Las Vegas Dentist Pleads Guilty to Health Care Fraud

8 NEWS NOW

Posted: Jul 19, 2012 6:42 PM CDT
Updated: Jul 19, 2012 10:55 PM CDT
By Steve Kanigher, I-Team Reporter - email

Las Vegas Dentist Pleads Guilty to Health Care Fraud

LAS VEGAS – A dentist and his office manager pleaded guilty this morning to felony health care fraud for submitting false claims to a labor union's insurance administrator for dental work that was not performed, Nevada's U.S. Attorney Daniel Bogden said.

Mauricio Vargas, 50, and Enoc Adrian Renteria, 33, both of Las Vegas, pleaded guilty to one count of conspiracy to commit health care fraud. They face up to five years in prison and a $250,000 fine, and are scheduled to be sentenced Oct. 17 by U.S. District Judge Gloria Navarro.

According to the plea agreements, Vargas as a licensed dentist who operated AV Dental in Las Vegas, and Renteria as his office and marketing manager, conspired with an employee of Laborers Union Local 872 to submit false billing claims to the union. Local 872 is self-insured and contracted with a third-party administrator to adjudicate and pay claims on behalf of union members.

Dr. John G. "Jack" Vondrak’s Sun Orthodontix abandon possible 4,000 patients.

 

EL PASO, Texas – KVIA TV Part 2

Parents of former patients, an attorney and Health and Human Services are claiming a chain of orthodontics clinics are committing patient abandonment.

After Texas Medicaid cut off reimbursement to Sun Orthodonix, amid a fraud investigation by the Texas Office of Inspector General, the chain of clinics in turn cut off treatment to its Medicaid patients still in the midst of orthodontic treatment.

The move has left hundreds of teens and adolescents with braces on their teeth but no doctors treating them.

One El Paso orthodontist estimates up to 4,000 El Paso kids could be affected from the response from Sun Orthodontix and other local clinics which may be doing the same to their Medicaid patients.

Not having a doctor is a hard fact to swallow for two Northeast El Paso teens well into their orthodontic treatment they had be undertaking with Sun Orthodontix.

The pair has fought through the discomfort of braces, the pain of tooth extractions and even the stretching of their mouths by orthodontic devices.
"He ran a fever he was in pain, he didn't eat," the boys' mother Emma Diaz said about her 14-year-old, Issac. "And now it's like we go through all of that and what now?"

Diaz says her sons showed up to their routine orthodontics appointment at Sun's Northeast El Paso location in June, where they were handed letters giving the boys two options: have the braces removed by Sun, or leave the braces on and find another orthodontist.

"It would be considered patient abandonment," Health and Human Services Commission spokeswoman Stephanie Goodman said. "And it's true for dentists, orthodontists, doctors, it's fairly standard across the medical profession."

A patient contract obtained by ABC-7 from when a teenager first got her braces at a Sun Orthodontix clinic in El Paso reads:
"Good news! Once the braces have been placed, your treatment is fully covered. Even if you happen to lose your insurance, by keeping your monthly appointments, you are guaranteeing that your insurance will continue to pay for services rendered."

But even though the patient kept her appointments, as soon as Medicaid cut its payments to Sun Orthodontix, a subsidiary of National Orthodontix Mgmt, treatment was cut as well.

Sun Orthodontix's attorney, Frank Sheeder, would not address this "guarantee," but he did say the clinics are following the process for terminating and transferring care.

Sheeder says the state pre-approved the treatments, then without warning, put a hold on Medicaid reimbursement five months ago.

In an email, Sheeder writes:
"An orthodontic practice can't reasonably be expected to continue to provide services for free for such a long time."

In the letters to patients, Sun states that it has been forced to lay off more than a hundred employees and four orthodontists.

Still, Goodman says lack of payment should not translate into lack of treatment.
She says doctors have a professional obligation to finish what they started or they could face consequences.

"In those cases where we have an orthodontist, who is accepting Medicaid, put braces on a child or did any treatment, in most cases braces, and now says that because the payment's not there, 'I'm not going to continue the treatment'? We will be referring those to the dental board, who we're working very closely with," Goodman said. "And they've assured us they will move on those cases."

That assurance is not of much comfort to 16-year-old Andy Diaz.
He has had four teeth extracted as per his course of treatment prescribed by his orthodontist at Sun Orthodontix.

He has been left with the braces on his teeth and big gaps where his teeth used to lie.

"If they can at least just close the bottom ones, I'd be happy," Andy Diaz said. "You can't leave a kid with gapped teeth."

They already have, but for how much longer is the real question.

ABC-7's Matt Dougherty spoke with the owner and founder of Sun Orthodontix, Dr. John G. "Jack" Vondrak, when he was in El Paso recently.
Vondrak refused to comment on the record.

From Sun Orthodontix Website:

Dr. John Vondrak is the founder of Sun Orthodontix. His experience as a practicing orthodontist, that spans over three decades, and his commitment to provide families of all income levels with affordable, quality care have been instrumental to Sun's growth and success. Dr. Vondrak continues to treat patients and oversee the training of new orthodontists in Sun's specialized method of treatment.

Dr. Vondrak earned his orthodontic degree from Howard University School of Dentistry in Washington D.C. and completed his internship in oral surgery at Louisiana State University Medical Center in New Orleans. Dr. Vondrak received his Doctor of Dental Surgery from the University of Nebraska in Lincoln and served in the U.S. Air Force as a dental officer before entering private practice.

Dr. Vondrak is a past president of the New Mexico Orthodontic Society and a member of the American Association of Orthodontists (AAO), the Southwestern Society of Orthodontists (SSO), the American Dental Association (ADA), and local and regional dental societies in both New Mexico and Texas.

Dr. Vondrak's wife, Barbara, is herself an accomplished dental professional, who plays an active role at Sun. She holds a Masters Degree in Dental Hygiene Education, has worked as an Accreditation Consultant for the ADA, and has served as chairwoman of the American Dental Hygienist Association's Dental Education Committee.

The Vondraks have two daughters and a son, all of whom live in Texas. Their daughters, Cameron and Clarian, are following in their father's footsteps and are currently enrolled in dental programs. Their son, Greg, is the Project Coordinator for Sun, and their son-in-law, Craig, is the Director of Operations. The Vondraks are the proud grandparents of seven beautiful grandchildren.

Texas Medicaid Orthodontics Mills are abandoning patients–leaving approx. 200,000 children with a mouth full of braces and no one to continue treatment

KIVA-TV El Paso

Big Thumbs Up to Dr. Rick Black for stepping up!

EL PASO, Texas -

Some children are lucky enough to be born with straight, pearly whites, but every year, millions of American families find themselves spending big money on braces.

Braces in El Paso typically run around $5,500 for a three-year orthodontic term.
Medicaid does not pay for cosmetic procedures, but according to Texas Health and Human Services, Texas Medicaid has been paying for cosmetic orthodontics work for years.

Texas Medicaid spent nearly $500 million on orthodontic treatment for children from 2009 to 2010, according to state records.

That is more than all other U.S. states spent on Medicaid orthodontics combined.

The vast majority of the cases paid for by Texas Medicaid were cosmetic cases, an HHSC spokesperson said.

In response to a public outcry and an investigation exposing the spending by WFAA-TV in Dallas, HHSC stopped all payment to some of the highest billers of Texas Medicaid, which a spokeswoman says have committed fraud.

"If they find credible evidence of fraud, where it appears a provider knowingly submitted incorrect information about cases, they can put a payment hold on them," HHSC spokeswoman Stephanie Goodman said. "And that's what they've done in this case.

Medicaid does not pay for cosmetic orthodontics, only for cases where the child cannot eat or chew his food properly.

Such cases would be children with cleft palate, Down syndrome, or cases where the child has had severe facial trauma due to an accident.

Goodman says fraudulent claims were made, making cases appear more severe, so that they would pass through Medicaid's approval process.

This scenario happened so frequently, eventually racking up a bill of nearly half-a-billion dollars in three years, Medicaid now admits its contractor reviewing the cases was negligent.

One local group of orthodontics clinics, currently under investigation, has now stopped treatment for around half of their patients.

"We're in the midst of treatment! You're just going to abandon my kid?" Erika Mendoza, mother of a Sun Orthodontix Medicaid patient said.

Marcos Mendoza, 12, had his braces put on by Sun Orthodontix almost a year ago.

His mother said his crooked teeth made it necessary for him to get braces, and she said a doctor at Sun Orthodontix told her the braces would be paid for by Medicaid.

Now that Sun has discontinued treatment to Marcos, Erika Mendoza says she is scrambling to find another orthodontist to treat him.

Sun Orthodontix, with four locations in El Paso, is among several orthodontia clinics being investigated for fraud by the Office of Investigative Affairs.

Sun's location in Las Cruces is not included because the investigation is limited to the state of Texas.

In a statement provided by the company's attorney, Frank Sheeder, Sun Orthodontix blames the mess on Medicaid for signing off on the treatments in the first place.

"Our orthodontists were required to submit forms, x-rays and photographs of the patient to Texas Medicaid before they were permitted to provide treatment," the statement reads. "These abrupt changes make it impossible for our orthodontists, and for many others, to continue to serve children in the Medicaid program."

In the meantime, patients like Marcos are scrambling to find new orthodontists.

ABC-7 called a number of Medicaid-accepting El Paso orthodontists to see if they are taking Sun Orthodontix transfer patients.

All of them said 'no,' except one orthodontist.

El Paso orthodontist Dr. Rick Black says he is already taking former Sun Orthodontix patients -- reevaluating their cases, and resubmitting their claims to Medicaid.

We asked him what he would do if payment was suddenly cut off from a case he had initiated. "I think, Matt, you kind of get what you ask for -- in other words, even in private practice, even though I'm a Medicaid provider and I had a small amount of Medicaid patients before this happened -- I feel an obligation," Black said. "When you start a patient, regardless of what happens, especially money, you are obligated to finish that patient."

It is a practice that Sun Orthodontix is apparently unwilling to honor in Marcos' case.

Want to hear a real crock? …

By Jim Cross
PHOENIX -- An ABC News investigative report found some states require very little for dentists to be certified to administer sedatives to children and that 12 children have died nationally after being sedated by dentists.

Arizona dentists face some of the toughest standards in the nation. Kevin Earle is executive director of Arizona Dental Association and said if parents have fears make sure their dentist is board certified.

"If you go to a board-certified pediatric dentist you can be certain the individual has had proper training. Where the concern lies is with individuals who have not had that extensive training.

"The use of oral sedatives have become much more common in the past 10 years so if you have a general dentist who graduated more than 10 years ago, there is an obligation to have more extensive training before they proceed with using oral sedatives."

Earle said board-certified dentists are trained to deal with any emergency.

"There's a rigorous permitting process that includes having proper equipment on site in case there is an incident and having proper medication in case there's a reaction. The assistants are trained to react quickly in the case of an incident."

"We're lucky here in Arizona that those have been in place for more than 10 years."

Earle said to the best of his knowledge there has never been an incident involving the administering of oral sedation.

Jim Cross, Reporter

HIV, Hep A, B or Death.. no line not crossed in dentistry out of pure greed.

This blog has spent the last four years trying to drive home the fact that dentistry in the 21st Century is based on greed with little sign of healthcare considered before treatment.  (no, not everyone) but it is becoming the norm. So much so that madness as reported here has become acceptable.  The ADA and most of its members has remained silent.  This is yet another black mark on what was once a noble profession.

There are over 1100 blog posts here about the corners that are being cut and those who are cutting them.  Yet, today I continue to have to report crap like this!  Why? Why does everything lead back to Colorado? This time, Stein's Oral and Facial Surgery and Dr. Stephen Stein.

July 12, 2012
DENVER -- Patients of a Highlands Ranch and Cherry Creek dentist were advised Thursday to be tested for HIV, hepatitis B and/or hepatitis C.

CALL7 Investigator John Ferrugia began asking questions of the state health department early Thursday and the department made its investigation public Thursday afternoon.

The Colorado Department of Public Health and Environment issued the advisory urging anyone who was a patient of Dr. Stephen Stein, who practiced oral surgery at his practice in Highlands Ranch and Cherry Creek, may have been exposed if they received intravenous medications, including sedation, under Stein’s care between September 1999 through June 2011.

The health department said patients may be at risk if they were seen by Stein during the 12-year period and at these locations:

- September 1999 to June 2011 at Stein Oral and Facial Surgery, 8671 S. Quebec St., #230, Highlands Ranch, Colo. 80130

- August 2010 to June 2011 at Stein Oral and Facial Surgery, 3737 E.1st Ave., Suite B, Denver, Colo., 80206. Patients were also seen at this location by Stein under another name, New Image Dental Implant Center.

The health department said there have been no specific infections linked to these offices, so far.

Investigation Found That Injection Needles Were Reused

The department began its investigation following a report of unsafe injection practices. Upon investigation, it was determined syringes and needles used to inject medications through patients’ IV lines were saved and used again to inject medications through other patients’ IV lines. This practice has been shown to transmit infections.

The investigation continues. State health officials are working with health officials at Tri-County Health Department and Denver Public Health due to the locations of Stein’s practices in those counties.

Practice Closed, Stein Not Practicing

Stein Oral and Facial Surgery is closed. Stein entered into an Interim Cessation of Practice Agreement with the Colorado State Board of Dental Examiners at the Department of Regulatory Agencies on June 24, 2011, and currently is not practicing.

In the original action from 2011, the state found “the public health, safety or welfare imperatively requires emergency action.” Because of privacy issues, the state won’t release details about the complaint to Call7.

Maulid Miskell, DORA Program Director, says that the agency continued to investigate Stein’s practice. In April 2012, the agency notified Colorado Public Health about the Stein possibly reusing needles on patients.

"It’s related but unrelated. It’s hard to talk about. I can’t go into detail, but the information provided to them, as soon as we found out about that information, it was timely reported to them," Miskell said.

Under this agreement, Stein can hold a dentistry license, but he cannot practice because no final action has been taken in the 2011 complaint.

The Highlands Ranch office was purchased by another oral surgeon in September 2011. State health officials have determined that the reuse of needles and syringes on multiple patients in Dr. Stein’s offices did not continue past June 2011.

8,000 Letters Sent Out To Former Patients

CALL7 Investigator John Ferrugia reported that 8,000 letters have been sent out to former patients of Dr. Stein. The letters should be received within the next few days, the health department said.

However, records may be incomplete, so any patients who remember receiving IV medications, including sedation, at one of Stein’s offices between the dates listed contact their health care provider to be tested as a precaution.

Patients who are uncertain if they received IV medications should also be tested.

Patients who did not receive IV medications do not need to be tested. Members of the public can call 1-877-462-2911 or visit http://www.cdphe.state.co.us/ for more information.

People infected with viruses such as HIV, hepatitis B and hepatitis C may not have symptoms for many years, so it is possible patients might have been infected and not know it. Even though patients who may have been exposed may not feel ill or remember getting sick, they should get tested. Although testing cannot determine where or how someone was infected (at Stein’s offices or from another exposure), it is important to know so treatment can begin.

Health providers who test Stein’s former patients are being asked to report any tests positive for HIV, hepatitis B or hepatitis C to their county health department or the state health department and to specify the patient was tested as a result of unsafe injection practices at Stein Oral and Facial Surgery. HIV, hepatitis B and hepatitis C are reportable conditions in Colorado, meaning they must be reported to public health authorities.

Former Patient "Angry," Felt "Instant Denial"

Shannon Stamey saw Stein for a dental implant in 2008. She found out about the potential health scare when she read it first on the 7NEWS Facebook page.

"I got on Facebook and saw on 7NEWS that Dr. Stephen Stein's patients should be tested for HIV and Hepatitis," said Stamey. "I immediately, actually, began shaking. I was with my young son. I talked with my husband on the phone. But definitely, instant denial."

Stamey has a weakened immune system and because she receives blood transfusions every three weeks, she already gets tested for HIV and Hepatitis.

"They just tested me in May and said I'm in the clear, most likely, because this was four years ago," said Stamey. "I'm just very angry for everyone else who has to go through this. I definitely can't imagine waiting to go into a doctor's office and get tested and waiting for those results. That would be very stressful."

She also doesn't understand how this could have been going on for 12 years with no one coming forward.

"How could people working in the office not say anything? And I just don't understand why. I mean, I don't know if it was a money thing? I don't think syringes cost that much," said Stamey. "I don't really understand how someone could do that or why you would do that and why no one would speak up for 12 years."

More Info: http://www.cdphe.state.co.us/dc/Epidemiology/dentistFAQs.pdf or call 1-877-462-2911.

In all fairness Malouf did take his business model from the DeRose family in Pueblo, Colorado… and they have their own footballs stadium and city for that matter…

Who said you can’t make any money seeing to the oral health of our nations poor.

WFAA-TV Byron Harris reports:

WFAA

Posted on July 12, 2012 at 10:30 PM

Updated today at 9:37 AM

DALLAS - The Texas Medicaid dental scandal is moving into a new phase. A construction phase.

One of the dentists charged with fraud in billing Texas taxpayers tens of millions of dollars for unneeded braces on children is in a new spurt of expanding his mansion.

He's building a water park on the property.

It's happening out of public sight, among the high-dollar homes on Dallas' glitzy Strait Lane. All the homes are big here, but the home of dentist Richard Malouf, former majority owner of All Smiles Dental Centers, is even bigger.

Plans for the expansion are on file with the Dallas Planning Commission.
"There's going be a gymnasium, a rock climbing wall," said real estate columnist Candy Evans. "There's plans for a bowling alley upstairs. There's going to be exercise rooms."

The complex, which began taking shape six years ago, began with one chateau. Malouf's Medicaid dental empire was expanding, and he sold a major share to a private equity fund.

Now he's sinking his earnings into a new mansion next door, along with a private Schlitternbahn in the back acreage, along with a second swimming pool to match the one at the original mansion.

All this is happening as two suits charge Malouf with massive fraud, brought by the Texas Attorney General and private attorneys under the False Claims Act.
Attorney Jim Moriarty is one of a consortium of attorneys in the action, led by Waters & Craus in Dallas. They say samples of Malouf's records show that 100 percent of his Medicaid claims were false.

"Frankly, it borders on being obscene," Moriarty said of the mansion expansion. "The taxpayers of the State of Texas paid to build that house, and are paying to expand that house for a guy who claims to have made his money treating the people of Texas."

"I think the only other park I know of is in Jupiter, Florida," Candy Evans said.
That one belongs to singer Celine Dion. A comparison of photos of Dion's estate with those of Malouf's, obtained by News 8, show that Malouf's water park may be bigger.

In Texas, a family's home is immune from seizure. But the lawyers in the false claims action against Malouf say his home may be fair game.

"If that home is purchased with stolen money, or that home is based on money that has been earned by falsehood or deceit, then that home is not protected at all," Moriarty said.

Malouf has several groups of attorneys, since his former company, All Smiles, is in bankruptcy in addition to his pending false claims suit. His most recent criminal attorney did not get back to us.

Related:

• Candy's dirt real estate blog
• Texas AG lawsuits spurred by WFAA dental investigation
• All Smiles Dental Center files for bankruptcy following investigation
• Texas Medicaid dental program pays millions for crowns, fillings
• Texas doctor accused of Medicare, Medicaid fraud gives up license
• Medicaid recruiters scramble for Texas dental patients
• Outrage on Capitol Hill follows News 8 Medicaid probe

Who is the new Texas Coalition of Dental Support Organizations?

Five Private Equity firms, who are steadily marking their territory, it’s not a coalitions, it’s a cartel.

 

 

Coalition Launched to Protect Texans' Access to Quality and Affordable Dental Care

PR Newswire

AUSTIN, Texas, July 9, 2012

AUSTIN, Texas, July 9, 2012 /PRNewswire/ --  Leading providers of dental office administrative support services today announced a new group called the Texas Coalition of Dental Support Organizations (TCDSO).

Members of the coalition - known as dental support organizations or DSOs - help increase access and lower the cost of dental care for Texans at a time when access and affordability are a critical challenge for many Texas families: Texas currently ranks among the bottom eight states in the number of dentists per 10,000 residents, according to data from Kaiser State Health Facts.

TCDSO members provide vital business and administrative support services - including facility maintenance, supply management, billing, scheduling, accounting, taxes, payroll and marketing - that simplify the process of running a dentist office and enable dentists to spend more time caring for their patients. 

ABC News - Death, Greed at the Dentist: American Children at Risk

By MEGAN CHUCHMACH (@megcourtney) and BRIAN ROSS (@brianross)

July 12, 2012

Death, Greed at the Dentist: American Children at Risk

American children are being put at risk by inadequately trained dentists who often seek to enhance profits by sedating their young patients for even routine tooth cleaning and cavity treatments, an ABC News investigation has found.

In many cases, even well-trained dentists have been unable or ill-equipped to handle emergencies with young patients.

More than a dozen children have died after being sedated by dentists, according to the Raven Maria Blanco Foundation, which seeks to alert parents to the potential dangers of the increasingly widespread use of oral sedatives on patients as young as 18-months old.

ABC World News and Nightline to air segment on pediatric sedation dentistry–tonight July 12, 2012

I know, I’ve posted this before and ABC pulled the story. However tonight I have faith it will air. GMA had a teaser about it this morning. Check your local listings and set your DVR’s.

Richard J. Malouf, DDS adjoining two homes! One $14-mil home isn’t big enough, I bet something else he has isn’t big enough either… Just saying…

Dr. Richard J. Malouf’s over inflated ego is reflected in his newest home addition. He’s adjoining two homes into one, and it will have a “lazy river” ride. I think it may be for practice for his “up the river” ride. But again I’m just guessing. 

Yes, this is the same Dr. Richard J. Malouf whose company stole millions of tax dollars and who has filed bankruptcy. Also the same one who the Texas Attorney General has filed lawsuits against to recover stolen funds.

Looks like Texas taxpayers may have a new “Six Flags Over Malouf” amusement park soon.

Richard J. Malouf, DDS - Adjoining two homes, to include lazy river ride. Practice for "up the river" ride?

Robin Lockwood, DDS pleads guilty in Medicaid fraud scheme with Chad Hoecker owned Ocean Dental Centers

Dentists who are participating in this scheme, at all the dental mills across the country; I didn’t see anywhere in here where Ocean Dental or Chad Hoecker pled guilty did you? Are you guys smelling what I’m stepping in here?

U.S. Attorney’s Office July 11, 2012

• Western District of Oklahoma (405) 553-8700

OKLAHOMA CITY—Robin R. Lockwood, 44, a dentist from Oklahoma City, pled guilty to committing health care fraud, announced Sanford C. Coats, United States Attorney for the Western District of Oklahoma.

Lockwood is a dentist licensed to practice in the state of Oklahoma and was employed under contract by Ocean Dental at offices located at 1610 Southwest 74th Avenue, Oklahoma City. Ocean Dental’s dentists provided dental care to Medicaid-eligible children. The Medicaid Program is a cooperative program that provides federal and state funds to pay for health care benefits for individuals with insufficient incomes to meet the costs of necessary medical expenses. In Oklahoma, Medicaid is administered as “SoonerCare” by the Oklahoma Health Care Authority (OHCA), a state governmental agency. Ocean Dental submitted claims to the OHCA for reimbursement of dentists’ services based on patient treatment notes created by the dentists. Ocean Dental paid Lockwood a percentage of the funds that OHCA reimbursed to Ocean Dental for services she personally rendered.

More Casamassimo propaganda; he needs more money from Medicaid. He says the same crap year after year, and never is enough ever enough. Kinda of like a drug addict chasing the dragon isn’t it.

I’m so sick of people like Paul Casamassimo, DDS spewing his bullshit. He has a vested monetary incentive to mouth off this crap and people just keep right on publishing it. Amazing! I’m sick of him and the elites like him saying people on public assistance are no show losers. And I’m sick of him trying to say the American taxpayer should pick up the bill for doctors who have missed appointments, or empty chairs as he puts it.  Empty chairs may be a problem. Shit, don’t have 14 chairs you need to fill, Dr. Cass-ass! Think about it, you fool! BTW, are you still on the “advisory board” of that child abusing, scumbag company Small Smiles Dental?? If Cassamassimo would stop helping corporations steal Medicaid dollars to line their pockets there might be more money for us to pay for empty chairs and those missed appointments. Of course, that’s just how I see it… and I’m an idiot…so who cares what I think, right?

 

Dentists, Medicaid don't mix
Dental care for poor faces challenges of culture, funding

Marionstar.com

You're at a job interview, so smile. But if you're missing teeth, you're less likely to get hired.

Ohio's Medicaid-eligible population largely ignores dental health, dental professionals say. This means minor problems turn into big problems, which frequently end up with the dentist yanking out the problematic tooth.

Texas Attorney General, Greg Abbott, seeks to recover millions from Dr. Richard Malouf and All Smiles Dental Centers

In March Dr. Richard J. Malouf agreed to pay $1.2-million to settle fraud charges in Texas. That was just the beginning for Dr. Richard Malouf’s woes.

Dr. Richard J. Malouf and Valor Investment thought they could create enough shell companies to hide their flagrant fraud of the Medicaid system in Texas. They thought wrong.

Initial reviews of records seem to indicate 90% of the services for which Dr. Malouf and Valor billed Medicaid, did NOT meet standards and were unnecessary. In other words, 90% of Dr. Malouf’s income was stolen from taxpayers, not just Texas taxpayers but all taxpayers. (Medicaid is funded with both state and federal funds)

Laws in Texas, as in most states,  say that each defendant is liable for the amount of payment they obtained either directly or indirectly from unlawful acts-fraud. They are liable for:

• Two times the amount of the payment,
• Interest,
• Fees,
• Expenses,
• Cost incurred by the AG and the Whistleblower to investigation and recover the stolen funds.

In two Whistleblower suits recently unsealed the following corporations, professional corporations or limited liabilities are named:

All Smiles Dental Centers – ASDC Holdings, LLC owned by Valor Private Equity in Chicago, IL.
All Smiles Dental Center, Inc owned by ASDC Holdings, LLC
All Smiles Dental Professionals, PC – Dr. Adrian Codel
Dr. Richard J. Malouf, DDS
Lewisville Smiles, PLLC
St. Francis Smiles, PLLC
Garland Road Smiles, PLLC
Jacksboro Smiles, PLLC
Jacksoboro Smiles by Wire, PLLC
Valleyview Smiles, PLLC
Plano Minyards Smiles, PLLC
Haltom City Smiles, PLLC
Haltom City Smiles, PLLC
Haltom City Smiles, PLLC dba All Smiles Dental & Orthodontics
Northwest Highway Smiles, PLLC
Fort Worth Smiles by Wire, PLLC
Garland Road Smiles by Wire, PLLC
Garland Road Smiles, PLLC dba All Smiles Dental and Orthodontics
S. Hampton Smiles, PLLC
Park Plaza Smiles, PLLC
Park Plaza Smiles, PLLC dab All Smiles Dental and Orthodontics
Richard J. Malouf DDS P.A
Richard J. Malouf, DDS P.C.
2009 Strait Land Family, L.P.
Camelia Family Limited Partnership
RGS Dental Management Services, LLC
RMAL Holdings, LLC
Discount Dental Supply, LLC
As Property Holdings, LLC
M5 Holdings, LLC
Hypermart Lot 6, LLC
Dr. Raffy Kouyoumdjian

(the guys highlighted should go on a no fly list, they may try to skip the country)

The number of people and companies Greg Abbott has named blows the number entities the Connecticut AG filed suit against in May off the charts – Conn AG files suit against dental practice over billing – 28 named. This would make for a great reality TV series – “Battle of the Attorney General’s” or '”Operation Bring Back the Bacon”

Anyway, hats off to Texas AG Gregg Abbott for trying to bring the bacon back home. With any luck at all his office will be covered up with these suits.

 

April 2012 Ellis Whistleblower Lawsuit

---

June 25, 2012 Whistleblower suit

Castillo Whistleblower Lawsuit

Yes, Malouf is trying to escape these claims by filing bankruptcy. Let’s see how far that gets him in this case. Just remember, Salmon swim up stream.

Story of child abused by ReachOut Healthcare America Big Smiles Mobile Dental Van pulled from MyFox Phoenix website. Why? Someone’s got some ‘splainin’ to do!

On June 12, 2012 MyFox Phoenix aired a nearly 10 report on ReachOut Healthcare America’s mobile dental clinic abusing a Camp Verde, AZ special needs child.

Below is what the webpage looked like the day the story aired.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

This is what the website looks like today, no video investigation to be found.

POOF! GONE!

They did manage to leave up some comments from an under-educated person who calls himself Dale Earnhardt, which is slanderous, to DE, by the way.

The promotional post MyFox Phoenix put up on their Facebook page about the story also seems to be missing.

Just after this story aired, I heard that many parents called in with similar complaints, even some insiders contacted Fox 5 ready to blow the whistle on ReachOut Healthcare. So many in fact that MyFox Phoenix was doing a follow-up story with more damning news about ReachOut . It was so explosive they thought it would be picked up by the National network.

What happened, MyFox Phoenix? What did you do with all that evidence of child abuse that came pouring into your station? Why will you not return the Gagnon’s phone calls.

There may be good reason it’s gone, but I’m not finding it!

I think MyFox Phoenix might have some ‘splainin’ to do!

Yeah, it’s quite a story, just wondering if the pulling of this story from the Internet is an even bigger story!

It’s not like this was some little 45 second news story about a fender bender at the corner of Walnut and Main. This was (is) a HUGE story that had been worked on for a very long time! 

So who pressured MyFox Phoenix to remove it…?  Let me guess….

To contact MY FOX Phoenix:

KSAZ FOX 10 & KUTP My45
511 W. Adams Street
Phoenix, AZ 85003
MAIN LINE: (602) 257-1234
NEWS ROOM: (602) 262-5109
WEB SITES:
www.myfoxphoenix.com
www.my45.com
www.mydatingplacephx.com
MOBILE SITE:
wap.myfoxphoenix.com

 

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(Love this one, “Had Enough”, just not too much it appears!)

Someone unemployed?

 

The state of Texas is not done with Dr. Richard Malouf–Orthodontics Fraud King of Texas - and his All Smiles Dental Centers

 

 

FOR IMMEDIATE RELEASE
Contact: Brandy Dietz
bdietz@waterskraus.com
800.226.9880

Waters & Kraus Client Takes on Dental Medicaid Fraud in Texas

Texas AG Joins Whistleblower Lawsuit Against Dallas Dentist and Dental Clinics
DALLAS — July 9, 2012 — Dallas-based law firm Waters & Kraus, LLP announces that Dr. Christine Ellis has sued Dr. Richard Malouf and several All Smiles clinics, alleging violations of the Texas Medicaid Fraud Prevention Act.
Dr. Ellis is represented by Waters & Kraus and Jim Moriarty of Moriarty Leyendecker in Houston. Her lawsuit was recently joined by Texas Attorney General Greg Abbott.

"We at Waters & Kraus are proud to represent Dr. Ellis and to be a part of the fight against dental Medicaid fraud," said Waters & Kraus attorney Dan Hargrove. "Whistleblowers like Dr. Ellis represent our best chance to fight serious fraud that drains the public funds and puts important services at risk."

After serving as an auditor for the Office of Inspector General of the Texas Medicaid Program, Dr. Ellis became concerned about dental fraud she had uncovered. When she spoke before the U.S. House Oversight and Government Reform Subcommittee in April, Dr. Ellis testified to a “flagrancy of fraud that is truly unbelievable." Shortly thereafter, Dr. Ellis filed her whistleblower lawsuit.

The lawsuit alleges that the defendants misrepresented to Medicaid the dental and orthodontic treatment they provided, causing Medicaid to overpay them by many millions of dollars. They allegedly submitted claims for services that were not actually provided or were poorly performed, billed for services that were not medically necessary or were more expensive than those actually provided, and unlawfully recruited patients or paid kickbacks to those who did.

Jim Moriarty, of Moriarty Leyendecker, said, “The courage of Dr. Ellis has shown in reporting these allegations deserves the attention and respect of anyone who cares about public health and the responsible stewardship of taxpayers’ funds. We’re honored to work with Waters & Kraus and Dr. Ellis on this important case.”
If the lawsuit is successful, Dr. Ellis will be entitled to 15 to 25 percent of the recovery, in addition to her costs and attorneys' fees. Whistleblower awards encourage people who know about fraud to come forward. The government relies on citizens like Dr. Ellis to identify and fight fraud.

About Waters & Kraus
Waters & Kraus is a national firm with highly skilled lawyers practicing qui tam whistleblower litigation as well as complex civil litigation in four offices, including Dallas, Los Angeles, San Francisco, and Baltimore. Our attorneys have decades of experience successfully representing whistleblowers in a variety of fraud cases. Contact us or call our attorneys at 800.226.9880 to learn more about our practice and how we can assist.

About Moriarty Leyendecker
Houston-based Moriarty Leyendecker has represented thousands of consumers in cases involving allegations of healthcare fraud, consumer defects, and securities fraud during the past 20 years.

Brandy C. Dietz | Public Relations Coordinator
3219 McKinney Avenue | Dallas, TX 75204
Toll Free 800-226-9880 | Phone 214-357-6244 | Fax 214-357-7252
www.waterskraus.com

Kool Smiles Frick and Frack together again…

Appears they have reunited! Unlike Martin and Lewis who never reunited Frick (Tu Tran, DDS) and Frack (Thien Pham, DDS) have found their way back into each others arm.

Tran and Pham broke away from Small Smiles in Colorado back in 2002 and started Kool Smiles. A few years ago, Pham broke away and went off on his own. I heard he was “bought out”.

Thein Pham went on to open a couple of clinics in Arizona called Molar Magic. I hear he scouting out locations in New Mexico to open some clinics. 

 

 

 

Tu Tran, DDS stayed in the Atlanta area and slapped his name on the door of every Kool Smiles in the nation. I’m guessing he must spend his time taking CE’s and renewing his dental license since he has one in nearly every state.

 

 

 

Now, Tran and Pham are reunited and I have proof! I have proof they had “split the sheet” in 2010 and in 2012 they are sharing the sleeping bag so to speak. Maybe sharing a cell.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

You have to admire the copy paper taped to the door these days. It says:

“Kool Smiles Doctors Available to Care for Your Dental Needs Today Are…

Dr. Tu Tran, Dr. Mayfield, Dr. Nkashama, Dr. Jackson,Dr. Duckswork, Dr. Khan, Dr. Ogundipe, Dr. Twardy, Dr. Kalra.

They emphasized “Today”…  but I know dang well all these dentists are NOT available to see to anyone’s dental needs..not today, not tomorrow and not yesterday!

I don’t know what all this means, but you can bet they are up to no good.

Kool Smiles Dental–NCDR,LLC-FFL Partners’ written response to Senators Grassley and Baucus

Anyone buying this load of crap? Of course not. I can’t imagine sitting in my office reading this fairy tale and not getting angry as a wet hen (whatever that is). My blood would be boiling.

Kool Smiles Dental Centers Letter to Senators Grassley and Baucus 02-03-2012

Does your dental malpractice insurance have a $75,000.00 per claim deductible? If you work for Small Smiles it does!

Dentists currently employed by Small Smiles know they are open to lawsuits. The hundreds of malpractice suits on file in three states should make that crystal clear. What might not be so clear is exactly what kind of malpractice coverage they have. It’s not at all what it used to be.

Are you aware you have a $75,000.00 deductible per claim?

 

 

 

One single claim could ruin you and once again, Small Smiles the company, walks away unscathed.

The current policy is set to expire in September. I’m thinking getting your own coverage might be the best option. Never trust that wolf in sheep’s clothing.

Indiana AG filed complaint against Allcare Dental and Dentures

 

Complaint filed against Allcare Dental & Dentures

Jul 06, 2012 WNDU.com

The Indiana attorney general's office has filed an administrative complaint against Allcare Dental & Dentures President Robert Bates for multiple licensing violations.

In January of last year, Allcare Dental & Dentures, which is a national chain of dentist offices, abruptly closed its locations including one in Mishawaka.

According to the complaint filed before the Indiana State Board of Dentistry, the president gave a two-day notice to his Indiana employees that offices would close for two weeks.

Days before the offices were supposed to re-open, he notified his workers that the offices would be closed permanently.

Indiana's attorney general says patients were left without their dentist, their records, dental devices and did not get a refund.

The Indiana State Board of Dentistry will decide if a violation occurred and if so, what disciplinary action there will be.

The board is tentatively scheduled to hold a hearing on the complaint in October.

“We’re finding that these dental practices, under pressure from owners who are not licensed dentists”–Sen.Chuck Grassley.

Senator Grassley says the problem is rooted in the structure of these chains, “I’m finding in this investigation that there are people that know nothing about dentistry are saying you got to see so many people, you got to do so much work for each one, and in a sense, gaming the system,” There are legitimate concerns that children are receiving unnecessary care, sometimes in a traumatic way, and taxpayers are paying for it.”³– Sen. Charles Grassley (R) Iowasaying that it claims that dentists own the practices but in reality they do not have control.¹

The Senator also states, “These “owner dentists” are effectively ghost owners who maintain none of the traditional aspects of ownership of their operations, allowing the corporate investors to have control over clinical operations,” ²

Ghost owners, fake owners, throw away owners, call them what you like.

They are, in truth, are criminals, assisting, aiding and abetting the commission of serious crimes. Crimes against children and crimes against American citizens. Not for free, but for a piece of the pie. They willing lend their name, their professional license and their signature to assist in child abuse, insurance fraud and Medicaid fraud.

On June 21, Robin Lockwood, DDS of the Ocean Dental chain was arrested for Medicaid fraud. She could face up to 10 years in Federal prison.  Robin looks to be about the same age as the Small Smiles dentist below.

As Robin Lockwood, of the Ocean Dental Chain, can attest, when the law comes knocking, they are not going to be knocking on the door at 618 Church Street, Nashville, Tennessee or at NCDR, LLC’s headquarters in Atlanta…

Here is one of Small Smiles Dental Centers “ghost dentist”, that Senator Grassley was referring to – Dr. Jodi B. Kuhn

Doesn’t look much like a criminal does she? She looks like she could be a very loving and protective mom.

Wrong.

She seems to not be loving enough to make sure she is not the next Robin Lockwood facing 10 years of prison time. 

Dr. Jodi B. Kuhn claims to own 7 dental clinics, quite a feat to be so young. She claims to own:

1. SMALL SMILES OF AKRON, LLC - JODI KUHN, DDS AND ELIZABETH GEIER, DMD
2. SMALL SMILES OF CINCINNATI LLC - JODI KUHN, DDS AND ELIZABETH GEIER, DMD
3. SMALL SMILES OF COLUMBUS, LLC - JODI KUHN, DDS AND ELIZABETH GEIER, DMD
4. SMALL SMILES OF DAYTON, LLC - JODI KUHN, DDS ELIZABETH GEIER, DMD
5. SMALL SMILES OF ROSELAWN, LLC - JODI KUHN, DDS ELIZABETH GEIER, DMD
6. SMALL SMILES OF TOLEDO, LLC - JODI KUHN, DDS AND OLIVIA CROOM, DDS
7. SMALL SMILES OF LOUISVILLE, PSC

Small Smiles of Louisville PSC 6-13-2012

  (I see they are still using her rubber stamp signature…and even with all eyes upon you swearing you don’t own the Louisville dental center…this was just filed 2 weeks ago!!)

Dr. Kuhn worked at the Roselawn clinic until October of 2011 when she transferred to the Denver clinic. The Denver clinic was having production issues after a little x-ray scam went belly up and Kuhn is a top producer. Being a top producer, Dr. Kuhn got VIP  tour of the Colorado clinic by Mike Lindley in the flesh. She agreed to the deal and moved to Colorado.

Dr. Elizabeth Kay Geier, another “ghost owner” is the newest co-owner with Dr. Kuhn-there have been others. Dr. Geier comes from the Albuquerque –1 clinic. Geier has been with Small Smiles since August 2007 and was granted a dental license in Ohio in July 2010.

Hey owner dentists, like Jodi Kuhn, Gloria King, Monica Switzer, Randy Ellis, Karen Chu, and others you need to see this. YES, they will throw your butts under the bus in heart beat!!

 

Small Smiles Letter to Senator Grassley 11 29 2011

Small Smiles letter to Senator Grassley's investigators -12 16 2011

 

 

 

^1,2,3 Heath, David. (2012, June 30). “Evidence of overtreatment at dental clinics serving poor children”. Center for Public Integrity - iwatchnews.org

No one has stopped the “Child Abuse for Medicaid Fraud” scheme; not yet anyway.

1997 – Drs. Michael and Eddie DeRose along with Dan “put coke machines in schools” DeRose started opening dental centers to abuse children so they could defraud Medicaid, then build a football stadium in their own honor.

2001 – Dr. Tu M. Tran and Dr. Thien Chi Pham were dentists working at Smile High Dentistry in Colorado. Smiles High Dentistry is part of the Small Smiles Dental chain.

2002 – Tran and Pham were convinced to move to Atlanta and open up Kool Smiles, starting with 2 centers.

2004 – Friedman, Fleishcher and Lowe bought the centers and established NCDR, LLC to be the dental management division of FFL.

2006 – First Islamic Bank (aka Arcaptia aka Crescent Capital) gave the DeRoses $435-million for the dental centers.

2007 – In Georgia two companies who over saw Georgia's Medicaid benefits kicked Kool Smiles out of their network of dental providers for it’s Medicaid patients. Kool Smiles said it was because Wellcare wanted to cut it’s own costs! Wellcare said it was because children being abused for profit and fraud. Georgia agreed with Wellcare, and found over 6% of all Kool Smiles patients files didn’t need the care they received and over 3% of the treatment was substandard.

2012 - We are still where we were in 2007 with Kool Smiles – children abused, substandard treatment, fraud.

With Small Smiles nothing much has moved either. Pretty close to the same as in 2003 when reports of its child abuse first surfaced – 11 very long years have passed and we are zooming toward year number 12.

Kool Smiles continued to grow to over 120 dental centers today Small Smiles topped out at 72 or 73. Hundreds of dentists, who likely worked for one of these mills, broke off and opened their own smaller versions of this business mode- Abuse and Defraud for Profit. Adventure Dental and Vision is just one example. Their “owner” also worked for a Small Smiles Dental Center.

Small Smiles alone, treats 1-million children a year.

There have been numerous news reports on Kool Smiles Dental Centers since it’s beginning. There have been at least 72 73 news reports on Small Smiles Dental Centers since 2003.

Each report, from coast to coast, contained the exact same allegations:

• Children being restrained and physically assaulted.
• Unnecessary overtreatment.
• Parents filing complaints and nothing being done.
• A State or Federal Agency is Investigating.

There have been a few letters mailed out scolding the business practices, a tiny weeny fine or two – (that has not been paid yet) and a couple of Corporate Integrity Agreements that the executives wiped their asses on. (well, it’s true!) An a few “official” reports. Personally I’m not sure what a “report” actually accomplishes.

Here is reporter, Sydney Freedberg's report for Bloomberg, published just last week!

Today is July 4, 2012 and hundreds of these little houses of horrors will open their doors tomorrow.

So far Small Smiles has seen:

• $24-million dollar fine they have not paid
• A 66 page Corporate Integrity Agreement they have not followed
• A few scolding letters with no bite
• A $230,00 fine – they have not paid. (the actual fines for all the violations amounted to millions, but they got a discount)
• One measly dental center in Manassas, Virginia they swear they do not own had to be transferred to a new owner
• The Oxon Hill dental center closed for two days of training! I’m NOT kidding!!
• Checks from the Medicaid fund still arriving in their bank accounts daily.

Hell, no wonder everyone wants in on the action.

CSHM Breach of Corporate Integrity Agreement March13 2012 <p>&nbsp;</p>

On March 7, 2012, just days after filing bankruptcy, their independent monitor did a check of the Oxon Hill Small Smiles and turned up all kinds of problems. On May 15, 2012 HHS once again sent out another letter, telling them to shut Oxon Hill down for a two day training session.

The letter stress HHS’s concern that just days prior to the March 7, 2012 monitor visits, that the Chief Compliance Officer – Lorri Steiner,- the Chief Dental Officer, Steven Adair or Gus Ghassen or both – the SVP of Operations, Kevin Reilly,- the Executive Director of Operations,Lisa Mullinix or Scott Nearing maybe- the Compliance Attorney, Sheila Sawyer, and the Regional Director, Dr. Marlene Navedo had been to Oxon Hill Small Smiles and couldn’t find a thing wrong. NOT ONE THING! How can that be???

Are they incompetent or criminals, it has to be one or the other. Are the same folks still running the show down there? Yes indeed…several of them are still there.

Something big happened that was quite serious, I don’t know what, by the Oral Surgeon at the Oxon Hill Small Smiles on February 20,2012. I don’t know if I want to know either.

CSHM Agreement with Office of Inspector General May 15 2012

Next Wednesday, July 11, 2012 is the dead line for CSHM to have reviewed and report past overtreatment at the Manassas clinic. As Bloomberg Businessweek reported, with 42% of all the root canals checked, (104 unnecessary root canals out of 244) deemed unnecessary I’m guessing that report will not look good for the dentists working there, or the company.

This company has been under the watchful eye of government regulators since 2007, when the investigation first began. Can you get your head around the fact they have not changed their ways in 5 years!!!! 

Arrests next week?

Ontario Municipal Employees Retirement System (OMERS)–Raising capital for more dental center purchases?

July 3, 2012
Today OMERS is in the news because it sold a hunk of it’s private equity funds investments to AXA for $850-million.  OMERS says it likes “direct” investment much better. Citing – “direct investments give it more control over its assets than investments through third-party private equity funds, and keep investment costs lower.”

 In October 2011 Canadian OMERS purchased Great Expressions Dental Centers (GEDC) from Audax .

In March 2012, OMERS again put its money where your mouth is, with the purchase of Exceldent. Which added another 19 private equity owned dental centers to NY, CT and NJ.

Related -

About OMERS Private Equity
Operating under the OMERS Worldwide brand, OMERS Private Equity manages the private equity activities of OMERS and has over $6.3 billion of investments under management. The group’s investment strategy includes the active ownership of businesses in North America and Europe. OMERS Private Equity is headquartered in Toronto, with offices in New York and London. For further information visit: www.omerspe.com.

About OMERS
OMERS is one of Canada’s largest pension funds with over $55.1 billion in net assets. It provides first-class pension administration and innovative products and services to almost 420,000 members. Approximately one in every 20 employees working in the province of Ontario is an OMERS member. Through the OMERS Worldwide brand, our team of investment professionals uses a direct drive, active management investment strategy to invest in public and private market assets, including publicly-traded equities, fixed-income, infrastructure, private equity and real estate. For more information, please visit www.omers.com, or www.omersworldwide.com

 

21 Oct 2011

US private equity firm Audax has sold Great Expressions Dental Centers (GEDC) to OMERS Private Equity for an undisclosed sum.

Headquartered in Bloomfield Hills, Michigan, GEDC is a dental practice management company that provides general and specialty dental services through 152 affiliated practices in Michigan, Georgia, Florida, Massachusetts, Ohio, Virginia and Connecticut.

The company was founded in 1982 by Dr Knysz, who served as chairman. Audax acquired a majority interest from Dr Knysz in May 2008 and, along with management, subsequently sourced and integrated ten add-on acquisitions.

Geoffrey Rehnert, co-CEO of Audax, said, “Rich Beckman and his management team did a terrific job working with us to build the company through add-on acquisitions and by establishing best practices across the company.

“We implemented financial controls and reporting systems to improve operating efficiencies, enabling affiliated dental providers to remain focused on patient care and clinical excellence. We wish Rich and his team continued success,” he added.

Small Smiles Dental Changing It’s Ways… HA! –that’s what they said the last time they changed their name, and the time before that and the time before that…

Small Smiles is saying it’s changed it’s ways, I beg to differ, since we’ve heard that before…several times. This company has been under the watchful eye of government regulators since 2007, when the investigation first began. Can you get your head around the fact they have not changed their ways in 5 years!!!!
It’s changed it’s name a few times, but not it’s ways!
Struggling dental chain looks to mend its ways
By Rob Goszkowski, Assistant Editor
July 4, 2012 -- Church Street Health Management, a private-equity-backed company managing 63 dental centers under various "Smiles" brands in 21 U.S. states, has emerged from bankruptcy with new owners, a new identity, and a new strategy for staying in the dental game.
Now going by the moniker CSHM, the company has a history of legal problems that forced it to file for bankruptcy earlier this year and prompted additional federal scrutiny.
For example, in January 2010, while still known as Forba Holdings, the company paid $24 million plus interest to settle allegations of Medicaid fraud with 22 states and the U.S. Department of Justice. The fine resulted in part from a policy of "converting" patients, whereby dentists were systematically urged to perform additional procedures and the number of procedures performed was tracked.
Read the rest over on Dr. Bicuspid

Senators Chuck Grassley and Senator Max Baucus inquire into illegal ownership of dental chains.

Did the Senators get nothing but lies from Small Smiles Dental, Kool Smiles Dental, Reachout Healthcare America, and Aspen? I'll let you decide.

Small Smiles Dental attorney's, King and Spalding, respond to Senator Grassley’s Investigators - November 29, 2011

Second response letter from Small Smiles Dental Centers to Senator Grassley’s Investigators - December 16, 2011

Kool Smiles Dental responds to Senators Grassley and Baucus Inquiry - February 3, 2012

Reachout Healthcare America responds to Senators Grassley and Baucus inquiry- February 23, 2012

Reachout Healthcare America's second response to Senators Grassley and Baucus - March 22, 2012

Aspen Dental response to Senators Grassley and Baucus inquiry -February 13, 2012

Aspen Dental's second response to Senators Grassley and Baucus - April 18, 2012

Aspen Dental Defrauding the poor and elderly esposed

 

$2,540 for 2 fillings? Poor hit by high fees at chain

By David Heath

The Center for Public Integrity

updated 7/1/2012 2:41:00 PM ET

Surviving on a meager $1,300 a month, 87-year-old Theresa Ferritto fretted about the cost when her dentist told her she needed two teeth pulled.

She figured an oral surgeon would be too expensive. So she decided to try out a dental chain that promoted steep discounts in its advertisements. She went to an Aspen Dental office just outside Cleveland.

Ferritto said Aspen Dental wouldn’t just pull the teeth but insisted on a complete exam. She was bewildered when they finally handed her a treatment planfour pages long. Total price: $7,835.

Ferritto could not afford it, but Aspen Dental signed her up for a special credit card, with monthly payments of $186 for five years. She blames herself for signing the papers.

“I made a big mistake going there,” she says. “I should have known better.”

After a day of cleanings and two fillings, Ferritto asked her son for help. He called Aspen Dental to complain but said he got nowhere. So they turned to the state Attorney General.

Aspen Dental took all charges off her credit card for treatments she hadn’t yet received. But said the $2,540 she was charged for two fillings and cleanings was appropriate.

Read the rest at MSN.com

Bill Brigham – Chief Operating Officer for Kool Smiles Dental Centers is said to have “resigned”.

Coming two days after scathing exposé by FRONTLINE and the Center for Public Integrity of the fraud, child abuse and corruption at Kool Smiles Dental Centers and NCDR, LLC.

Of course I’m not 100% sure, but I’m “pretty dang sure”, he’s gone.

Bill has been with Kool Smiles since 2007, so his hands are plenty dirty one would suspect. Where was he before Kool Smiles Dental? He was with Kohls, Home Depot, Macy’s and Belk’s department stores.
(me shaking head)

I don’t think there would have been much fan fair as he slithered out the back door, do you?

Should we be on bankruptcy watch? Maybe so.

Bill Brigham - Former COO of Kool Smiles Dental Centers

Academy of General Dentistry and American Dental Association Responces to “Dollars and Dentists” Program on PBS

Considering the Academy of General Dentistry (AGD) and the American Dental Association (ADA) are in the same building in downtown Chicago, my mouth actually fell open when I read this statement from the AGD.

Academy of General Dentistry Responds to “Dollars and Dentists” Program on PBS

Chicago (June 27, 2012)—On Tuesday, June 26, the PBS “Frontline” documentary series aired “Dollars and Dentists,” a special program that investigated what it referred to as the “broken nature of the dental care system” in the U.S. According to the PBS piece, more than 100 million Americans currently do not have dental insurance and cannot afford treatment. “Dollars and Dentists” attributed this lack of patient care to the Medicaid system, stating that it did not provide enough of a profit margin to dentists treating children at Medicaid rates. The segment implied that there are very few solutions available to solve this access to care problem. However, extensive analysis conducted by the Academy of General Dentistry (AGD) and other dental organizations has found that this is not the case.

“Dollars and Dentists” showcased the plusses and minuses of high-production dental franchises, which many claim will help to decrease the cost of care for Medicaid rates. The AGD shares the concerns voiced by “Frontline” that, as a business model, dental franchises that focus on quantity before quality may not be in the public’s best interest.

“I am concerned by business models that emphasize production quotas and do not individualize treatment for every patient,” says AGD President Jeffrey M. Cole, DDS, MBA, FAGD. “The focus becomes the company’s revenue rather than personalized care. Each patient deserves the type of time and attention provided by the traditional dental team business model, which promotes better oral health.”

In the “Academy of General Dentistry (AGD) Barriers and Solutions to Accessing Care” white paper, the AGD renews its call for proven dental care solutions and quality care, which were originally outlined in its 2008 “White Paper on Increasing Access to and Utilization of Oral Health Services.” The AGD calls for an increase in Medicaid reimbursement rates, greater efforts to improve oral health literacy and education, expansion of water fluoridation, and the creation of loan forgiveness programs for dentists working in underserved areas, among numerous other solutions that preserve the focus of providing quality care to each individual patient.

Polly “Wanna Crack Her” Buckey Remix

You can't hide your lyin eyes
And your smile is a thin disguise
I thought by now you'd realize
There ain't no way to hide your lyin' eyes
There ain't no way to hide your lyin' eyes
Honey, you can't hide your lyin' eyes – The Eagles

All joking aside, there is no way you can miss when she’s lying. The corner of her mouth pulls to the left, she looks to the right, and her voice is deep and raspy. (shaky)… and she gets that whacked out look on her face.

What I’m wondering is why Dr. David M. Strange has stopped putting his family at risk by going on TV and lying. Maybe it’s because, even though she sucks at it, she is the one willing to risk it all to do it.

There is a lot of hoopla over the FRONTLINE and Center of Public Integrity investigation, which is well deserved. But all the allegations are not new. These same allegation have been hitting regional and local news stations for years.!

Reports have landed in the local press and on local news stations since at least 2008. It is 2012, right?  Is anyone listening to these parents; to these employees?

Here are some of the reports:

Bloomberg reports on Private Equity Dental Chains thus far in 2012

 

To READ:

by Sydney Freedberg - sfreedberg@bloomberg.net.

Dental Abuse of U.S. Poor Dodges Ejection from Medicaid – June 26, 2012 The latest from Bloomberg demonstrates how the OIG is still turning it’s head to the child abuse for fraud, at Small Smiles Dental Centers. This one is outrageous. They ask CSHM to put the clinic in the name of a third party. Well, according to CSHM sworn testimony on numerous occasions, by various Small Smiles Executives they don’t own the clinics. Their mantra is that they only manage them for already third party dentists. The take away is  that the OIG. HHS and DOJ are fully aware (how could they not be) that the true owners of these houses of horrors is CSHM and it’s Private Equity backers. They must simply give them a wink and a nod to falsifying documents, committing fraud, and perjury, just to name a few illegal acts. These would land you or I in jail, by the way.  I don’t know what else a person could think. Do you? Republicans Hit Dental Bill That Private Equity Hates – June 1, 2012 Dental Abuse Seen Driven by Private Equity Investments – May 16, 2012

Texas Attorney General Lawsuit–Dr. Richard Malouf–All Smiles Dental Centers

Texas AG lawsuits spurred by WFAA dental investigation

 

Posted on June 26, 2012 at 12:38 PM

Updated today at 9:40 AM

Related:

• Dental Investigations

DALLAS - A year-long WFAA investigation into questionable Medicaid dental payments has resulted in the Texas Attorney General filing lawsuits this week.

Greg Abbott charges that a Dallas dentist and his corporate entities bilked taxpayers out of millions for fraudulent orthodontic work on poor families.

Dallas dentist Richard Malouf amassed a multi-million dollar mansion, corporate jets and luxury vehicles through his dentistry, News 8 has found.

He and his former firm, All Smiles, declared bankruptcy following a series of reports detailing how he and other dentists around Texas gamed the welfare system by billing for unnecessary dental work.
WFAA found that over the past few years, Texas has paid out more in Medicaid orthodontic claims than all other 49 states combined.
All Smiles billed Medicaid for at least $15 million over two years, which is twice as much as the entire state of Illinois. The Attorney General’s lawsuits, filed in Austin Monday, seek to recoup “two times the amount of the overpayments.”

WFAA’s findings have spurred outrage among lawmakers and hearings in Austin and Washington D.C.

Madelayne Castillo, a former All Smiles employee, and Dallas orthodontist Dr. Christine Ellis filed separate whistleblower lawsuits in April and May alleging fraud by Malouf and his corporations.
Both lawsuits remained sealed while the Attorney General’s office investigated the claims. On Monday, Abbott’s office joined those lawsuits by refiling them in the state's name.

In April, Dr. Ellis testified before the U.S. House Oversight and Government Reform subcommittee that Malouf and other dentists were responsible for “flagrancy of fraud that is truly unbelievable."
In May, WFAA reported that All Smiles bankruptcy documents showed that Malouf owns 28 percent of the company, and Valor Equity of Chicago had the remaining 72 percent.
A subsidiary of Valor is a named defendant in one of the Attorney General’s suits.

Abbott alleges Malouf and others violated of the Texas Medicaid Fraud Prevention Act.

“The defendants knowingly or intentionally submitted false information, and misrepresented material facts, when seeking prior approval for orthodontic services,” the lawsuit states.
“Defendants submitted claims for services which they did not provide, and misrepresented or concealed the true nature of the services which they provided,” it states.

“Defendants also knowingly paid or received consideration as a condition of the provision of dental/orthodontic services by unlawful recruiting and paying kickbacks for the recruiting of Medicaid clients,” it continues.

The suits allege that Malouf and the other defendants billed for work that was not medically necessary, and in some cases, performed it with unqualified dental workers. They also “upcoded,” or billed for orthodontics which were more expensive than what was actually provided, the suit states.

by BYRON HARRIS and JASON TRAHAN

Bio | Email

WFAA