Prior Year ReportsLargest Sum Ever Recovered in Single YearWASHINGTON –Attorney General Eric Holder and Department of Health and Human Services (HHS) Secretary Kathleen Sebelius today released a new report showing that the government’s health care fraud prevention and enforcement efforts recovered nearly $4.1 billion in taxpayer dollars in Fiscal Year (FY) 2011. This is the highest annual amount ever recovered from individuals and companies who attempted to defraud seniors and taxpayers or who sought payments to which they were not entitled.
These findings, released today, in the annual Health Care Fraud and Abuse Control Program (HCFAC) report, are a result of President Obama making the elimination of fraud, waste and abuse a top priority in his administration. The success of this joint Department of Justice and HHS effort would not have been possible without the Health Care Fraud Prevention & Enforcement Action Team (HEAT), created in 2009 to prevent fraud, waste and abuse in the Medicare and Medicaid programs, and to crack down on the fraud perpetrators who are abusing the system and costing American taxpayers billions of dollars. These efforts to reduce fraud will continue to improve with the new tools and resources provided by the Affordable Care Act.
“This report reflects unprecedented successes by the Departments of Justice and Health and Human Services in aggressively preventing and combating health care fraud, safeguarding precious taxpayer dollars and ensuring the strength of our essential health care programs,” said Attorney General Holder. “We can all be proud of what's been achieved in the last fiscal year by the Department’s prosecutors, analysts and investigators – and by our partners at HHS. These efforts reflect a strong, ongoing commitment to fiscal accountability and to helping the American people at a time when budgets are tight.” more here
WILMINGTON — Prominent Wilmington dentist Marieve Rodriguez admitted to 10 misdemeanor counts of filing false Medicaid reports today in exchange for state prosecutors dropping 19 felony counts of health care fraud.
In addition Rodriguez, who operates Gentle Care Family Dentistry on Gilpin Avenue, will pay a $100,000 fine, repay $72,000 to the state’s Medicaid program and $50,000 to cover the costs of prosecution.
She also agreed to have her license to practice medicine suspended for a year and to not participate in the state’s Medicaid program -- should she get her license back -- for at least five years.
A dentist who surrendered his license in 1993 was indicted Tuesday on allegations he practiced dentistry without a license in 2011.
Chester Kyle Little, 58, of Warner Robins, is accused of performing dentistry from June 30, 2011, to Aug. 25, 2011, at an office located at 2533 Hillcrest Ave. in Macon, according to an indictment filed Tuesday in Bibb County Superior Court.
DALLAS - No one would say being a single mom is easy. Especially being a single, teenage mother.
But the State of Texas appears to be encouraging teenage girls to become pregnant so they can receive free dental care under Medicaid.
Our investigation last year found hundreds of millions of dollars of taxpayer money spent for free braces on kids' teeth under Medicaid. That spurred a federal investigation, because cosmetic braces aren't supposed to be paid for under Medicaid.
If that is an example of good intentions gone bad, Latricia Banks and her mom, Patricia Jones, may exemplify a good idea gone terribly wrong.
For them, home is a tiny, wooden house in the shadow of Dallas' skyscrapers, which they share with Latricia's 82-year-old grandfather. It is a household held together with love, not money. Medical and dental care came mostly through Medicaid.
A little more than two years ago, Latricia's mom got a postcard in the mail, like many people in the neighborhood. Access Dental was offering to provide free braces for qualified children like Latricia, then 17 years old.
We hear a lot about the “revolving” door in Washington, but seldom does anyone talk about the revolving door within agencies and professional organizations. The same organizations that write the rules, regulations, tests, and guidelines that effect each of us in a more personal way. The same organizations that states and lawmakers trust to protect the public from harm. Chances of corruption are 100% when there are no checks and balances.
Their Publications and Studies
Looking are various websites including the American Academy of Pediatric Dentistry (AAPD), you find publication after publication, study after study, dating as far back as the early 1990’s to the present. Just about all of them are, rewritten and republished studies that are merely mashups of their own previous written articles and studies.
Here is just one of hundreds of examples :
Journal of Dental Education – Vol. 68, Number 1
General Dentists’ Perceptions of Educational and Treatment Issues Affecting Access to Care for Children with Special Needs.
Written by:
Paul Casamassimo, DDS, MS;
N. Sue Seale, DDS, MS;
Kelley Ruehs, DDSReferenced:
Casamassimo PS. The great educational experiment: has
it worked? Spec Care Dentist 1983;3:103-6.Seale NS, Casamassimo PS. Access to dental care for
children: profiling the general practitioner who treats
young and low-income children. J Am Dent Assoc
2003;134:1630-40.
If you get to looking at all the professional opinions, publications, studies, and continuing education courses concerning pediatric dentistry, the same names are there over and over.
Posted: Saturday, February 4, 2012 12:00 am
Engine trouble eyed in plane crash By NICK BONHAM | nickb@chieftain.com The Pueblo Chieftain | 0 comments
An engine problem appeared to have caused the Thursday night slide-off of a Learjet at Pueblo Memorial Airport, a preliminary report by the Federal Aviation Administration said.
The plane "lost power in right engine during take-off and ran off side of runway," the report said.
Due to weather conditions, investigators with the FAA and National Transportation Safety Board won't arrive in Pueblo until early next week, said Mark Lovin, airport director, on Friday.
No one was injured in the Thursday night crash. The private plane was occupied by the prominent DeRose family of Pueblo. The group was taking off in poor weather conditions to Las Vegas to watch the Super Bowl. Lovin, however, has said it doesn't appear the weather was a factor.
The report said the plane sustained "substantial damage" in the crash. The name of the pilot has not been released.
The DeRoses were on Learjet ID number N31WS, which was once owned by singer John Denver, according to flightaware.com
"John Denver took delivery of this Lear in 1975. He named it WindStar 1. He created WindStar Aviation. His father, Dutch, was the chief pilot," the website said.
Records show the Learjet is now owned by Extra Point LLC, in Delaware. The plane's most recent flight was from Centennial to Pueblo on Jan. 27.
The Learjet was removed from the side of the runway late Thursday night and is being stored at the airport for investigators.
The airport was closed following the incident but was reopened Friday morning.
Engine trouble eyed in plane crash - The Pueblo Chieftain: Local News
This morning I awoke to hear news about the big snow storm in the Rockies. Next thing that was talked about was the flight cancelations and so forth. Then it was mentioned a private jet had already slid off the runway in Pueblo due to the fierce snow storm.
Pueblo! The sudden adrenaline rush woke me on up, since I was still in bed half asleep. When I hear Pueblo, I think DeRose.
Being the meanie I am, I thought, “Oh, please let that be a DeRose jet.”
Then the newscaster said, “luckily no one was injured.” Again, being the meanie I am I thought, “dang”. That little devil on my shoulder shows up every now and again, ya know. (it does for everyone, I just might admit it more…lol)
That was the end of the report and the newscaster moved on.
The devil side of me disappeared as quickly as it had appeared. I came to my senses and thought, there has to be dozens of private jets in Pueblo.Then, just moments ago a reader sent me a link to the following story!
So why does your dentist strap your child in a papoose board as soon as they get their hands on them, instead of taking the time to go through the acceptable standards set out by the American Academy of Pediatric Dentistry? (Listed in detail below).
Answer - M.O.N.E.Y.
How much?
Every MINUTE saved is $6-$8.
For a Private Equity firm, or other Wall Street bank or investment firm, wasting $6-$8 a minute is UNACCEPTABLE! For a greedy dentist who cares nothing about your child, only about his/her 5 million dollar home and private jet it’s also UNACCEPTABLE. (see below about these numbers)
From the AAPD Guidelines for Behavioral Management
AAPD Guidelines Page 4 - Regardless of the behavior guidance techniques utilized by the individual practitioner, all guidance decisions must be based on a subjective evaluation weighing benefits and risks to the child. The need for treatment, consequences of deferred treatment, and potential physical/emotional trauma must be considered.
Decisions regarding the use of behavior guidance techniques other than communicative management cannot be made solely by the dentist. They must involve a parent and, if appropriate, the child. The dentist serves as the expert on dental care (i.e.,the timing and techniques by which treatment can be delivered). The parent shares with the practitioner the decision whether or not to treat and must be consulted regarding treatment strategies and potential risks. Therefore, the successful completion of diagnostic and therapeutic services.
Acceptable Techniques
1st – Tell-Show-Do Tell-show-do is a technique of behavior shaping used by many pediatric professionals. The technique involves verbal explanations of procedures in phrases appropriate to the developmental level of the patient (tell); demonstrations for the patient of the visual, auditory, olfactory, and tactile aspects
of the procedure in a carefully defined, nonthreatening setting (show); and then, without deviating from the explanation and demonstration, completion of the procedure (do). The tell-show-do technique is used with communication skills (verbal and nonverbal) and positive reinforcement.
I made an entry here a few weeks ago about Kool Smiles telling their patients they have to choose a doctor, not their clinic under the new rules. I wondered how that would work, since the dentist’s don’t stay too long at the dental mills. Chances of seeing the same dentist twice (unless it’s the next day) slim to none.
Here’s a comment on that from a Texas dentist I thought deserved being front and center.
About Us
Learn how HCE can improve your profitability by
obtaining eligibility—especially with the most
difficult casesHeadquartered in Manhattan, with offices in Nassau and Westchester counties
HCE LLC provides Medicaid eligibility services to the New York metropolitan area and lower Hudson Valley. The firm’s clients range from independent health care providers to major medical systems.
HCE maintains a consistent reputation for superior results and client-focused services, and has done so for the past seventy years.
HCE is focused exclusively on Medicaid eligibility services. The firm’s knowledge of and experience with the intricacies of the New York Medicaid system is unmatched. HCE professionals have dedicated their careers to Medicaid eligibility, with most having at least ten years of experience in the field. This depth of knowledge and expertise results in superior return of Medicaid dollars to our clientele.
HCE LLC has expanded into opening a new source of additional revenue for hospitals through the federal grant program, Section 1011 that provides reimbursement for uncompensated ED care for undocumented aliens.
(CBS/AP) FALL RIVER, Mass. - Dr. Michael Clair, a former dentist who substituted paper clips for stainless steel posts in root canals, was sentenced to one year in jail on Monday.
Clair pleaded guilty earlier this month to charges including assault and battery, illegally prescribing medication, witness intimidation and defrauding Medicare of $130,000.
Prosecutors say that Clair sometimes used pieces of paper clips while performing root canals. This caused infections and other problems in patients.
One woman said her teenage son's tooth turned black and had to be removed after Clair gave him a root canal in 2005.
"He put my kids in pain for months ... I hope he rots there," said Brenda Almeida after Judge Richard Moses sentenced Clair to a year in the Bristol County House of Correction.
An announcement from the Office of the New Jersey Attorney General
Attorney General Jeffrey S. Chiesa announced that a Monmouth County dentist has been indicted for allegedly submitting false claims to the Medicaid program.
Ping Cai, 49, of Holmdel, a licensed dentist whose practice is located in Hazlet, was charged with second-degree health care claims fraud and two counts of third-degree Medicaid fraud.
The Monmouth County grand jury indictment alleges that between Jan.1, 2007 and Jan.1, 2010, Cai fraudulently billed the Medicaid Program for dental service purportedly rendered to Medicaid recipients.
It is alleged that Cai submitted fraudulent claims for payment from Medicaid for relining and rebasing of dentures and filling of cavities when those dental services were not rendered.
American Academy of Pediatric Dentistry - Media Information
I can’t believe I missed this in 2010! She’s walking in Steven Adiar’s shoes while she’s suppose to be monitoring his child abusing, Medicaid defrauding company, Church Street Health Management. Adair used to be the Editor. I’ve heard about how her “monitor” visits go at the Small Smiles Centers. She’s either not looking or turning her head! But that’s what you get with self-policing. It really amounts to more layers of cover-up protection. Disgusting!
AAPD Appoints New Editor-in-Chief
The American Academy of Pediatric Dentistry (AAPD), the recognized leader in children’s dental health, appointed Dr. N. Sue Seale as Editor-in-Chief of Pediatric Dentistry and Journal of Dentistry for Children effective January 1, 2010.Seale is a Regents Professor of Pediatric Dentistry at the Baylor College of Dentistry, Texas A&M Health Science Center in Dallas, Texas. She received her dental degree in 1970, her certificate in pediatric dentistry in 1972 and her Master of Science in Dentistry in 1979 from the Baylor College of Dentistry. Since 1974, she has been a full-time faculty member in the Department of Pediatric Dentistry at the Baylor College of Dentistry and was Chairman of the Department from 1986-2009.
Seale has served in a variety of leadership roles, including serving as a past president of the Texas Academy of Pediatric Dentistry and on the Board of Trustees of the American Academy of Pediatric Dentistry. She received a Distinguished Alumni Award from the Baylor College of Dentistry Alumni Association and was elected to the Baylor College of Dentistry Hall of Fame in 2010. In 2001, the AAPD named her Pediatric Dentist of the Year. Seale was also a recipient of the AAPD’s Merle C. Hunter Leadership Award in 2003. Seale is a diplomate of the American Board of Pediatric Dentistry.
“I am excited to take on this new role and look forward to participating in the changes that will take place in our journals over the coming years as we strive to meet the changing needs of our readers,” said Seale.
Seale’s areas of interest include pulp therapy for the primary and young permanent dentition, dental education and access to care.
FOR IMMEDIATE RELEASE AT
TUESDAY, AUGUST 30, 1994 (202) 616-2771
TDD (202) 514-1888
DEPARTMENT OF JUSTICE AND ARIZONA STATE ATTORNEY GENERAL
BREAK UP DENTAL GROUP'S CONSPIRACY TO ELIMINATE DISCOUNTING
WASHINGTON, D.C. -- The Department of Justice and the Arizona Attorney General's office acted jointly today to stop a statewide agreement that made it almost impossible for many dentists in Arizona to cut their prices or offer discounts on dental services.
Similar agreements are common in the health care industry, and those that stifle price competition are likely to be challenged elsewhere, the Justice Department warned today. In a civil antitrust suit and proposed settlement filed in Phoenix, the dentist-controlled Delta Dental Plan of Arizona Inc. was accused of eliminating discounts and reducing price competition under an agreement that had the effect of preventing dentists from cutting fees below those offered in the Delta Plan.
This is the first action challenging such contract provisions, which are known in the industry as "most favored nation" clauses. Approximately 85% of the dentists in Arizona have affiliated with Delta, the dominant dental plan in the state, the Department said.
2011 Behavioral Management Guidelines
The link above contains the latest version, according to the American Academy of Pediatric Dentistry (AAPD). It’s written and revised by the AAPD Clinical Affairs Committee – Behavior Management Subcommittee. I want to know who is on this committees, don’t you?
In fact, I think it is extremely important to know who is on each of these committees and subcommittees. They are setting guidelines and standards that our federal and state government rely heavily on. Most of the time these guidelines are 100% relied upon.
We certainly demand to know who is making our laws and just who these lawmakers are all cozied up with, well, what’s the difference?! NONE!
I’ve found a helpful little website where you can check guidelines for various healthcare professions. It’s at the Agency for Healthcare Research and Quality (AHRQ). It’s the National Guideline Clearing House.
I’ve not tried it, but it appears you can compare guidelines, now isn’t that cool. Well, if it works anyway.
You can check past guidelines going back to 1997, that seems handy: browse by Organization,Topic,Guidelines in progress, get expert commentaries and much more.
Of course in checking this place out I got fired up over reading all the guidelines for Behavioral Management (D9920). Various terms for it are used; Behavior Guidance, Behavior Management, Behavior Control. The latest term, “Guidance” sounds so much nicer doesn’t it.
I don’t care what they call it, it’s worse than a straight jacket. In a straight jacket you can at least have use of your legs, but not in the papoose board, rainbow wrap, blankets or whatever cuddly term is thrown at the damn thing.
It’s not been a good month for dentist committing Medicaid Fraud has it?
Shreveport dentist convicted of Medicaid fraud | Shreveporttimes | shreveporttimes.com
Shreveport dentist David Earl Reed faces prison and fines after a conviction on two counts of Medicaid fraud.
Reed, 56, was barred from participating in the Medicaid program after a fraud conviction in 1992.
He continued applying to participate in the program from 2006 to 2008 and was denied. In 2009, state health officials told him he would be barred from the program for at least five more years.
However, from 2005 to 2007, Reed treated Medicaid patients while working for another Shreveport dentist. Reed submitted false billing claims to the program under the other dentist's provider number and received payment from Medicaid.
Health providers excluded from the program can't provide any services that will be billed directly or indirectly to Medicaid. It's a crime to be employed by, have a contract with or have an ownership interest in a healthcare provider that bills Medicaid, said Louisiana Attorney General Buddy Caldwell.
Reed will be sentenced April 27. He faces up to five years in prison and fines up to $20,000 on each fraud count.
January 27, 2012
A Washington County dentist, who allegedly prescribed more than 6,600 narcotic pain killers to seven patients, was arrested today by state narcotics and Medicaid fraud agents.
Dr. Charles Kokoska, 48, 2 Mill St., Millsboro, was charged by the state attorney general's office. Koskoska has offices at his Mill Street home and at 161 Waterdam Road, McMurray.
According to the criminal complaint, between January 2009 and October 2010 Dr. Kokoska wrote more than 300 prescriptions for more than 6,600 narcotic pain killers to at least seven different patients.
The prescriptions were written for the powerful prescription pain killers Oxycodone, Hydrocodone, and Propoxyphene and filled at various pharmacies in Allegheny, Fayette, Greene and Washington counties. Kokoska also wrote prescriptions for Diazepam, a generic form of Xanax, commonly used to treat anxiety.
Dr. Kokoska is charged with seven counts of prohibited acts by medical professional and two counts of provider prohibited acts.
He was arraigned before Brownsville Magisterial District Judge Joshua Kanalis and released on $25,000 unsecured bail.
Dentist arrested for Medicaid fraud - Breaking News - www.observer-reporter.com
January 27, 2012 at 6:46 AM
HARRISBURG, PA – Attorney General Linda Kelly announced criminal charges have been filed against a Centre County dentist accused of submitting more than $52,000 in false insurance claims following a joint investigation with the Federal Bureau of Investigations (FBI) State College office.
Kelly identified the defendant as Dr. Jamshid Assadinia, 53, of 1764 Cambridge Drive, State College, Centre County. Dr. Assadinia owns and operates Jamshid Assadinia DDS,300 South Allen St., State College.
Kelly said Assadinia allegedly submitted insurance claims for dental procedures that he never performed and then billed the insurance companies more than $52,000 under the names of several different patients.
I’m hearing ReachOut Healthcare America mobile dentistry, and their Big Smiles 
Telemarketers? Yes,telemarketers. This is where the “ReachOut” part comes into play. Each telemarketer has a list of the names of children, parents, your child’s school, and parent or guardian contact information.
For example, let’s say you are home, the phone rings, you answer and it’s a nice lady telling you the mobile dental clinic your school has approved, which is staffed with a highly qualified dentist and two assistants will be at your school on such and such date. Sounds just like picture-day doesn’t it?
The telemarketer tell you they just your verbal permission - probably recorded- or so they might tell you. ReachOut can have their highly qualified and well trained dentist do just a little look-see, a screening so to speak, or maybe its been a while since your child’s last cleaning, they could do that for you too. They may tell you they will send home a report detailing Susie’s dental health.
They might ask, if their highly trained staff does find a problem, with Susie, do you what them to fix it, right then and there, since it is a full service mobile clinic. It will save you all kinds of time and we know as parents, time is a valuable commodity, right? Plus, how can you neglect your child by withholding dental care? Free dental care?! Free, you may ask?
The telemarketer, I mean company representative, tells you there will be no cost to you, since your child is eligible for free dental services because of your states Child Health Insurance Program (CHIP). Sounds like if you are on the “free lunch” list you get free dental care at school too, doesn’t it?
In fact you may feel at the end of the phone call your this is all arranged by your school system as a service to all the children, included as a normal as the school nurse. Remember the fluoride rinses back in the 1980’s?
You could be lead to believe it’s nothing more than dental hygiene instruction – remember those Bell Telephone movie reels that used to make the rounds at schools? No, well you’re not as old as me then.
If you decide you would like to be there for the event, you’re likely to be told that since they aren’t sure exactly what time Susie will be called, you could possibly be sitting there in the school all day, and you don’t want to be doing that, right? That’s just another classic separate the child and the parent ploy.
Speaking of that “free lunch” list, is that where ReachOut Healthcare got your contact information?
The Greater Pueblo Chamber of Commerce will honor Center for American Values founder Adolph "Rudy" Padula with its annual Citizen of the Year award, the group announced Monday.
The award presentation will take place at the chamber's annual dinner Thursday night at the Pueblo Convention Center. Tickets remain available for the event. For reservations, call 542-1704.
Padula, a Pueblo dentist for nearly 40 years, launched the Center for American Values several years ago. He purchased and renovated The Waterford, a large, aged building on the Historic Arkansas Riverwalk of Pueblo, into a new retail-office building that also is home to the center's meeting room and Medal of Honor portrait display.
BUSINESS BRIEFS: Padula chosen citizen of year - The Pueblo Chieftain: Local Business
UPDATE, 3:30 p.m.: The attorney general's office has 31 orthodontists under investigation for possible Medicaid fraud, David Maxwell, the office's deputy director of law enforcement, testified to the House panel. According to Rep. Lois Kolkhorst, R-Brenham, the panel's chairwoman, 24 percent of the nearly 80,000 children who last year received orthodontic services from Medicaid were under the age of 12. State social services czar Tom Suehs testified that, starting in March, the minimum age for treatment of severe misalignment of upper and lower teeth will be 13. "Some of our providers out there gamed and manipulated the system," Suehs testified. "I won't use the word fraud. ... Clearly, we didn't have some of the controls we should've had."
ORIGINAL POST: Poor youngsters in Texas who were put into braces courtesy of taxpayers saw their orthodontist an average of 22 times in fiscal 2010, state Medicaid chiefs said in testimony they were to give to a legislative panel Tuesday.
"Typically, 12 visits per year is expected," said the written testimony by Medicaid chiefs Tom Suehs (right) and Billy Millwee to the House Public Health Committee.
Read the rest – click below
Hi there,
I saw your post regarding the dentist in Mass that "did a root canal with a paperclip. I am not defending him at all. I just wanted to let you know that the use of a paperclip as part of a provisional crown is a legitimate technique. Now, I have no knowledge of the legitimacy of billing this to Medicaid. Attached is a photograph I just took from Herb Schillenberg's "Fundamentals of Fixed Prosthodontics" 3rd edition. This is the most cited text book on the market on the subject of fixed prosthodontics.
Thank you for your time,
DrJ
Clair will be sentenced on Jan. 30 in Superior Court.
Clair, 53, now of Maryland, was scheduled to begin trial today in Superior Court on a total of 15 charges including fraud, assault, illegally prescribing drugs and coercing office staff to remain quiet about the conduct.
Instead, he offered to plead guilty to two counts of assault, three counts of larceny, five counts of Medicaid fraud, three counts of writing illegal prescriptions, one count of tampering with evidence and one count of intimidating a witness, according to a release from Attorney General Martha Coakley.
Clair remains free on bail pending his sentencing.
Last September(2011) R. Kirk Huntsman’s was featured at a seminar entitled “Beat The Dental Practice Management Companies” Warning attendees of the “Walmart Effect” taking over dentistry.
Yet, among many other ventures in Dental Practice Management, R. Kirk Huntsman has been Managing Partner of Montage Venture Group LLC since March 2010, according to Business Week.
R. Kirk Huntsman Bio from Nexus Dental Alliance, his virtual Dental Management company. Virtual, meaning you just “pretend”, “not real”?
Mr. Huntsman has been active in the dental industry for over 23 years.
Yet, never took time to become a dentist, wonder why? If he was so into it, you’d have thought he would want to actually be one, right?
In 1988, he became the Dallas/Ft. Worth licensee for Associated Financial Transition Consultants, Inc.(AFTCO Associates,) a dental practice brokerage company with over 65 offices nationwide. Within two years, his was the top performing office in the nation. In 1991, he acquired the Houston license and continued to rapidly expand.
By 1995, he was ready to begin owning and operating practices, so he launched Dental One as a dental management services organization, or DMSO.
In 1995, as well as today, it was illegal for a non-dentist to own dental practices! I guess Mr. Huntsman failed to read the following page of info over at the AFTCO website, but it’s easy to see how he could become confused, since it’s written in a lot of double speak BS. Plus, it used the word “Goodwill” which I’m sure is not in his vocabulary. Had the word, “Greed” been used, it would have had his complete attention. Here is what is on the AFTCO’s website:
It was titled Building a business with unwanted customers”, so I guess I had an attitude before I read it.
My first thought was; of all the dental centers out there geared to treat child whose parents have fallen on hard times, why this one?
All the right buzz words and phrases the dental mills use today - “Underserved” and ”Target Patients on Medicaid” for example – were used perfectly. Even the added “nobility” factor was included – “believes that treating the underserved can make for good business.”
By the end of the article it sounded more like a story about a business in the ‘hometown” section of the local newspaper, not CNN Money.
This may be a fantastic dental center, I don’t know. All I know is what I read and it had the sound of a local, one shop, assembly line style dental center. That was until I saw the logo. Continue on and you’ll see what I mean.
Many fake owner dentists have been removed from service, Dr Chu in Phoenix for example has dropped out of sight. Employees have been asking questions for some time and despite denials from company officials, clinics are closing across the county by February 7, 2012. The Toledo center closed the Friday before Christmas. (employees found out by seeing the emails between corporate and Dr. Olivia Croom-stupid woman)
(Dr. Karen Chu is listed as owning all the stock in the Children’s Medicaid Dental Center, PC in Arizona, with William Nash as President and Chu as Vice-president. Of course, Chu owns all of nothing but if I were her, I’d be demanding some further compensation since this is probably the end of the end for her dental career, all the other fake owners as well, like Dr. Monica Switzer in Oklahoma)
The rest of the clinics are up for sale. Their corporate owner-Church Street Heath Management-Small Smiles Holdings- is trying to pawn the clinics off on individual dentists. Surely CSHM is not stupid enough to offer them financing or management services! Surely any individual dentist is not stupid enough to take it! Ask the one dentist who truly does own a piece of his center’s pie. (Not sure, but I believe that is Dr. Michael Crites.)
Financing should be very difficult for any dentist who might want to purchase any of the clinics since the true income for each center will be difficult to obtain, if not impossible.
In cases where Church Street Health Management does hand over the numbers, they will be based on inflated revenue by the corporation's requirements of overtreatment, up coding (x-rays for example) and out right fraud that continues to this day.
To get an accurate idea of what any center's true income is impossible. Not one of the Small Smiles dental centers has ever operated in a honest professional manner, following any guidelines based in anything other than their own greed; first the DeRose family-Eddie, Michael and Dan, then in fall 2006 the Carlyle Group and First Islamic Bank k/n/a Arcaptia.
As for dentist who work there or have worked there in the past, look for lawsuits to follow you for years to come.
For those who did your best to represent your profession well and treated your patients properly , you should have nothing to be concerned about.
For those that fell under the spell and drank the Kool-aid; assisted in the fraud and abused children, you will get what you deserve. People always do.
For the innocent support staff who will lose jobs, get your resume's out now and I would double think mentioning Small Smiles as a past employer and personally I would not be applying at the other mills, Small Smiles is just the first domino to fall.
The clinics include:
Albany Access Dentistry
Small Smiles of Phoenix
Children’s Medicaid Dental Clinics
Texas Smiles
Oklahoma Smiles
Indian Springs Dental Center
On September 20, 2010, I received an email from Todd Cruse, Church Street Heath Management’s SVP of Development and Government Affairs.
“I’ll be in Kentucky next month. Any interest in having a cup of coffee and conversation?’
After a couple of days I finally responded, “I do apologize for taking so long to respond. I've been seeing to my daughter and granddaughter. I was about to reply to your suggestion today when I received a phone call from my attorney telling me Thor Urness wanted my attorney to call him. Upon hearing that, I thought I should wait to hear back from this conversation that Thor requested. However, I've not heard back. Until I hear what Thor wanted, I'm not comfortable granting your request for coffee and conversation. However, I do enjoy a good cup of coffee and am open for conversation.”
Thor Urness is the Nashville attorney who Church Street Health Management hired to harass me in the Federal Court system since November of 2008.
Todd responded back, “Thank you for your response. If at some point you become comfortable and would like to have that cup of coffee just let me know.”
By September 29, Thor had never returned the call my attorney had made to him, so I emailed Todd and we made arrangements to meet up for that “coffee and conversation” he so desired.
Todd said in his return email, “I believe that Thor was following up on the posts that you have since removed so I don’t think Pat will be hearing from him. I am flexible as to where to meet. I have to run up to Bowling Green on Thursday to pick something up - Any interest in meeting me there. I believe there is a Starbucks right on 231 off of I-65 (Scottsville Rd I believe?).Thanks for reaching out.” He closed the email with “TRC”.
I agreed and the meeting was set for 10 am Thursday October 7, 2010.
I find this hilarious!
Ok, kids, now is your chance to tell the world what happens to you behind those doors at Kool Smiles Dental and why they ever needed “quiet” hygiene rooms!
Kool Smiles Playlist:
Raven Marie Blanco died during dental treatment on March 9, 2007. Since that time her family created a foundation that advocates much stricter guideline for medical emergency readiness. Virginia has no requirements other than basic CPR, but dentists regularly sedate children for dental treatment.
March 9, 2012 will be the 5 year anniversary of Raven’s death and on that day, the Virginia dental board will present the petition to its members to enlist comments for or against the petition.
The petition asks that the Six Links of Survival developed in 2003 by the Institute of Medical Emergency Preparedness become part of the license renewal process for Virginia dentists.
You can email the dental board your comments at:
denbd@dhp.virginia.gov
The Six Links to Survival are:
Written by Bill McCleery
An Indianapolis dentist faces fraud charges stemming from an apparent scheme to perform unnecessary dental work in order to collect payment's from Indiana's Medicaid program.
In one case, for example, Arnel J. Gallanosa removed 33 teeth from three patients who were residents of Midtown St. George Residential Facility, said Brienne Delaney, spokeswoman for Marion County Prosecutor Terry Curry.
The dentist also allegedly paid patients small kickback fees for agreeing to receive dental work.
"In an effort to garner more business for his dental practice," Delaney said in a release, "Dr. Gallanosa paid staff members and a 'runner' to recruit new patients who were eligible for Medicaid benefits. The patients would be offered five or ten dollars and 'free' dental work."
The Indiana Medicaid program reimbursed Gallanosa for the services, Delaney said, and patients would have no out-of-pocket costs.
The man hired as the runner for the three patients named in court documents previously pleaded guilty to felony prescription fraud in relation to this case. The runner, Darnell White, kept Vicodin pain pills that Gallanosa had prescribed to the three Midtown residents. He remains on probation, Delaney said, following his conviction.
"A licensed medical professional, such as a dentist, should inspire trust and respect," Curry said in a release. "It is thus particularly disturbing for a medical professional to abuse the trust of his patients and prey upon some of our most vulnerable citizens. We will vigorously prosecute any such fraud and abuse."
Working with police and prosecutors, the Indiana Attorney General's Medicaid Fraud Control Unit investigated the fraudulent Medicaid claims and alleged abuse of the patients in the St. George institution, Delaney said.
Alexandria Dentist Pleads Guilty to Health Care Fraud
January 10, 2012
ALEXANDRIA, Va. –Tuan Vu, 43, of Annandale, Va., pleaded guilty today to fraudulently billing insurance providers hundreds of thousands of dollars for dental services that he did not provide to his patients.
Neil H. MacBride, United States Attorney for the Eastern District of Virginia, and James W. McJunkin, Assistant Director in Charge of the FBI’s Washington Field Office, made the announcement after the plea was accepted by United States District Judge Liam O’Grady.
Vu was charged today by criminal information with health care fraud, and he faces a maximum penalty of 10 years in prison when he is sentenced on May 4, 2012.
In a statement of facts filed with his plea agreement, Vu admitted to committing health care fraud from at least January 2007 to September 2011. Vu is the owner of Cosmetic & Family Dentistry, PLLC, a dental practice located in Alexandria, Va. During the time of his health care fraud scheme, Vu consistently billed dental insurance providers for services that he did not provide his patients. As a result of Vu’s offense, at least 10 private insurance providers suffered more than $400,000 in losses. Dr. Vu’s conduct also resulted in a substantial loss to the federal government and the Commonwealth of Virginia, including $87,389 to the Federal Employee Health Benefits Program and $180,048 to the Virginia Medicaid program.
This case was investigated by the FBI’s Washington Field Office. Assistant United States Attorney Chad Golder is prosecuting the case on behalf of the United States.
A copy of this press release may be found on the website of the United States Attorney's Office for the Eastern District of Virginia at http://www.justice.gov/usao/vae. Related court documents and information may be found on the website of the District Court for the Eastern District of Virginia at http://www.vaed.uscourts.gov or on https://pcl.uscourts.gov.
In the past three weeks I’ve seen more people with resume’s posted online over at indeed.com who list Small Smiles as their current or former employer.
[you can search resume’s. Not sure listing them as a former employer is a plus, personally, I would reconsider]
What is that saying?
Well, it tells me clinics are closing, being sold off-piece mill, massive layoffs are happening, or it’s very possible it could be all of the above.
Toledo closed the week before Christmas. One of the Oklahoma City centers closed a few months ago. I heard this week the Lead dentist (fake owner) in Phoenix, Dr. Karen Chu, enjoyed her final day last Friday, December 30,2011.
Add in the CEO and President, Michael G. Lindley and Al J. Smith, being fired along with at least one regional manager; it sounds like things are rocky, to say the least, at Church Street Health Management and their string of Small Smiles dental clinics.
This is pure speculation but the Carlyle Group could be purchasing a larger piece of the Small Smiles brand pie. Can you say “bailout”?
What I’m confused about is just how they can “sell” clinics they claim they do not own. After all, they claim individual dentists “own” the clinics and CSHM simply “manages” them. [liar, liar pants on fire] I’m suspecting if these clinics are ever sold, the IRS will have a field day!! In fact, I’m shocked the IRS hasn’t already had fun trying to figure out how Dr. William Nash came to own all these clinics in the first place and then he supposedly sold them to other individual dentists. He still remained as either president or secretary of all the various entities that have been created.
If I’m not mistaken one “owner” dentist claimed under oath, and penalty of perjury, they purchased their three clinics directly from Dr. Nash. However, under oath, they weren’t sure when they purchased them or just how much they paid for them. Bahahahah!
There is no doubt Arcapita Bank has experienced buyers remorse from day one. There are literally hundreds of legal claims and lawsuits against Church Street Health Management, their Small Smiles Dental Centers and various employees, and many more on the horizon.
This is just a guess, but they have probably wanted to cut the tongue out of the attorney who told them this illegal operation was legit in the first place. Since this person was irresponsible at the least and guilty of malpractice at the most.
In light of everything, any one would be foolish to buy any of these centers or this company as a whole.
I would also me very worried if Church Street Health Management or any of their individual Small Smiles Dental Centers owed me money. Personally, I’d me headed to 618 Church Street in Nashville, Tennessee and asking for a cashiers check immediately!
Yep, blogging of all things. Not just one blog, but two of them.
Karen Chu, DMD Blog
Phoenix Small Smiles Blog
On one of her blogs, Dr. Chu gives the public a fun “how to ” tip to help parent prepare children for their first dentist visit, to her I suppose. (you’ll see what I mean)
She recommends story time saying:
“Much of the fear and upset young children experience on those 1st appointments come from having no "frame of reference" for the strange environment, strange people and even stranger actions happening to and around them.”
To further assist she’s taken the time (a lot it appears) to put together a little slideshow/visual aid to help parents spin a fun,yet accurate, fairy tale. It’s absolutely delightful, you’ll see.
Dr. Chu’s profile says she believes every child should have a beautiful smile. I 
Being that Dr. Chu is an “owner dentist” she must be quite loyal to the corporate heads, they only allow those they can truly trust or blackmail to be “owner dentists” I think. She was one of their top producers in 2010 that’s for sure. However, she is not indispensible, her last day was Friday December 28, 2011! Whoop Whoop!!
(it’s likely when I post this, the blogs will disappear within minutes, but not to worry, I have the nice slideshow presentation backed up if necessary)
Posted by Frenchpotato
The reason they can take advantage of you is simply because there are too many dentists, and a lot more are coming down the pike.
The ADA does not care. The ADA has really disappointed me. ADA automatically gives all these new schools provisional accreditation.
I hope I live long enough to see dental schools start closing as they did in the 1980's. Maybe I will live long enough to see people wake up and stop joining the ADA.
BTW, when I was being encouraged to join the ADA, other dentists would say, if you do not join and you are ever sued, the opposing attorney will say, "she is not even a member of the ADA."
Seriously, I would like to hear ONE good reason to be a member of the ADA.
This was posted on a dental forum/message board back in April 2011:
A friend of mine is an associate for a dental office. There are two doctors working that day, he and the other doctor ( i will call her Sue). Dr. Sue attempted to perform a surgical extraction #17 on the patient. The patient is 39 yr old male. After spending some time unsuccessfully trying to remove tooth, Dr. Sue decided to stop and refer to OS. Pt. was dismissed from the chair, and walked to front desk to reappoint with OS. Pt. complained of dizziness shortly after. He went to use he restroom. Dr. Sue didn't want to enter the restroom so she asked my doctor riend to check on him. He went and checked blood pressure of patient. Pt. had bp 250/110 and called paramedic. Without going further into detail, Pt. was taken by paramedic. My friend doctor found out later the pt. had hx hypertension and didn't take his bp meds that day. Also, my friend found out only later that night pt also fell while trying to use restroom. Pt. had surgery for something in his head (no specific details given) in ER and went into coma. Apparently he never came out and passed away a month later. My friend said Dr. Sue never checked her pt. med hx prior to procedure. No blood pressure was taken either prior to work and no consent forms were signed for extraction procedure. Dr. Sue did state in her notes that she administered local anesthetic with epinephrine and she stated same to paramedic upon questioning by them. My friend was the one who took the pt. blood pressure and called 911, helped get Oxygen for pt and stayed with patient. Dr. Sue was working on another pt the whole time and didn't come out until paramedic came. It seemed she defer all responsibility to my friend when it was her patient. What type of legal repercussions will this have on Dr. Sue or my friend doctor. I know he was not the treating doctor but since this is involved a pt. death what is going to happen legally here for everyone? The owner of the dental office is neither Dr. Sue or my friend.
Beth A. Dorain, DMD
Lafayette, Colorado
Employer: Perfect Teeth
Management Company: Birner Dental Management Service, Inc – Mark Birner, DDS-President
I am working for a corporate chain. I do not like it, and I thought they were jerks. The CEO called to yell at me about October's low production. (FWIW, there were many legitimate reasons for the low production in October.) Not worth listing here. Production more than doubled in November. The next day, he called to say he was going to change my compensation to purely a percentage of production. After the first phone call, I was 100% certain that I was going to quit in short order. So, I went ahead and signed it.
Now, I've come to realize that I make 30% of insurance reimbursements and patient's co-pay. The problem is that they take a lot of DMOs with capitation checks. I spend a lot of time doing exams, fillings, etc. and discovered that there is no re-imbursement for those procedures. The compensation for the work comes in the cap check. But, they will not give me ANY percentage of that cap check. I did not realize that I was doing exams, fillings, etc. FOR FREE. In many cases, the fillings are $0.00 or the co-pays are ridiculously low.
For example, I did three anterior root canals on one patient. The total reimbursement for it was $120.00. So, I made $36.00 for the three root canals.
Is it even legal for this organization to expect me to work for FREE.
My contract does say (excludes capitation check)
I'm getting a lawyer!!!!!!!!
I did forget to mention one very important detail, one month after I signed the Addendum, I did get another offer which I accepted. However, I am supposed to give my current employer 90 days notice (which I did on December 15. That keeps me in "jail" until mid March. I am hoping to not honor those 90 days due to the language of the original agreement.
A very disturbing search term that was used December 29, 2011, that brought someone to my site. The person was from Jackson, Mississippi and used the term “child overdoeses at kool Smiles” IP was 76.107.149.87
If you have information about this, please email me at cckaddie@yahoo.com
Dr. Jay Jensen is now unleashing his dental care to the citizens of Leander, Texas, and apparently he has a problem with quality. He just paid a $5000 fine to settle one complaint and there are three more complaints against him. He’s employed at Crystal Falls Dental. For some reason, this guy still has a dental license!
November 28, 2011
WEST DES MOINES — A former West Des Moines dentist has been fined $5,000 over allegations he provided poor care.
The Des Moines Register reports Dr. Jay Jensen agreed to pay the fine to settle the case filed in 2009 by the Iowa Dental Board. He's accused of making several mistakes during a full-mouth reconstruction.
Jensen used to own Restoration Dental. His attorney says he's moved to Texas and now practices in the Austin area.
Meanwhile, another West Des Moines dentist has surrendered his license to the dental board after admitting to a relapse into alcoholism. Dr. Bruce Krook says he hasn't been accused of poor care and hopes to have his license reinstated in the future.
05771 LACL117004
ADRIENNE BOYD & BART BOYD VS JAY J JENSEN DDS ET AL
JENSEN DDS, JAY J
DEFENDANT
05771 LACL118969
SANDRA EGLI VS JAY J JENSEN DDS ETAL
JENSEN DDS, JAY J
DEFENDANT
05771 LACL120790
ZSUZSANNA F ASCHOFF & JAMES ASCHOFF VS JAY J JENSEN DDS ETAL
JENSEN DDS, JAY J
DEFENDANT
05771 LACL123316
DIANE J ROBERTS VS JAY J JENSEN DDS AND RESTORATION DENTAL
JENSEN DDS, JAY J
DEFENDANT
