WFAA-TV Dallas with reporter Byron Harris and team win award for “Denticaid: Medicaid Dental Abuse in Texas”

It has been announced that Byron Harris and the investigative team at WFAA have been honored with the Alfred I. duPont Silver Baton Award by the Columbia University School of Journalism. One can only imagine what didn’t make it on air in the “Denticaid” series. 

Kudos to WFAA-TV Dallas for supporting Byron and his team. 

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WFAA-TV, Dallas & Byron Harris
“Denticaid: Medicaid Dental Abuse in Texas”

 

A relentless two-year long investigative series that brought to light rampant pediatric dental Medicaid fraud

In this series of dogged reports, WFAA-TV and reporter Byron Harris uncovered a corrupt system in which hundreds of millions of taxpayer dollars went to dentists who billed the government for questionable orthodontics and other procedures that, in some instances, harmed children.

One Dallas-area dental clinic cruised poor neighborhoods, luring kids with food and cash before performing extensive, unnecessary and often harmful dental work all without parental consent. WFAA’s detailed reporting featured whistleblowers, hidden camera video and the tireless pursuit of one dentist living in a mansion the size of Versailles. Because of this reporting, the Texas Medicaid commissioner and the state’s dental director resigned, and congressional hearings were held.

Byron Harris, reporter; Jason Trahan, producer; Billy Bryant, photographer and video editor; Carolyn Mungo, executive news director; Mike Devlin, president and general manager.

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Don’t miss this enlightening discussion between Byron and his team.

Behind the Story - WFAA from Alfred I. duPont Awards on Vimeo.

Interview with Dr. Jay W. Friedman

 

Interview with Dr. Jay W. Friedman

by: Michael Davis DDS
December 17, 2013

 

Dr. Jay W. Friedman has had a significant impact on the oral health of the public. His commitment to public health has spanned seven decades from the 1950s to the present. He pioneered in the development of quality standards for dental care, group practice, and dental insurance. An accomplished clinician, he has been a consultant to a number of state and national organizations. Notable are Dr. Friedman's remarkable contributions in leading the challenge against the prophylactic extraction of third molars, as well as advocating for adding dental therapists to the oral health work force. 

Dr. Friedman earned his Doctor of Dental Surgery degree from Columbia University in 1948. Subsequently, he practiced general dentistry in Farmingdale, New York from 1948-1954, including two years in the U.S. Air Force Dental Corps. In 1955, Dr. Friedman became the director of an innovative group practice dental cooperative in Seattle, Washington, which served as a prelude to his pursuit of a life in public health. He received his MPH in 1962 at the University of Michigan, followed by an NIH Fellowship. Friedman then moved to Los Angeles, California, becoming actively engaged in research, writing, consulting, and clinical practice. Between 1964 and 1977, he served as a researcher at the UCLA School of Public Health. His 1972 Guide for the Evaluation of Dental Care was distributed widely by the U.S. Public Health Service; it set the standard for monitoring dental practice. In 1974, he co-edited, with Jerge, Marshall and Schoen, Group Practice and the Future of Dental Care. In 2002, he reissued a revised edition of his Consumer Reports Book, “The Intelligent Consumer’s Complete Guide to Dental Health.” In 2012, he received the John W. Knutson Distinguished Service Award in Dental Public Health from the Oral Health Section of the American Public Health Association.

Introduction

Dr. Davis: Dr. Friedman I’m honored to interview you, both because of your work to advance public health dentistry over the years, but very specifically your efforts to reduce the routine removal of asymptomatic third molars (wisdom teeth). Extraction of these asymptomatic teeth most often generated no patient benefits. All the while, patient risks of morbidity and mortality were elevated, especially injury to the jaw nerves causing numbness of the lip and tongue, jaw fractures, post-operative infections, and the potential risks from sedation. A number of young adults faced serious clinical injury, inclusive of untimely death. Dr. Friedman, I’m not overstating, that your work to educate our dental profession actually saved many lives. In the face of your work, you were highly criticized by elements of the oral surgery community, whose potential income was threatened. Regardless, you took the high road, in advancing the dental profession, in service of the public welfare.

Interview Questions

Dr. Davis: Dr. Friedman, in recent years we’ve seen advancement of corporate owned and managed dental clinics. These private equity backed dental clinics have a fiduciary responsibility, to place the interests of shareholders to the fore, and generate profits. By contrast, doctors have both an ethical and legal responsibility, to place the patient’s interests to the fore. The conflict of interest seems obvious. Would you like to elaborate?

Dr. Friedman: It is not only excessive third molar extractions that should concern us. They are just one part of a pattern of what I call FUN (Functionally Unnecessary) treatment, which may be physically and fiscally harmful to the individual and exploitive of public funds. It applies to the whole gamut of dentistry, including unnecessary x-rays, cleanings, fillings, crowns, replacement of missing teeth, and the array of “cosmetic dentistry.” Nonetheless, I believe the majority of dentists are well-intentioned and provide care they believe is in the best interest of their patients. That they―we―are not immune to FUN treatment is due in part to deficiencies in our education and the need to generate money to pay rent, utilities, supplies, salaries, and our own income.

Corporate owned dental clinics and private dental practices share the same objective, which is the generation of profits. In a capitalistic system, corporate shareholders benefit as if their investment produces the profit rather than the workers who perform the service. In a private practice, at least the dentist is part of the workforce. He or she may share some of the “profits” by awarding bonuses to auxiliary staff. In many private practices, the staff is given incentives to generate income and a bonus in the same manner as the corporate practice. So in that respect, I do not see a big difference between the two systems.

The Medicaid gravy train continues

If you read this blog, then you know profits with Medicaid dentistry is made on high volume, gross excessive treatment, all at a single visit. The prime example is Small Smiles and their Production Per Patient (PPP) mantra handed out to their employed dentists. As testimony revealed in a New York malpractice case, "PPP is the Golden Goose", said one Small Smile executive. As was put another way by one of Small Smiles managers, “you eat what you kill”. 

It’s undeniable, years ago, Small Smiles Dental set the gold standard of excessive treatment by restraining children with use of the papoose board. 

As heat from press, parents and few state dental board followed some Medicaid accepting dentists and dental chains decided sedation would be the key even more profits, leaving the least amount of yuk in everyone's mouth—the children, the parents and especially the public.

Weekend "get-a-way" sedation courses were developed, lobbyist hired and representatives of the dental community were sent on press junkets stressing the need for higher reimbursements from insurers and Medicaid; all to accomplish the same thing—Production Per Patient. Now, as ABC news has reported in 2012, we have children being overdosed, brain damaged and dying at an alarming rate.

All the while, government regulators appear to be hiding under their desks. It is understandable that the bulk of the dental profession has given up. It’s been proven over and over there is no money to be made in Medicaid dentistry, if provided ethically. Add government corruption and ineptitude to the mix and it’s like the sadistic relationship between the addict, and their co-dependent enabler; life and death danger to both.

Family says 3 year old Finley Boyles was given too much anesthesia.

 

December 11, 2013

KAILUA, OAHU (HawaiiNewsNow) -

A three-year-old girl is in critical condition following a procedure at a local dentist in Kailua, Oahu.

Three year old Finley Boyle is at Kapiolani Medical Center.  It's unknown if she had any pre-existing medical conditions but we do know a lot of lives have been changed forever.

Photos show three year old Finley Boyle's bright smile.  Family friends say on December 3 she was brought in for a dental procedure at Island Dentistry in the Kailua Professional Center when something went horribly wrong.

The friends say Finley was given too much anesthesia and sedatives.  She then went into cardiac arrest and now has severe brain damage and will never be the same.

Friends say the dentist is Dr. Lilly Geyer.  Her office, called Island Dentistry for Children, has a sign up saying it is currently closed.  Not even the delivery man was let in. There were people in the office but they weren't talking.

"We have no comment," said an unidentified man inside the office.

The Island Dentistry website has also been taken down, but a screen grab from the archived website says the practice opened in 2006 and has 2,000 patients.

The "about us" section of the site also says Dr. Geyer "is certified in Basic Life Support, Advanced Cardiac Life Support, as well as Pediatric Advanced Life Support."  However friends say when Finley began having complications the staff ran to the pediatrician's office down the hall and that doctor came to help with CPR.

Update on Dr. Michael Tarver–Polliwog Dental–Ocala, Florida

December 11, 2013

On December 6, I received a long rambling email about Dr. Michael Tarver’s, apparently sent out by his dad, Buzz.  In this letter he blames everyone for Tarver’s woes, except Michael, which is typical, after all it is his dad writing it. You can read Buzz’s email in it’s entirety at the end of this post, along with other stories about Dr. Tarver and Polliwog Dental.

Buzz may have gone too far, when blaming Florida Department of Health Investigator, Mike Knezevich.  Buzz writes,

“Basically an unscrupulous investigator for the DOH, Mike Knezevich, fabricated evidence, filed false, misleading and inaccurate reports, possibly intimidated witnesses and ignored sworn affidavits and other statements from dental professionals.  In addition, Knezevich did not ask for or consider advice or clarification from any general dentist, pediatric dentist or medical or dental anesthesiologist.  Equally disturbing is that the DOH lawyers appear to have rubber stamped Knezevich's false reports without checking the facts.

I’m assuming Buzz is grasping at straw, since just days prior, The Health News Florida published an article about Dr. Michael Tarvers, a Whistleblower and video of Tarvers altering patient records. 

Tarver maybe going down, but he’s kicking and screaming every lick of the way.

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Mon December 2, 2013

By Health News Florida Staff

A whistleblower’s lawsuit has been filed by two former employees of a troubled Ocala dental practice.

Polliwog Dental, the focus of investigations by the Florida Department of Health and the U.S. Drug Enforcement Administration is being sued for retaliation and failure to pay overtime to the two fired workers, the Ocala Star-Banner reported (paywall alert).

The lawsuit says employee Andrea Frederick used a cellphone to videotape Polliwog owner and dentist Dr. Michael Tarver as he altered medical records that had been subpoenaed by DOH. The other worker, Tiffany Sullivan, alleges that Tarver ordered her to stall investigators and refuse to turn over records, the lawsuit states.

The former employees are asking the court for $15,000 per allegation and attorney’s fees. Tarver told the Star-Banner he would have no comment.

The Star-Banner reports that problems first emerged at the practice in July, when DEA investigators visited the Ocala practice, took some files and questioned employees. That investigation continues.
In September, Tarver was suspended under an emergency DOH order. That suspension stems from allegations involving two 4-year-old patients, but the local State Attorney’s Office said they found no reason to charge the dentist with child abuse, the paper reports.

Last month, Tarver and the DOH reached a settlement with the state's Board of Dentistry, which includes a $7,500 fine, education and the requirement that Tarver hand over operation of the business. The day before the hearing Polliwog changed its name to Churchill Dentistry. Tarver’s wife and business partner continue to run the practice.

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Mass Email from Buzz Tarver

Dear Friends and other interested parties,

All families occasionally go through some tough times and our family is no exception.

In September, Michael's dental license was suspended by the Florida Department of Health (DOH).  Michael's license was recently reinstated.  The license suspension has been played out several times on the front page of the Ocala newspaper and on various local TV news reports. Michael has been subjected to extensive negative publicity accompanied by some personal threats.  Basically an unscrupulous investigator for the DOH, Mike Knezevich, fabricated evidence, filed false, misleading and inaccurate reports, possibly intimidated witnesses and ignored sworn affidavits and other statements from dental professionals.  In addition, Knezevich did not ask for or consider advice or clarification from any general dentist, pediatric dentist or medical or dental anesthesiologist.  Equally disturbing is that the DOH lawyers appear to have rubber stamped Knezevich's false reports without checking the facts.  A simple Google search, a search on the American Academy of Pediatric Dentistry website or a brief conversation with a pediatric dentist doing conscious sedations could have quashed these false accusations.  On several occasions, Michael and his attorney provided irrefutable evidence of Michael's innocence to both the DOH and Board of Dentistry Probable Cause Panel.  The evidence was ignored and in the case of the Probable Cause Panel, even though the evidence package was hand delivered to each member of the panel, Michael's package was not considered at the hearing.  Frustrated with any semblance of a fair hearing or due process and at some risk to Michael from possible DOH retaliation, , Michael filed a formal complaint with the DOH on Investigator Knezevich.  The complaint became a matter of public record and the DOH was forced to consider the accusations by Knezevich against Michael.  It only took a few days for the DOH to check the facts.  According to Michael's attorney, The DOH has started termination proceedings against Knezevich and the Florida Attorney General's office is having conversations with Michael's attorney about filing criminal charges against Knezevich.  I guess the Ocala press doesn't consider this misconduct newsworthy as there has been no mention of it in the newspaper.  I'm going to send this email to them as a long "letter to the editor."

If you want the full, detailed story, please read on below.  Much of the information I am presenting is now a matter of public record.  To the best of my knowledge, the information I am presenting is accurate.  I understand that the truth is my defense against libel.  You are most welcome to share this email with other interested folks.  The facts are disturbing and disgusting.  Don't think for even a moment that something like this could not happen to you or someone you love.

Paraphrased from Michael's attorney, a former prosecutor for the Attorney General's office, former lead prosecutor for the Florida Board of Dentistry and now a private practice defense attorney…'What happened to Dr. Michael Tarver is the most compelling abuse of power and investigative misconduct I have experienced in my 30 years of legal practice.'

As a way of introduction, Michael is a native of Lakeland.  He graduated summa cum laude from both Wake Forest University and Tuft's Dental School.  Michael completed his pediatric dental residency at the University of Florida and is board-certified by the American Academy of Pediatric Dentistry.  Michael also earned a CPA license and a Series 7 license and holds a multi-engine Airline Transport Pilot license and is a Certified Flight Instructor.  Michael and his wife Rebecca, a general dentist limiting her practice to children, opened their children's dental practice in Ocala in January of 2012.  They purchased a bank-owned, run-down building in a great location.  They remodeled the building and personally installed most of the dental equipment.  They also purchased a home in Ocala. They have substantial financial equity and sweat equity invested in their practice and the Ocala community.  They loved Ocala and thought of themselves spending the rest of their lives there.  All of that may have changed.

Michael was the only pediatric dentist within the 5 surrounding counties of Ocala seeing any significant volume of Medicaid children.  Michael's thriving practice was shut down by the DOH.  22 employees lost their jobs…most of whom collected unemployment and many  have not found new jobs.  Thousands of children had no local pediatric dentist available for treatment.  In addition, MCNA Dental and DentaQuest, Medicaid dental managed care organizations, suspended Michael from their programs.  Neither group has reinstated Michael into their programs.  This means that the vast majority of Medicaid children in the 5 surrounding counties cannot see a local children's dental specialist…especially one doing conscious sedations.  In addition, MCNA Dental and DentaQuest suspended Rebecca from their programs…and Rebecca has a spotless record… guilt by association.  Neither organization has reinstated Rebecca's credentials either. 

Michael was accused of 2 serious violations which if true (which they were not) would warrant a license suspension.  A mother accused Michael of administering, without permission, GENERAL anesthesia on her child.  Michael has never administered general anesthesia on any child…ever.  Michael knows of NO pediatric dentist that administers general anesthesia by themselves.  Specialized equipment is required to administer general anesthesia and a cursory tour of Michael's office would confirm that Michael does not possess such equipment.  Michael had signed consent forms, in both English and Spanish, for conscious sedation, which he administered.  Michael has performed thousands of conscious sedations.  Michael has never had to call 911 or other medical emergency personnel on any patient…ever.  This accusation by Knezevich was proven totally and absolutely false and without merit.

A second case involved a patient, under conscious sedation, that was starting to experience labored breathing.  Michael administered oxygen and a reversal agent and, within 15-20 seconds the patient was breathing normally.  At that point, Michael stopped his treatment, spoke with the mother and referred the patient to Shands Hospital for treatment.  Shands evaluated the patient and declined treatment.  The patient returned to Michael for treatment.  Michael used a different conscious sedation drug to successfully treat the patient.  The patient returned several times to Michael for additional treatment.  A 3-month employee, who had never previously worked for a pediatric dentist, sent an email to the Ocala police saying that she thought the patient died in the dental chair, Michael brought the patient back to life by performing CPR, and didn't tell the mother what happened. 

The Ocala police called Knezevich about the email.  That seemed to be the extent of Knezevich's investigation.  Michael has never performed CPR on any patient…ever.  This accusation by Knezevich was proven totally and  absolutely false and without merit.  In BOTH cases, Knezevich ignored sworn affidavits from attending dental assistants confirming Michael's innocence.  As mentioned previously, Knezevich did not consider advice or clarification from any other general dentist, pediatric dentist or medical or dental anesthesiologist.  The DOH in both cases, seemed to accept Knezevich's reports verbatim without doing any fact checking.

Michael was also accused of 2 records violations...one on each of the above patients.   A subpoena was issued on, I believe, July 18th for Michael's dental records on the above patients.  The subpoena expired in 2 weeks.  After holding the subpoena for 13 days, Knezevich delivered the subpoena to Michael's office on August 1st, the day before the subpoena expired.  Interestingly, and very convenient for Knezevich, that morning Michael and Rebecca left Ocala for a planned trip to Iowa City, Iowa to visit Rebecca's 92-yr old grandmother and some other relatives.  If was the first vacation Michael and Rebecca had taken since they opened for business.  They had talked about taking the trip for weeks with staff, patients and anyone that may have been interested.  Knezevich knew that they would be out of the office.  Michael never saw a copy of the subpoena but was informed by his staff through Knezevich that Michael had 24 hours to produce the records or he would be held in contempt of court.  Of course that wasn't true but Michael didn't know that. By law, the patient dental records belong to the DOCTOR. 

Michael did not give Knezevich permission to take the patient dental records.  In Iowa City, Michael used a computer program, for the very first time, to remotely access his patient dental records.  Most in-office computer programs automatically date-stamp entries into dental records.  This remote program did not. Michael made some late clarifying and explanatory notes to the two patient dental records without identifying the notations as late entries.  Michael did not delete any information from the records, he only added clarifying information.   Our research showed that there is no law in the Florida dental regulations prohibiting late entries or requiring a late entry be notated as such, and even though both a pediatric dentist and a dental anesthesiologist reviewed Michael's notes and submitted sworn affidavits that no material change was made to the patient records, Michael was charged with the records' violations. 

To the best of our knowledge, no dental license suspension has EVER occurred for such a records violation.  In order to get his dental license reinstated, Michael had to agree to the records violation.  The agreement obligated Michael to reimburse the DOH for its $17,000 in investigative costs by its unscrupulous investigator.  The reimbursement seemed to be very important to the DOH.  It's a bit like being jailed for a crime you didn't commit…being found innocent and released 3 months later, then being billed for all the costs of your incarceration.  If you don't pay up, you remain in jail. 

Oh, in the mean time, you lost your job, your incarceration was played out in the press, your home and office building went into foreclosure, all of your employees were let go and haven't found new jobs, your wife and friends no longer speak with you, your dog doesn't recognize you and you've been kicked out of your Sunday school class.  A bit of an exaggeration…but just a bit. 

Within 2 business days of the license suspension, Michael and his attorney delivered to the DOH complete and irrefutable evidence of Michael's innocence of the serious accusations.  The evidence was ignored.  The Board of Dentistry convened a probable cause panel of dentists.  Michael's attorney hand-delivered the same evidence to each panel member.  The panel ignored the evidence.  Later in the dental board hearing, after considering the lack of evidence to support the charges against Michael, the incoming Chairman of the Florida Board of Dentistry recommended dropping all charges against Michael.  The motion was seconded but did not receive a majority vote.

One week before the Florida Dental Board hearing, Michael took the unprecedented step of filing a formal complaint with the DOH against Investigator Knezevich.

The first business day AFTER the dental board meeting, the DOH initiated termination procedures against Knezevich…I suspect for gross misconduct.  The following day the Attorney General's office solicited information from Michael's attorney about possibly filing criminal charges against Knezevich.  Of course if this information had been available the day BEFORE at the dental board hearing, Michael may have had a more receptive audience.

Knezevich was a Gainesville police officer for 20 years attaining the rank of corporal.  My Army days would suggest he didn't advance very far in those 20 years.  A public records request by Michael showed some disturbing information about Knezevich…multiple driving while drinking violations, multiple internal affairs investigations, lying under oath, an extended suspension from the police force, scathing performance reviews, finally leading to a possible "quit or be fired" meeting.  He left the police force.  The DOH hired this guy.   He was their employee for 7 years.  

A public records request to the DOH revealed more of the same…scathing performance reviews, report filing violations, insubordination.  Knezevich liked to boast that "he puts dentists in jail."   Knezevich is a bad guy with a huge chip on his shoulder.

This begs the question…what was the DOH thinking when they hired this guy?  Either the DOH ignored his past history or they failed to do even a cursory background check…and they gave Knezevich cart-blanch authority, without adequate supervision, to act as judge, jury and executioner with Michael and other medical professionals. 

The actions of Knezevich, the DOH and the Florida Dental Board Probable Cause Panel are egregious.  The stress on Michael, Rebecca, their former employees and all of our families has been intense.  Michael and Rebecca are understandable disillusioned, anxious, distressed and uncertain about their future.  What this loving and caring couple has been put through is both tragic and unwarranted.

Thank you for taking your time to read this long email.  Colette and I appreciate you and thank you for the support of our family.  If so inclined, Michael can be reached at: tarver330@hotmail.com or 863-899-$%$$.

My best personal regards,

Buzz Tarver

863-838-#$##

The personal phones numbers were redacted by DTM

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Related:

 

On August 30, 2013 the Ocala Post published an article where Travers lashes out at patients and parents, blaming Medicaid patients for his woes. click here to see the article and Tarver’s Facebook post.

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September 10, 2013 WTEV issued a story where locals evidently were wore out with Dr. Michael Tarver and his ugly ways.  (click here to read the article and comments)

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Florida Dental Board allows Dr. Michael Tarver access to children after Florida Department of Health says he’s too dangerous

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Tip of the hat to Dr. John Armstrong and state investigator Michael Knezevich

 

 

Dr. John Armstrong and Michael Knezevich-
A Story of Two American Patriots

by: Michael W. Davis, DDS

Dr. John H. Armstrong led a highly distinguished and venerated career as a physician, in the US Army. His active duty responsibilities included orthopedic surgery, supervision of a specialized trauma unit, as well as education for our next generation of physicians. He assumed responsibility not only for active duty personnel injured in the line of combat duty, but also their families at times. As a command medical officer, he was there for the well being of our nation’s soldiers.

Dr. Armstrong fully comprehends working with a team, and within chain-of-command, to obtain the desired objective. He will get results. He will support his command subordinates, in the field. As such, he generates team morale. He serves as both a leader by example, and importantly as a teacher, mentor and coach, to his subordinates.

This is the remarkable individual, Florida Governor Rick Scott appointed to position of Florida State Surgeon General, in 2012.

(for more please read: http://www.floridahealth.gov/public-health-in-your-life/about-the-department/ssg/index.html)

Michael Knezevich is a retired police officer veteran, of over twenty years. His skin is calloused from years, of dealing with the criminal element in our society. It’s in his blood to “protect and serve”, the public welfare. Today, Mr. Knezevich works at a salary of approximately, $36,000 per anum, as a malpractice investigator for Florida’s Department of Health and Human Services. He investigates allegations of Medicaid and Medicare fraud, for basically a peanut’s income. Mr. Knezevich is only a few paychecks himself distanced, from the disadvantaged, who depend on government assistance. He’s often up against highly skilled white-collar criminals and medical professional criminals, who cheat the taxpayer and harm the most vulnerable in our society. Mr. Knezevich is definitely fighting the good fight, “in the trenches”.

The bipartisan US Senate report of July 2013, on corporate dentistry offered firm evidence of dental Medicaid fraud, as a well-established industry and business model, within the dental profession. Further troubling evidence has been provided by reports of Bloomberg Business News, PBS Frontline, investigative reporters Byron Harris and Roberta Baskin, Debbie Hagan’s “Dentist The Menace” online blog, etc. At the federal level, the Office of Inspector General for Health and Human Services has been continually admonished for “wrist slaps” on violators, which enable and perpetuate unlawful activities. Individual state auditors and regulators fare no better, in their enabling of Medicaid and Medicare abusers and fraudsters.

Dr. Thomas Floyd recently embarrassed Florida. He was an entrenched icon of organized dentistry, both in Florida and nationally. Dr. Floyd was allegedly involved in numerous acts of physical abuse of disadvantaged Medicaid children, going back for over a decade. Florida’s “good old boy” system gave him pass after pass. Allegations came and went, as did witnesses, but it was business as usual for Dr. Floyd. Florida’s regulatory authorities were in perpetual hiding, under their collective desks. Eventually, even this disturbing boil came to a head and popped. Dr. Floyd has since surrendered his dental license, and agreed to never again practice dentistry. However, this alleged Medicaid violator’s abuses were so egregious, this amounts to “a day late and a dollar short”, when it comes to protection of the public interest.

Next came the alleged actions against Dr. Michael Tarver, a pediatric dentist and Medicaid provider. His actions of amending patient records, after knowledge of those records being under Florida State investigation, have been confirmed. He added entries into patient records, but neglected to openly signify the amendments were at a later date, and not the day of patient care. This represents a potentially serious misrepresentation, which any first-year medical or dental student would be sanctioned for. In my personal work as an expert dental witness, this act alone usually changes the questions asked. It’s no longer a question of malpractice or not, but a question of fraud, and how severe the settlement will become against the violator.

Supporters of Dr. Tarver nitpick over a parent’s complaint of lack of informed consent for general anesthesia. In actuality, medicated conscience sedation was employed for the minor patient. Either way, medications were delivered to a child, which have known risks, without the consent of the parent, and with their expressed disapproval. Only a trained medical or dental expert is held to the standard of care, of understanding different levels of sedation and their associated risks. An untrained person can’t be held to medical/dental standard of care, but the doctor certainly is.

Dr. Tarver allegedly resuscitated a child patient, after they stopped breathing during dental treatment. The parent was allegedly never informed of this adverse clinical outcome, which violates standard of care, as well as Florida statutes relating to practice of dentistry. Parents were routinely denied access to accompany their children during dental care by Dr. Tarver, so they often had no direct knowledge of exactly how their children were being cared for. Although Dr. Tarver claimed in a press report, that the American Academy of Pediatric Dentistry (AAPD) condones his actions of denying parent’s access to their children during dental procedures, the opposite is the truth. The AAPD Guidelines state that most children behave better (not worse) with their parent’s presence. One is left to wonder, what Dr. Tarver may be hiding?

The Smile Center—San Antonio—Settles Malpractice Lawsuit Involving 253 Patients

As the San Antonio Express-News reported December 3, 2013, Dr. Stephen Simpton, owner and operator of  The Smile Center, with 6 clinics in the San Antonio, TX area settled the malpractice lawsuit involving 253 patients. Details still about the dollar amount of the settlement have not been released.

Shorty after the law suit was filed in 2011, Dr. Stephen Simpton filed a defamation lawsuit against the law firm representing the parents of the children, as well as the television station and reporter, Brian Collister. 

Protecting First Amendment rights in Texas, District Judge David Berchelmann’s ruling in July 2012, threw out the lawsuit against the attorney representing the parents, and ordered Simpton’s Smile Center to pay $108,000 in attorney fees and sanctions.  The following month Dr. Simpton was sanctioned for his attempt to silence WOAI-TV, and ordered to pay $70,000.

Simpton further tried to escape the spot light on his misdeeds, having his attorney, Mr. Jon Michael Smith, send “Cease and Desist” letters to anyone else who reported about the abuse taking place in his dental clinics, including Flap’s Dental Blog and this one.  This one actually received two, after the first one didn’t seem to phase me.

Kenneth Morris Wiggins, Jr., DDS–Medicaid Fraud: Former Ohio “prison dentist” who fled to the Netherlands is returned to Georgia and sentenced to 7 years in prison.

 

MARIETTA, GA — Dr. Kenneth Morris Wiggins, Jr. pleaded guilty and was sentenced Monday (November 25, 2013) in Cobb County Superior Court for Medicaid fraud. Records indicate between January 1, 2007 and March 11, 2009 Dr. Kenneth M. Wiggins, Jr.,owner of Cosmetic and Family Dentistry with two locations, one in Marietta and one in Roswell, defrauded the state and federal government of $2.2 million.  That, ladies and gentlemen would be you!

In perfect Joran Van Der Sloot style, Wiggins fled to the Netherlands after he was indicted by a Cobb County grand jury in 2011.  (Joran Van Der Sloot, you remember, is the admitted murder of Stephaney Flores and suspected murder of Natalee Halloway, who disappeared while on spring break in Aruba.) 

In February 2013, Wiggins was apprehended in Punta Gorda, Belize where U.S. Marshals transported him to Miami, Florida.  There he waived extradition, and subsequently returned to Cobb County, Georgia, where he has been held without bond.

According to a September 2011 report, Wiggins submitted some 7,000 fraudulent Medicaid claims on 220 patients for “tooth re-implantations and “complicated suturing of wounds” that he never performed.

Wiggins’ plea deal would satisfy any sweet tooth.  He pled guilty to 1 count of Medicaid fraud and Judge A. Gregory Poole sentenced him to 7 years in prison and restitution of $2,230,718.81.

Cosmetic and Family Dentistry, originally ownership was Dr. Kenneth Wiggins and his wife, Dr. DeAnthia Childs-Wiggins.  Cosmetic and Family Dentistry became Family First Dentistry in February 2012 with Dr. Wiggins wife, DeAnthia at the helm according to records at the Georgia Secretary of State’s website.  Searching Cobb County court records fails to find a divorce between Kenneth and DeAnthia Wiggins.

Just a wild guess, but I imagine more than that has been spent since the investigation of Dr. Wiggins began.

Medicaid dentists giving children multiple stainless steel crowns–Reddit

That’s the headline of a discussion happening over at reddit.  Check it out.

Discussion:

I have read news stories about a 4-year old girl named Savannah who had all of her teeth capped during a visit to an Arizona dentist. The mother believes she was scammed. There were cases where kids had almost all or all teeth capped and there were accusations of dental Medicaid fraud (Medicaid Dental Center in North Carolina). Papoose boards are used to restrain the kids.

If state dental boards are unable to stop this, how should the public stop it?

Comments

AIG’s “Creepy” and “Seedy” Stalking Attorney Story from Dr. Bicuspid’s Donna Domino

 

New trial ordered for Small Smiles case

 

By Donna Domino, Features Editor

November 19, 2013 -- A New York judge on November 18 ordered a new trial in the Small Smiles case after ruling that a lawyer for the insurance company stalked the jury during the trial. The judge found that the lawyer's misconduct intimidated the jury and probably influenced the verdict in favor of Small Smiles.

In October, the jury found that Small Smiles dentists did not perform unnecessary dental procedures on Jeremy Bohn. Justice Deborah Karalunas found that corporate ownership of the clinics was illegal under state law, but the jury found no liability by the company or the dentists.

But after the jury's verdict, jurors complained about a man who "stalked them throughout the trial," according to the November 18 ruling by Justice Karalunas in the New York Supreme Court.

Jurors complained that Scott Greenspan, an attorney who works for the National Union Fire Insurance Company, was following them and videotaping them. National Union is the insurer for Forba Holdings, the former operator of Small Smiles, and the three dentists named in the lawsuit. The jurors said Greenspan followed them when they went out to lunch, took smoking breaks, and when they were in the elevator.

Read more here

Are Dentists Drilling For Dollars?–Inside Edition Video Shocking Report of November 2013

Aired November 13, 2013

This  “metal mouth” epidemic has been reported since as early as 2003—if not before.  WJLA-TV did a shocking report in November 2007. 

It is 2013 and no one in government or governing agencies have bothered to stop it. 

Why?

I want some answers!

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Here is the contract information for the attorney mentioned in the above report.

Tom Crosley, Esq.
877-535-4529
information@crosleylaw.com

San Antonio Location
755 East Mulberry Ave
Suite 250
San Antonio, TX 78212
210-354-4500

Houston Location
4203 Montrose Blvd.
Suite 150
Houston, Texas 77006
281-661-4250

Rio Grand Valley Location
323 West Cano St
Suite 200
Edinburg, Texas 78539
956-314-0561

The “Creepy” and “Seedy” Stalking Attorney” story is spreading.

The “Creepy and Seedy” Stalking Attorney” story is spreading.  I think once I used “sleazy”.  That was a mistake, it was “seedy”.  I want to make sure I correct that right away.  LOL

'Stalking' of Jury Leads to Malpractice Retrial

Wednesday, November 20, 2013

By NICK DIVITO 
SYRACUSE, N.Y. (CN) - Near "stalking" by the attorney AIG hired to monitor a dental-malpractice trial "violated the sanctity of the jury" and compels a retrial, a judge ruled.
     With the verdict thrown out, Kelly Varano will have another chance to prove that her son, Jeremy Bohn, did not receive proper care from Syracuse dental clinic Small Smiles and its parent company, Forba Holdings.
     It's one of 2,900 such lawsuits filed across the nation against the dental chain, which is insured by AIG.
     After the jury in Varano's case ruled for the defense last month, its members confided in Judge Deborah Karalunas that they felt they were being "stalked" by a spectator from the trial.
     Identifying that man as AIG's Manhattan-based attorney, Scott Greenspan, Karalunas ordered a new trial Monday.
     "Mr. Greespan's conduct violated the sanctity of the jury, raises ground for suspicion that the decision was founded on something other than the evidence, and was prejudicial and likely to influence the verdict," Karalunas wrote.
     One of the attorneys who filed the underlying lawsuit, Jim Moriarty, told Courthouse News that he was "thrilled" with the decision.
     In 40 years practicing law, "I have never seen an attorney go as far out of line as this lawyer did," Moriarty added. "To me it's dumbfounding."

“Dirty Dentist” sparks in-depth report on infection control in dentists offices that could (and should) spread nationwide

After news broke that patients of Dr. Wayne Scott Harrington's dental practice may have been exposed to HIV and two types of hepatitis, thousands of patients across the state were urged to get tested. It's a medical scare that's left many wondering how this could have happened, and how to keep it from happening again.

This story aired on the ONR on OETA-The Oklahoma Network. The reporter is Cathy Tatom; the photographer is Tony D'Astoli. For more information, go to the ONR web site www.news.oeta.tv and ONR blog http://blog.oeta.tv/onr For more about OETA-The Oklahoma Network, visit www.oeta.tv.
Published on Apr 8, 2013

Dr. Scott Harrington – November 2013 UPDATE: 100 Patients now test positive for Hepatitis, 4 test positive for HIV

A class-action lawsuit was filed against Oklahoma oral surgeon, Dr. W. Scott Harrington - license number 3666 (creepy) - on September 3, 2013; included were two assistants, Terri (Waugh) Velega and Lisa Young.  Now, more patients have tested positive for infections.

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In the class-action Terri (Waugh) Velega and Lisa Young are accused of administering IV sedation illegally.The lawsuit also accuses Hospira, Pharmaceutical Systems, and Southern Anesthesia & Surgical -- the makers, distributors, and marketers of the propofol used in Dr. Harrington's practice -- of selling multiuse vials that are "unreasonably dangerous and unfit for use as anesthesia in an oral surgery center because of the foreseeable misuse of treating multiple patients from the multiuse propofol vials."Class Action Complaint - Dr. W. Scott Harrington, filed September 2013

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Below are two of the latest reports:

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More patients test positive in Okla. infection scandal

By DrBicuspid Staff
November 15, 2013 -- Oklahoma health officials have confirmed that 100 patients of oral surgeon W. Scott Harrington, DMD, have now tested positive for hepatitis and HIV.
The state health department said 90 patients have tested positive for hepatitis C, six for hepatitis B, and four for HIV, according to a press release.
More than 4,200 people have been tested since the dental board launched in investigation in March. Health officials have notified 7,000 of Dr. Harrington's patients that they may have been exposed to blood-borne viruses at his Tulsa and Owasso offices and should be tested for hepatitis B, hepatitis C, and HIV.
The Oklahoma Board of Dentistry launched the investigation after being notified that health officials were looking into complaints about potential hepatitis C contamination at Dr. Harrington's practice. Investigators found numerous violations of health and safety laws, including the use of rusty instruments on patients known to have infectious diseases.
Two new lawsuits were filed against Dr. Harrington in November, according to a newson6.com story. The most recent case was filed on behalf of a man who had 14 teeth extracted last December.
A class-action lawsuit was filed in September by seven former patients, including five who claim they contracted infectious diseases during treatment at Dr. Harrington's dental clinics.
Dr. Harrington is scheduled to appear before the dental board on January 17, 2014, in Oklahoma City.

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Lawsuits Piling Up Against Tulsa Dentist Accused Of Spreading Diseases

TULSA, Oklahoma -
November 13, 2013 - The lawsuits are mounting against a Green Country dentist accused of exposing thousands of patients to diseases. Two new suits were filed against Dr. Scott Harrington this month.
The health department has confirmed 90 of Harrington's patients tested positive for hepatitis C, six for hepatitis B and for HIV.
Harrington's practices in Tulsa and Owasso have been locked up tight since March. The State Dentistry board said Harrington was using unsafe and unsanitary practices. He's now facing a number lawsuits by patients, who say the dirty practice left them with a potentially deadly disease.
"To think that it's happening in Tulsa, Oklahoma, it just boggles my mind," said Attorney Paul Boudreaux.
Boudreaux is representing five former patients of Dr. Scott Harrington.
9/18/2013 Related Story: Attorney Says Client Contracted Hepatitis C At Dentist Harrington's Office
The most recent case was filed on behalf of a Mannford man who went to Harrington to have 14 teeth extracted last December.
"Now his life is probably shortened, now he can look forward to significant health problems and treatment as a result of contracting hepatitis C, because he went to the dentist," Boudreaux said.
The attorney said the Tulsa Health Department told his client in April that he'd tested positive for the disease. He said the man is so ashamed by the diagnosis, he didn't want to go on camera.
"He's obviously devastated, as is his wife," Boudreaux said.
In September, the health department confirmed genetic tests by the CDC proved one of Harrington's patients transmitted hepatitis C to another patient. But a spokesperson with the state's health department told us Wednesday that only a select few of the positive results were sent to the CDC--those who met specific criteria, like having no other risk factors and matching the right time frame.
Boudreaux said his client lives a clean lifestyle.
6/18/2013 Related Story: More Lawsuits Filed Against Tulsa Dentist Scott Harrington
"He's a very healthy individual. He practices martial arts, he's a married man," he said.
Boudreaux said his client's DNA was not sent to the CDC, but he said the only place the man could have contracted the disease was in the dentist's chair.
"I certainly don't know of any indication, other than going to this dentist and having 14 teeth extracted by no telling what equipment," the attorney said.
The health department said it's unlikely any more results will be sent to the CDC.
Boudreaux said he has a team of experts examining his cases and said it's possible his clients will look into private genetic testing.

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According to court records, W. Scott Harrington was arrested following a DQI arrest in Dallas, Texas November 2, 2001
 
 
Other Videos News Reports on Dr. W. Scott Harrington:
March 29, 2013 – Local dentist reacts to allegations against Dr. Scott Harrington
March 29, 2013 – Dr. Gary Burnidge personally knows and defends Dr. Scott Harrington
March 29, 2013 - Tulsa dentist investigation gets national attention
March 29, 2013 – Dentist tracked down
March 30, 2013 – Dentist under investigation in Tulsa, OK has second Carefree, AZ home (neighbors shocked)
April 12, 2013- KOTV interviews attorney Pat Carr regarding Dr. Scott Harrington
patients not testing positive have “still suffered at Harrington’s hand”)
May (6, 2013 – Do you have a dirty dentist?
 
 
Reporters have interviewed attorneys representing patients of Dr. W. Scott Harrington. Below is the contact information for each.  

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Attorney Paul Boudreaux representing patients of Oklahoma dentist Scott Harrington
7447 South Lewis Avenue
Tulsa, Oklahoma 74136-6808
Phone – 877-777-4539 or 918-492-7674

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Attorney Pat Carr representing patients of Oklahoma dentist Scott Harrington
4416 S. Harvard Ave
Tulsa, OK  74135
Phone – 918-747-1000 or 800-777-4878

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Sill Law Group has filed the class-action against Dr. W. Scott Harrington
15005 N. Eastern Ave.
Edmond, OK  73013
Phone – 405-509-6300 or 855-329-8276

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AIG’s stalking attorney, Scott Greenspan is making headlines.

AIG’s stalking attorney, Scott Greenspan is making headlines.  Below is the article from The Post-Standard in Syracuse, NY.  Most interesting are the comments.  I’ve reposted just a few following the article.  There is an article at the New York Law Journal as well – subscription required

 

 

 

 

 

 

 

 

'Creepy' jury stalker hired by insurance giant AIG forces retrial in Syracuse dentistry malpractice case

Douglass Dowty | ddowty@syracuse.com By Douglass Dowty  ddowty@syracuse.com

November 19, 2013 at 6:07 AM

Syracuse, NY -- A jury's finding of no wrongdoing against a Syracuse dentistry accused of mistreating poor children will not stand after a "creepy" jury stalker prejudiced the verdict, a judge ruled Monday.

State Supreme Court Justice Deborah Karalunas ordered a new trial in the malpractice case against Small Smiles dental clinic, which operated on South Geddes Street before closing in March 2012.

The parents of Jeremy Bohn were among nearly three dozen to accuse Small Smiles of unneeded and improper treatment involving poor children. Bohn's case was decided by jury in October, which found no wrongdoing by the dental clinic.

But in a weird twist, the jurors complained to the judge after the trial about a stalker. The man was identified as Scott Greenspan, who said he was hired by the dental clinic's insurance company, AIG. Greenspan told the judge he was hired to observe the trial, nothing more.

But here are some descriptions of Greenspan's actions, taken from court transcripts after the trial:

Judge Karalunas:

The first question the jurors asked me was whether they did a good job. The second
question the jurors asked me was who was the individual who was stalking them
throughout this trial. When I inquired of the jurors what did the person look like who was "stalking" them, to use the juror's word, they advised me that it was the individual who I had admonished - I don't know that the jury used that word - during the course of the trial, the individual with the computer.

Aspen Dental Nightmares on Facebook

If you have an Aspen Dental Nightmare, there is a Facebook page dedicated to such.

https://www.facebook.com/pages/Aspen-Dental-Nightmares/213106462203040?fref=ts

Judge Orders Retrial for 1st Small Smiles Malpractice Case in New York–“Creepy” AIG Attorney Stalks Jurors

Syracuse, NY -  In October a verdict for the defendants was handed down by the jury in the 1st of 33 malpractice cases against Small Smiles and their dentists slated to be heard in New York courts.

Just after the verdict, the jury informed the judge they were stalked throughout the 15 day trial by a “creep” and “sleazy” guy who turned out to be a New York attorney by the name of Scott Greenspan.  Greenspan was hired by malpractice insurance carrier National Union Fire Insurance Company, a division of AIG .

Now, “upon examination of the facts”, Judge Deborah Karalunas. has ordered a new trial, concluding “…that Mr. Greenspan made improper contact with the jury.”

In her November 18, 2013 decision, Judge Karalunas finds AIG attorney Scott Greenspan’s conduct “violated the sanctity of the jury, raises ground for suspicion that the decision was found on something other than the evidence and was prejudicial and likely to influence the verdict.”

“This is not a matter of an isolated elevator conversation, cake for juror appreciation day or expression of condolence.  This is a case where jurors over a 15-day period believed that they were stalked, videotaped and closely monitored by a person they believed worked for the defendants,” says Judge Karalunas.

“This is a case where jurors performing their civic duty were made to feel bothered and scared.”

Under questioning by Judge Karalunas, one juror said:

“He followed us everywhere. When we would go to lunch, he’d follow us to where we were going.  One day we had an hour and 15 minutes, a little extra time, so we walked down to the Armory Square to Blue Tusk.  And I told the other jurors, this guy is following us everywhere.  So after the third time I saw him, I said look behind you, that’s what I’d say to them, and he would always be there.

“But when we would go on the elevator, he would always be there.  when we got outside, we would go to have a cigarette right out front, he’s always be standing close by.  When we got back on the elevator to come up,he was always there.”

‘…the only times we did not see him out of the whole time was once we went to Ale and Angus and once we went over to The Mission and we didn’t see him there.”

The juror told Judge Karalunas that Mr. Greenspan was in the elevator “at least half the time, if not three quarters of the time.” 

So there ya have it.  A new trial and I would guess that National Union/AIG would need to pick up the tab for this. Now, wouldn’t it have just been easier to write this child a check for all the hell he’s been put though?!  Just saying…

Small Smiles Dental Syracuse Bohn Malpractice New Trial Decision

Florida Dental Board allows Dr. Michael Tarver access to children after Florida Department of Health says he’s too dangerous

Apparently the Florida Board of Dentistry is more concerned about “saving face” of one of their licensees—Dr. Michael Addair Tarver— than they are about the  safety of the public, most notably, children.

At a board hearing on November 15, 2013, the board voted to reinstate the dental license of Dr. Michael Addair Tarver and agreed to a proposed settlement  with a few changes. Reports say the Dental Board members agreed to “reduce the fine imposed by 1/2;  from $15,000 to $7,000 and to removed a stipulation whereby Dr.Tarver must publish a 2,500 word article. (don’t worry, Dr. T, I think the the 2,500 word article is covered)

In September 2013, the Surgeon General and Secretary of Health, John H. Armstrong, MD, FACS, issued an Emergency Suspension Order for the dental license of Dr. Tarver after an investigation of serious allegations of patient endangerment and malpractice.  (see Background below)

According to the Ocala Post article, Tarver admitted he would sedate children if they misbehaved!  This is far past outrageous!  It’s criminal!!!  What next will happen that sends the message it is acceptable to sedate a child for misbehaving?!  Teachers?  Daycare providers?  Parents?  Grandparents?  Does this not scare anyone but me?!

Tarver must also complete continuing education on Ethics and keeping Dental Records.  By reading the Emergency Suspension Order, Tarver knows all about record keeping, since he was able to go into the computer an altered many of them.  Maybe this required CE class is about how to restrain the urge to alter patient records when investigators come knocking.  Reports also say he must be “monitored” by another dentists, someone other than his wife. 

WSJ - Getting a Grip on Dental Expenses

LOL, ya gotta love it.  There’s a “grip” on it alright.  A damn tight one!

 

 

 

Getting a Grip on Dental Expenses

Health Law Should Help Children and Some Low-Income Adults

By Kristen Gerencher

Nov. 16, 2013 8:05 p.m. ET

Oral health typically isn't covered by traditional health insurance, but kids and low-income adults soon may have more opportunity to take care of their teeth. As many as 8.7 million children are expected to gain dental insurance through the Affordable Care Act by 2018, according to the American Dental Association, though some experts expect a more modest addition of about 5 million children.

The news for adults is mixed. Medicaid, the federal and state health-insurance program for low-income people, will expand in some states under the health-reform law, providing more adults with dental coverage. While 29 states offer adult Medicaid recipients limited or comprehensive dental coverage, 21 states offer bare-bones, emergency-only coverage—or none at all, according to Oral Health America, a national nonprofit based in Chicago.

Medicare, the federal insurer for the disabled and for adults 65 or older, doesn't cover routine dental care, so many seniors still face hefty out-of-pocket costs. Two-thirds of 407 seniors earning less than $35,000 a year said they couldn't afford a procedure such as a crown, implant or bridge, according to a recent survey by Oral Health America and Harris Interactive.

Here are a few tips for managing dental costs, whether you're shopping for insurance or discounts:

Starting Jan. 1, more kids may find coverage through Medicaid, as 25 states and the District of Columbia make plans to expand the program, and through state or federal health-insurance exchanges. But the options can be confusing. Only two states, Washington and Nevada, require families who shop for health coverage on the exchanges to buy pediatric dental insurance as well, says Evelyn Ireland, executive director of the National Association of Dental Plans in Dallas.

On the exchanges, you need to weigh whether to buy a separate "stand-alone" dental plan or one that is part of a health plan. In some markets, because of the way deductibles are structured and because premiums could exceed the cost of expected care, it may make more financial sense to forgo dental coverage altogether.

If you choose to get pediatric dental coverage through a medical plan, check to see how the deductible is applied, Ms. Ireland says. "We've seen them all over the map," she says. The health plan may require you to pay its deductible before the dental plan will cover routine care such as well-child cleanings, sealants and X-rays. Because dental insurance has traditionally paid the full cost of preventative care, "it will be a big shock if [consumers] go under a medical plan and end up having to pay all of it out of pocket instead of none of it out of pocket."

Texas Dentists for Medicaid Reform Press Release Re: Antoine Dental Center

Hey folks, it’s not the Office of Inspector General who “lost”, it’s not just the taxpayers of Texas, it’s all taxpayers.  The Medicaid system is funded with state and federal funds.  Taxpayers should be outraged over this ruling! 

Texas Dentists for Medicaid Fraud Reform Press Release Re: Antoine Dental Center:

Judges Finds Another Texas Orthodontic Practice Innocent of Medicaid Fraud and Misrepresentation

Two administrative law judges with the Texas State Office of Administrative Hearings (SOAH) have issued their proposal for decision in the case of Antoine Dental Center of Houston (ADC) SOAH Docket No. 529-13-0997. ADC had been placed under a 100% payment hold in April of 2012 by the Texas Health and Human Services Commission Office of Inspector General (OIG) for "credible allegations of fraud" and willful misrepresentation in their orthodontic billings from 2008 to 2011. ADC had been one of the top 25 billers of Medicaid for orthodontic services in the state. The judges, in their decision, found that ADC had not committed fraud or any willful misrepresentation and ordered the payment hold discontinued.

"I am extremely relieved and happy with this decision," stated Dr. Behzad Nazari, the owner of ADC. "We had been crippled to the point of near bankruptcy by this payment hold and the allegations that had been swirling around the practice. I have been saying for a long time that we weren't guilty and I am thankful that the judges recognized that fact. There is something wrong with the way these cases have been prosecuted by the state."

Oh, I bet Dr. Nazari is happy happy happy.  Just because some judge (or jury)says you aren’t guitly doesn’t make it true.i.e.Casey Anthony, O.J. Simpson.

Judges Howard S. Seitzman and Catherine C. Egan wrote in their decision that "the prima facie evidence failed to support a credible allegation of fraud or willful misrepresentation and failed to show that ADC filed claims for non-reimbursable services. The few non-fraudulent record retention violations that ADC committed were technical violations that do not warrant a payment hold."

Sorry, judges, I 100000% disagree!  Anyone at that hearing could clearly see the fraud, and their expert Dr. Orr, was a joke.

It’s hard to pin fraud on top executives in big complex companies! Poppycock, says Judge Jed Rakoff

This may seem to have nothing to do with corporate dentistry and fraud, but you would be wrong.

Judge Rakoff Blasts Breuer, Prosecution of Companies Rather than Individuals in Bar Speech

Thursday, November 14, 2013

Absent sitting on the Supreme Court, it is difficult for a single judge to effect much change. Yet Jed Rakoff, in sending the SEC back to the woodshed in two separate cases over its failure to get factual admissions, meaning admissions of misconduct, on civil settlements of SEC cases, singlehandedly embarrassed the SEC and the Department of Justice into seeking these statements (for instance, numerous media reports indicate that the Administration wants that sort of confession as part of its pending settlement with JP Morgan).

Rakoff threw down another gauntlet in a New York Bar Association speech on Tuesday. I’m taking the liberty of quoting it at length because his rebuke is a breath of fresh air and roused the Department of Justice to issue a “we really are doing our job” response.

But if, by contrast, the Great Recession was in material part the product of intentional fraud, the failure to prosecute those responsible must be judged one of the more egregious failures of the criminal justice system in many years.

Rakoff then pointed to the fact that the FCIC and numerous government officials had discussed fraud in connection with the crisis and went further:

While officials of the Department of Justice have been more circumspect in describing the roots of the financial crisis than have the various commissions of inquiry and other government agencies, I have seen nothing to indicate their disagreement with the widespread conclusion that fraud at every level permeated the bubble in mortgage-backed securities.

He then goes through their litany of excuses (his word). Ooh, it’s hard to pin fraud on top executives in big complex companies! Poppycock, says Rakoff:

Who, for example, were generating the so-called “suspicious activity” reports of mortgage fraud that, as mentioned, increased so hugely in the years leading up to the crisis? Why, the banks themselves. A top level banker, one might argue, confronted with increasing evidence from his own and other banks that mortgage fraud was increasing, might have inquired as to why his bank’s mortgage-based securities continued to receive triple-A ratings? And if, despite these and other reports of suspicious activity, the executive failed to make such inquiries, might it be because he did not want to know what such inquiries would reveal?

This, of course, is what is known in the law as “willful blindness” or “conscious disregard.” It is a well-established basis on which federal prosecutors have asked juries to infer intent, in cases involving complexities, such as accounting treatments, at least as esoteric as those involved in the events leading up to the financial crisis. And while some federal courts have occasionally expressed qualifications about the use of the willful blindness approach to prove intent, the Supreme Court has consistently approved it.

The second, “weaker” excuse came out of Lanny Breuer’s mouth in his notorious Frontline interview: that the investors in mortgage-backed securities were sophisticated; it would be hard to prove they relied on ratings and fraudulent misrepresentation. Rakoff basically says that Breuer is a crappy lawyer:

Actually, given the fact that these securities were bought and sold at lightning speed, it is by no means obvious that even a sophisticated counterparty would have detected the problems with the arcane, convoluted mortgage-backed derivatives they were being asked to purchase. But there is a more fundamental problem with the above-quoted statement from the former head of the Criminal Division, which is that it totally misstates the law. In actuality, in a criminal fraud case the Government is never required to prove reliance, ever. The reason, of course, is that would give a crooked seller a license to lie whenever he was dealing with a sophisticated counterparty. The law, however, says that society is harmed when a seller purposely lies about a material fact, even if the immediate purchaser does not rely on that particular fact, because such misrepresentations create problems for the market as a whole.

The third excuse is that prosecution might hurt the economy. Rakoff indicated his discomfort with the “too big to jail” idea, but used that to lambaste the notion of prosecuting institutions as opposed to individuals. No institution would perish if an executive were prosecuted.

Rakoff carefully and pointedly says he’s not accusing prosecutors of revolving-door corruptions and that prosecutors maximize their value in the post-government service market by collecting scalps. Whether of not he actually believes that to be true, he has to say that or risk never hearing a big securities case ever again, in that both defendants and regulators could ask to have cases assigned to other judges based on the notion that Rakoff had said that prosecutors were soft of big corporate crime because they were currying favor with prospective future employers. Notice, by contrast, the cautionary example of Judge Shira Scheindlin, who had a ruling opposing New York City’s stop and frisk rules overturned because she violated the code of conduct for Federal judges by showing partiality.

But he point out other reasons why no one could be bothered to go after the conduct that wrecked the economy. The best US Attorney’s office, the Southern District of New York, was busy on the Rajaratnam case. Any smart prosecutor would ride that horse, which was ready to go, rather than take on the slog of a case that was years away from being files. So basically, with Congress starving the SEC of budget and making it capable only of handing out parking tickets in the form of insider trading cases, SDNY staffers were incentivized to go after the comparatively easy cases the SEC threw over the transom rather than pursue far more important crisis-related cases. Rakoff argues the other reason for the government’s reticence to prosecute is that it would embarrass government officials and expose policy failings.

And Rakoff described why prosecuting companies, rather than targeting individuals, produces lame outcomes:

But if your priority is prosecuting the company, a different scenario takes place. Early in the investigation, you invite in counsel to the company and explain to him or her why you suspect fraud. He or she responds by assuring you that the company wants to cooperate and do the right thing, and to that end the company has hired a former Assistant U.S. Attorney, now a partner at a respected law firm, to do an internal investigation. The company’s counsel asks you to defer your investigation until the company’s own internal investigation is completed, on the condition that the company will share its results with you. In order to save time and resources, you agree. Six months later the company’s counsel returns, with a detailed report showing that mistakes were made but that the company is now intent on correcting them. You and the company then agree that the company will enter into a deferred prosecution agreement that couples some immediate fines with the imposition of expensive but internal prophylactic measures. For all practical purposes the case is now over. You are happy because you believe that you have helped prevent future crimes; the company is happy because it has avoided a devastating indictment; and perhaps the happiest of all are the executives, or former executives, who actually committed the underlying misconduct, for they are left untouched.

Terrence Ewing Syler, DDS was sentenced to 22 months in jail

A joint investigation between the Feds and the State have landed another Texas dentist in the poky.  70 year old Terrence Ewing Syler, DDS was sentenced to 22 months in jail by U.S. District Judge Thad Heartfield.

Texas dentist sentenced to prison for Medicaid fraud

By DrBicuspid Staff

 

November 14, 2013 -- A Beaumont, TX, orthodontist has been sentenced to federal prison for Medicaid fraud after submitting claims for palatal expanders that were never provided to his patients.

Terrence Ewing Syler, DDS, 70, pleaded guilty in June to healthcare fraud and was sentenced to 22 months in federal prison on November 7 by U.S. District Judge Thad Heartfield, according to a U.S. Department of Justice statement.

Dr. Syler, who owned and operated Syler Orthodontics in Beaumont, submitted the fraudulent claims from January 2007 to October 2012, according to the statement. As a result of the scheme, Dr. Syler received $829,000 to which he was not entitled. As part of his plea agreement, Dr. Syler agreed to forfeit several bank accounts totaling just over $829,000 and pay a $6,000 fine.