshire dentist who has repeatedly ignored calls from professional bodies to apologize to a patient following her complaint. This is the first time Ms Abraham has published a report specifically to alert Parliament to a health care professional’s refusal to put things right following a complaint.

Ms Abraham’s report sets out the findings of her investigation of the patient’s complaint about dentist Rajesh Narendranath (known as Mr Nath), of Stone Family Dental Practice in Stone, Staffordshire. The patient, Mrs D, complained that Mr Nath had been rough and had hurt her while trying to take x-rays, and also that he had been rude to her when she had objected. She described leaving the appointment feeling ‘battered emotionally and in more pain’.

Taxpayers spent $13 million on orthodontic transportation in Texas

Children picked up and escorted to dentist office for orthodontic treatment when dentist was not even in the state. 

Dollars are scarcely available to treat children who are in  very serious and real need, yet hundreds of millions freely distributed for unnecessary and useless braces on children in the Medicaid system.

These are just two of the allegations in the latest installment from Byron Harris of WFAA-TV in Dallas.

---

by BYRON HARRIS
Bio | Email
WFAA

Taxpayers spent $13 million on orthodontic transportation | wfaa.com Dallas - Fort Worth

Posted on October 6, 2011 at 11:42 PM

Last year, Texas taxpayers spent $184 million so kids on Medicaid could get free braces. Taxpayers did not just pay orthodontists for doing work many in the middle class consider a luxury. Under Medicaid, the public spent $13 million on orthodontic transportation.

Children got picked up, taken to orthodontists' offices, had their braces installed or worked on and were taken home again. Medicaid pays for up to 26 trips per patient. Many experts say that's evidence of a well-intentioned program gone wrong.

In his office in Dallas, Dr. Deji Fashemo looks at a three-dimensional photo of a child who badly needs orthodontic help. It is a mouth so crammed with teeth it's painful to look at. So in need of structural repair, the patient can hardly open to brush his teeth.

 

Dental One Under Investigation In Colorado Fallout Hitting Texas? Is Dell Computer CEO a dentist?

What does Michael Dell, the CEO of Dell computers know about root canals?

Word coming out of Colorado today is the Dental One clinic in Mountain, Colorado might be in some trouble. Rumor has it the District Attorney in Monument, Colorado is investigation billing fraud allegations.

Dental One operates 14 practices in Colorado including
Jackson Creek Dental Care
15854 Jackson Creek Parkway
Suite 140
Monument, CO 80132
719-302-2200

Dental One is based in Dallas, Texas
DentalOne Partners - Dallas
17300 Dallas Parkway
Suite 1070
Dallas, Texas 75248

 
Dental One

Dental One says it's an advisory company that owns clinics in various states.

Dental One Officers:
Edward H. Meckler, Chairman, DDS
Peter Grumbos, Chief Clinical Officer, DDS, FAGD
Keith Miller, Chief Operating Officer
David J. Krause, Chief Financial Officer
Dave Drzewiecki, Chief Information Officer
David G. Slezak, General Counsel and Corporate Secretary
Charlie Zasso, Chief Clinical Director, DDS, FAGD
Andy McBryde, Vice President, Central Operations
Chris Tsichlis, Vice President, Human Resources

Dental One, Inc
Dental Care Partners, Inc
Dental One Partners is a trademark owned by Dental One, Inc and refers to dental practices serviced by either Dental Care Partners, Inc or Dental One, Inc.
Dental Works – refers to dental practices serviced by Dental Care Partners, Inc

 

 

DentalOne Partners - Dallas
17300 Dallas Parkway
Suite 1070
Dallas, Texas 75248

Phone: 972-755-0800
Fax: 972-755-0890
Email: dallas.office@dentalonepartners.com

March 2007 – Purchased by North Peak Capital, LLC a subsidiary of MSD Capital, LP (MSD=Michael and Susan Dell, CEO, Dell Computers

Critics allege crying kids were hit - LA Daily News

I’m hoping this takes root, as it seems it has, and continues across the country.  C’mon parents, stand up for your children. 

Here is the story of another protest, this time at Dr. Dove’s Chatsworth, California.

Critics allege crying kids were hit - LA Daily News

CHATSWORTH - Angry parents demonstrated Friday outside the office of a pediatric dentist, accusing him of hitting young patients who cried and pulling teeth without proper sedation.

Picketing outside the Devonshire Street office of Dr. Edward E. Dove, more than a half-dozen mothers, grandmothers and others claimed that Dove mistreated children during visits and barred parents from being at their kids' side during procedures.

Janice Tucker, left, and Brooke Catalfamo demonstrate Dr. Edward Dove's pediatric dental office in Chatsworth on Friday, Sept. 30, 2011. Several parents who believe their children were mistreated by the dentist gathered outside his office to let others know their stories. (Andy Holzman/Daily News Staff Photographer)

"We're just here trying to protect other innocent children," said Brooke Catalfamo, of Reseda, who said Dove slapped her 5-year-old son in the face when he cried.

Another group held a similar protest recently outside Dove's office in Bakersfield, and critics have launched a Facebook page to detail complaints.

Central KY Commercial Real Estate Blog: NAI Isaac Brings Kool Smiles Dentistry to Elizabethtown, KY

Central KY Commercial Real Estate Blog: NAI Isaac Brings Kool Smiles Dentistry to Elizabethtown, KY

WARNING to Elizabethtown, Kentucky residents; it looks like you are about to become the unwitting prey of a Kool Smiles dental center. 

Danger to your children awaits.  Remember the dental mill mantra “Patients may be hard to increase, but billable procedures are not!”  Creative dentistry at its best.

I feel Kool Smiles operates illegally in Kentucky under the statues of a Professional Service Corporation (PSC) where by the person owning and directing the “professional service” must be licensed by the “professional” board of the state, in this case the Kentucky Board of Dentistry and the person MUST perform those services. KRS 313.060 (3) no person shall conduct dental practice in their name unless he or she personally performs services as a dentist is such office.  Not less then 1/2 of the officers of a PSC and ALL of the officers other than the secretary and the treasurer shall be qualified persons to perform the professional services. See KRS 274.027 and 274.045 

Why the KY Dental Board ignores its own laws, rules and regulations is beyond me. 

 

See many more Kool Smiles reports by clicking here.

 

Not letting Dr. Edward Dove off the hook, fathers drive to remove the dentist continues.

Today, Chris Cook, the father who created the Facebook page exposing the atrocities of Dr. Edward Dove of Bakersfield, California made an appearance on the Scott Cox, radio program.  Scott Cox is on KERN Newstalk Radio in Bakersfield.

 

 

Chris has also created a Petition asking parents to people to sign and plans to pass it along to the California Dental Board.

You can sign the petition here.

Pictures are from the latest protest of Dr. Dove.

You can join Chris’s Facebook group here.

 

 

 

 

 

Friday is Conscious Sedation day at Dr. Dove’s.  A protest has been planned Friday, September 30 · 6:30am - 2:00pm  at the Chatsworth Office

Edward Dove's Chatsworth Office
20523 Devonshire St
Chatsworth, CA

Incidents and Allegations:

The Real Cheaters

Boston Herald Monday September 26, 2011

The cheating done by food stamp recipients is peanuts compared to vendor fraud (“Life’s a beach on EBT street,” Sept. 22).

Most fraud is done by pharmacies, doctors, dentists, nursing homes, hospitals and sellers of medical equipment. The government recovered $2.5 billion in overpayments for Medicare in 2009 as the Obama administration focused attention on fraud enforcement efforts in the health industry.
Click here to read the full story
The Real Cheaters

Inside the mind of a corporate dentist who is paid based on production.

Here is what happens to a dentist working at a dental mill when they don’t produce. Names and dates have been changed.
I believe this is a letter from a “lead” dentist at a dental mill clinic sent to their “regional manager". It’s apparent production is the only goal and is precisely why getting a bonus and/or a piece of the pie for compensation is more than wrong! It’s criminal! This is exactly why under Quality of Care Corporate Integrity Agreements, employee compensation or bonuses are NOT to be based on “production” goals.

Dear Regional Manager,

This letter is in regards to the production levels of Dr. F. As you know the clinic was approximately $500 away in production from the $300/3000 Bonus for the month. This is one of MANY examples of Dr. F not completing the majority of the treatment on the patients she sees on a daily basis. The patient, RH, was seen on 12-1-2010 by Dr. F and the only treatment done was a facial composite on the #C and the rest of the treatment to be performed was dismissed because the patient was nervous and he wanted the dental visit to be easy.
The clinic missed out on the possible $425.96 of production because he wanted to make the visit EASY? I find this very upsetting because I strive to work at my full potential and lead by example to my fellow doctors and employees to work hard regardless if I want to make a dental appointment easy.
If I wanted to make the appointment easy for every nervous patient, I believe a strong majority of our parents would be upset that they would have to continuously keep coming back because the patient was nervous. RH was my patient today and I completed the majority of the treatment except the extractions (per mom) and yes the patient was initially nervous, but did great for the injections and treatment. In conclusion, my question is how many more patients are to be dismissed or partial work completed because they were nervous and how many production goals must be compromised because of Dr. F’s lack of effort?
Sincerely,
Dr. X Ray Fraud

As you can see, Dr. X Ray Fraud would have done all the extractions had mom not spoken up and refused.

Jim Moriarty “Only a human can practice dentistry” “No corporation is allowed to practice dentistry.”

by BYRON HARRIS
Bio | Email
WFAA
Posted on September 23, 2011 at 11:15 PM

WFAA's Byron Harris has investigated dental organizations that have charged the government millions for children's braces. Here is the latest from the on-going News 8 investigation which includes a statement from Texas attorney, Jim Moriarty. 

E-mail bharris@wfaa.com

 

Related:

• Feds investigate Texas dental Medicaid program  
• Questions surround lucrative Medicaid dental business
• Tax money for unneeded braces goes to hedge funds
• Texas taxpayers pay big for straight teeth

See all photos »

Don’t become part of the crime and cover-up–Report it!

This goes out to any Small Smiles or Church Street Health Management employees.

The Office of Inspector General and Health and Human Services take Corporate Integrity Agreements seriously, especially Quality of Care CIA’s and even more important the agreements that have to do with the treatment of children.

I know many of you are afraid to speak up about the violations and breaches of the Corporate Integrity Agreement.  I know many of you are concerned about other misdeeds happening at the dental centers as well as at corporate headquarters. 

I encourage each of you to report any and all violations.  If you don’t feel comfortable using the Hotline that is set up, and I understand that completely, then at least report directly to the OIG/HHS. 

You may direct complaints of suspected Medicaid fraud to
OIG's Hotline1-800-HHS-TIPS (1-800-447-8477) or directly to a

State Medicaid
Fraud Control Units

If the monitor is visiting your center, please talk to the monitor.  I’m sure all reports and allegations are taken seriously.  If you can’t talk freely right then, surely you can find a way to get the monitor’s attention to slip them a phone number or a note or something.  Get the name of the monitor and contact them later….do something.

Heck do all of the above if you don’t feel comfortable talking to the monitor and your concerns swept under the rug.  Even though I doubt that is the case.  But I understand just about every one of you are terrified. 

You guys are the first line of defense against children being mistreated and Medicaid fraud prevention.  Please do the right thing.  For example, if you see procedure being coded and billed improperly, please report it, please.  Don’t become part of the crime and cover-up.

Dr. James Crow sentenced to prison for Medicaid Fraud - using wrong billing codes

Medicaid Fraud and Perjury by Brownwood, Texas Dentist. Perjury(emphasis added).

Who at these Medicaid mills are willing to leave your family, newborns, sick parents and head off to prison? Better be thinking about it.
_____________

September 21, 2011
SAN ANGELO, Texas — A Brownwood dentist convicted in federal court in San Angelo of defrauding Medicaid has been sentenced to 70 months in prison and ordered to pay more than $1.6 million in restitution.

James Crow, 67, was ordered by U.S. District Judge Sam Cummings to surrender to the Bureau of Prisons on or before Oct. 26. He also was ordered to pay $1,653,474 to Texas Medicaid and forfeit that amount in cash, a truck, several Harley Davidson motorcycles, a residence in Brownwood and additional real estate elsewhere in Brown County, a camper, a boat and a trailer.

Cummings also issued a finding that Crow had committed perjury during the two-week, May 2011 trial in San Angelo.

Crow was convicted on evidence that he filed claims to Medicaid for services he didn't perform and for services billed under improper billing codes. Crow billed Medicaid for resin-based fillings when the service weren't performed or services were performed that were not reimbursable under Medicaid.

The case was prosecuted by the U.S. Attorney's office in Lubbock using investigations conducted by the Texas Medicaid Fraud Control Unit and the FBI.

Obit sheds light on DeRose family tree

Grove, Jean P.
Jean P. Grove - Pueblo Chieftain - March 12, 2001 - Longtime Pueblo resident, passed away March 9, 2001. Preceded in death by husbands, Frank G. Palladino and Arthur E. Grove; sister-in-law, Veronica DeRose; and brother-in-law, Bruno DeRose. Survived by nieces and nephews, Dr. Edward J. and Neta DeRose, Sel and Vivian Elizondo, Dr. Rudy and Berni Padula, Alfred J. and Rose Schiavoni, Mary Lou Keating; and sister in-law, Jada Willard. Mrs. Grove resided in Pueblo for 50 years and was a loyal member of Sacred Heart Cathedral and St. Pius X churches. Service will be held at Sacred Heart Cathedral on March 13 at 10 a.m. The family respectfully requests the omission of food and flowers. Contributions may be made to the Fellowship of Christian Athletes, 7 Glen Eagle Court, Pueblo, CO 81001, in memory of Mrs. A.E. Grove. Interment, Roselawn Cemetery.

How to slow the child abuse, tortuous dental overtreatment and fraud

If states want to stop the influx of these substandard dental mills; if states want to end the continued overtreatment and child torture perpetrated on the poorest and most vulnerable of our citizens; if states want to cut the Medicaid fraud by same dental mills by billions; the solution may be as simple as slowing down the reimbursements.

Many think they gravitate to states with the highest reimbursement rates or those states that pay for more procedures, but that’s not always true.  If you were to ask an exec at one of the mills, you may well be told it’s actually how fast the money flows into their coffers.

Look at the states who are slow to pay; you won’t find many dental mills there.  Take Illinois for example, they are considered to be slow to pay; no Small Smiles or Kool Smiles there. 

Of course that’s just one of the factors considered, but it’s a huge one!  Other factors could be:

How quickly dentists can be credentialed
How quickly dentists can be licensed with the state dental board
Who they know and can control at the state dental associations

Just Saying….

Being lectured about wasting taxpayer dollars by a Medicaid Fraudster is off the chart ridiculous.  Just saying….

Attorney Tom Crosley Taking The Smile Center Cases–Was your child injured?

SAN ANTONIO - More than 70 parents are preparing to sue a local company of dental clinics called The Smile Center.  A News 4 WOAI Trouble Shooters investigation unleashed a flood of complaints by parents who say their children got poor dental treatment at the San Antonio clinics.  The San Antonio clinics have made millions on work paid for by Medicaid
.
Tom Crosley runs the firm that is preparing to file suit. “In the last few weeks we've been approached by the families of 60 or 70 children to investigate whether their kids were victims of unnecessary dental work, shoddy dental work, excess dental treatment," said Crosley.

The Smile Center handed out letters to potential new patients that state the allegations are gross misrepresentation of the facts. The Smile Center also claims they are saddened and shocked that we would report this story without telling their side of the story.
 
See video and further story information here

Tom Crosley, Attorney At Law
2632 Broadway St
Suite 101 South
San Antonio, TX 78215
210-354-4500, 877-535-4529
Fax: 210-244-2744
info@crosleylaw.com

The Smile Center in San Antonio, Texas Under Investigation

WOAI TV

Published: 9/07 4:05 pm

Updated: 9/08 10:04 am


The Smile Center Investigation
Posted on 09/08/2011 by bcollister
A criminal investigation is underway into a chain of dental clinics here in San Antonio that targets children on Medicaid.  This comes after I uncovered complaints of poor treatment at The Smile Center.
The Texas Attorney General now confirms it has launched criminal and civil investigations into The Smile Center.
The Attorney General’s office wants to know if the clinics defrauded Medicaid by billing for dental work that did not need to be done.  I’ve been reporting since February about complaints from parents who say the clinics did unnecessary and shoddy work on their children.
These parents were unhappy with dental work done on their children and paid with millions of your tax dollars through Medicaid.
A representative from the Attorney General’s office confirms it’s Medicaid fraud control unit has 180 bankers boxes of records taken from The Smile Center locations here in San Antonio.  The agency’s civil Medicaid department has also filed a complaint in civil court against the business. But we don’t know what’s in that complaint because it’s sealed.

Medicare fraud strike force charges 91 individuals for approximately $295 million in false billing

 

FOR IMMEDIATE RELEASE
September 7, 2011

Contact: HHS Press Office
(202) 690-6343

Medicare fraud strike force charges 91 individuals for approximately $295 million in false billing

WASHINGTON – Attorney General Eric Holder and Health and Human Services (HHS) Secretary Kathleen Sebelius announced today that a nationwide takedown by Medicare Fraud Strike Force operations in eight cities has resulted in charges against 91 defendants, including doctors, nurses, and other medical professionals, for their alleged participation in Medicare fraud schemes involving approximately $295 million in false billing. 

Attorney General Holder and Secretary Sebelius were joined in the announcement by FBI Executive Assistant Director Shawn Henry, Assistant Attorney General Lanny A. Breuer of the Justice Department’s Criminal Division and HHS Inspector General Daniel R. Levinson.

Busy week for wasteful and abusive dentistry in the news–Corporations should be feeling the heat about now

In Rick Perry's Texas: Medicaid Is Wasting Millions -- On Braces

Sat, 09/03/2011 - 12:22am — Joe Conason

Republican presidential frontrunner Rick Perry complains constantly about Washington’s “culture of runaway spending,” wasteful government programs, and federal intrusions into the affairs of the states. In Fed Up, the book he published last year, the Texas governor bitterly criticizes Medicare (which he terms “unconstitutional”) as well as the health care reforms passed by President Obama and by Mitt Romney in Massachusetts, which he regards as infringements on freedom.

Before Perry goes after Romney and Obama on medical spending, however, perhaps he ought to try putting his own state’s government in order first. According to a new investigation by a Dallas television station, the Medicaid program in Texas – overseen by Perry – is wasting millions of dollars annually on orthodontic braces for children who may not even need them.

But the story gets worse: Texas Medicaid wasting big money on unnecessary braces due to lax regulation by the state –and those millions are going straight to for-profit clinics owned by hedge funds.

Reviewing Dallas ABC affiliate WFAA’s investigation, health care expert Trudy Lieberman explains in the Columbia Journalism Review how the teeth of poor children in Texas became a golden opportunity for wealthy investors on Wall Street. Last year, the state spent more than $184 million to provide braces for 120,000 children – many of whom apparently did not qualify for orthodontic care under the state’s own criteria, according to WFAA investigative reporter Byron Harris. That is more than twice as much as Texas spent on the same program three years ago –and the same amount as all of the other 49 states combined.

“Judging by the increased payouts,” Harris noted, “the teeth of Texas children are growing more crooked each year.”

Read complete story here

Corporate dentistry receiving a lot of press lately isn’t it?

Columbia Journalism Review:

Golden Teeth
Dallas’s WFAA shows crooked Medicaid spending on orthodontia
by Trudy Lieberman

These days it’s rare for local TV stations to produce anything resembling an expose. With their steady diet of crime, weather, and canned medical news, there just isn’t room for the hard reporting. WFAA, the ABC affiliate in Dallas, has earned a reputation as a notable exception. Throughout the summer, the station and its investigative reporter Byron Harris have taken on the Texas Medicaid agency and its spending spree for braces for poor kids.

Now there’s nothing wrong with these children getting braces. Many, no doubt, will benefit in the long run. The problem, Harris reported, is that last year the state paid more than $184 million—nearly double the amount it spent in 2008—to supply braces for 120,000 kids, some of whom may not have met the state’s criteria for orthodontic work.

Read the full article at CJR