Check out the uptick in legal, conference and lobbying expenses. I’m not sure how you can spend that much in a year and not work more than 8 hours a week.
Management fees have also skyrocketed.
Wednesday, March 12, 2014
CSHM comes out of hiding to issue statement regarding Medicaid Exclusion
CSHM and Small Smiles have been dodging media phone calls for days. They have finally issued a statement; begrudgingly I'm sure.
They say they will appeal. I hear they won't. Hell, they have been appealing since 2010; dang near quarterly.
They have received at least 2 earlier threats to be excluded; maybe three. The report issued last year by Senator Grassley's office basically asked, "how bad do these folks have to be before excluding them. They may appeal just to keep the revenue flowing. But I would think they should be on a Credible Allegation of Fraud pay hold.
CSHM Small Smiles Dental Media Statement 03-11-2014 by Dentist The Menace
Vice Chairman and Ranking Member of House Committee on Energy and Commerce-Oversight and Investigation subcommittee express continued concerns of dental management service companies (DMSOs).
In a letter (see below) to Inspector General Daniel R. Levinson, Rep. Michael Burgess (R-TX) and Rep. Diana DeGette (D-CO) express their continued concerns about “deceptive practices of dental management service companies (DMSOs)”.
They further call on HHS OIG to exclude any corporate dental companies from participating in the Medicaid program, saying, “Based on the report by the Senate Committees and the prior findings of HHS OIG, we concur with our Senate colleagues and recommend that HHS OIG should consider excluding any corporate entity that employs deceptive business practices that result in substandard care, from the Medicaid program.”
Burgess and DeGette are also concerned about the length of time it has taken to bring one of these companies—Small Smiles Dental Centers—to justice.
The letter recounts the history of the Small Smiles investigation, starting with the “2008 investigative news report” by WJLA in Washington. That report actually aired in November 2007; so it’s even worse, right?
The 3 page letter also states:
- “based on evidence undertaken by our offices, we are very concerned that the corporate structure and management of dental clinics often results in a failure to meet basic quality and compliance standards.”
Monday, March 10, 2014
Small Smiles exclusion- Senator Grassley is happy with the “Victory for Accountability”
Grassley: Notice from Inspector General is a Victory for Accountability
March 10, 2014
WASHINGTON – Senator Chuck Grassley, senior member and former Chairman of the Senate Committee on Finance, said the decision of the Inspector General for the Department of Health and Human Services to disqualify CSHM, LLC from the Medicaid program “will protect both taxpayers and vulnerable children receiving dental care in the Medicaid program.”
The Inspector General delivered a Notice of Exclusion (click here to read the Notice) following a year-long investigation by Grassley and then-Chairman Max Baucus of Montana into allegations of abusive treatment of children in clinics controlled by corporate investors rather than dentists. The senators issued a report and recommendations last July and urged the administration to ban dental clinics from participating in the Medicaid program if the dental clinics circumvent state laws designed to ensure only licensed dentists own dental practices to prevent substandard care.
“Our oversight found that when states can’t hold owners accountable, then clinics are more likely to fail to meet standards that protect the children who should be helped,” Grassley said. “The actions of some dental practices strained the Medicaid program and put low-income children in traumatic, highly questionable situations.”
FINALLY! Small Smiles Dental Centers are EXCLUDED from Medicaid and other Federal health programs!
OMG! OMG! OMG!
After 7 long years of persistence, it’s finally happened! Small Smiles Dental Centers are excluded from participation in Medicare, Medicaid and all Federal Health Care Programs!
Small Smiles Dental Centers - CSHM Exclusion Letter by Dentist The Menace
Let us not forget, the dental centers Quality and Compliance was overseen by:
Dr. Paul Casamassimo
Dr. Arthur Nowak
Dr. Joe Bernat
Dr. Anupama Tate
Dr. Steve Adair
Quality & Compliance - Dental Centers - CSHM by Dentist The Menace
I can’t woo hoo and OMG enough—I’m shaking from head to toe with glee!!!!!
Now, where can I locate a bottle of the “good stuff” Champaign!
Do you own your dental practice?
Let’s say you own your patient’s charts, do you own your dental practice?
Friday, March 07, 2014
Antoine Dental calling for a federal investigation into the judge because their win was overturned. Calling his decision “cut and paste”. What a bunch of cry babies.
Since the Antoine Dental Center's favorable ruling was overturned last week, TDMR, is calling for a Federal investigation into the judge. (God, I hate linking to these people! I think this is a ploy to get me to send them web traffic! LOL Don’t enter a password, it’s a phishing expedition.)
Yes, they want a Federal Investigation into the judge! Talk about cry babies! These guys simply can’t stand defeat. I bet they all got trophies for participation when they were kids.
However, to read about their game plan, you need a password. That’s right, a password. They have this big headline, then tell you to read it, you need their permission. Maybe it’s only a headline? Think?
I'd say an investigation should look at the previous decision of the administrative judges, but I try to give them a break that they just didn’t know what they didn’t know.
Frankly, the more Federal investigations into this the better. What's really odd, is this particular case is over some $400,000. Who spends $2-5 million in attorney fees to recoup that amount? Yeah, this is much bigger than Antoine Dental Centers.
One thing that crosses my mind, is how Dr. James Orr and Bob Anderton trained these dentists how to cheat the system—in Anderton’s own private law office—and now Orr is the “expert” witness for the dentists and Anderton is their attorney. Talk about conflict of interest! Geez! This seems to be more about Orr and Anderton covering their own butts, than it is about Antoine Dental Center’s pay hold.
Currently Orr and Anderton are touring, teaching dentists about—of all things—record keeping!
There is just no way that this is sliced where the attorneys representing Antoine Dental Center and Dr. Nazari have their clients best interest ahead of their own. I almost feel sorry for Nazari. He could have, reached some settlement, taken his slap on the wrist, paid a little fine, and gone on about his business. At worse, a few months jail time; he would have gotten more sleep there than I bet he’s getting these days. I believe he is being coerced. Pure craziness.
Where’s the popcorn?
Thursday, March 06, 2014
Analysis of ADC vs. Texas Health and Human Services Commission
Analysis of ADC vs. Texas Health and Human Services Commission
March 6, 2014 -- Why should anyone care about a dental Medicaid ruling from an administrative law court in Travis County in Texas? One reason is that this case involves several millions of taxpayer dollars. Other similar cases brought before this court of alleged dental Medicaid fraud and abuses have and will involve taxpayer money, in excess of $100 million.
The vast majority of dental Medicaid fraud cases are generally resolved in settlement agreements. Alleged violators usually pay some amount of restitution to the government in exchange for no admission of wrongdoing. Often, the alleged violators return to "business as usual." We, the public and dental profession, receive little or no data on case specifics. Records of investigations are sealed upon settlement.
Public record disclosure of this particular case exposed some of the dark underbelly of the dental Medicaid industry, along with some of its nefarious inner workings.
Wednesday, March 05, 2014
Dr. R. Quinn Dufurrena named Executive Director of that nasty Dental Group Practice Association (DGPA)
In the Welcome Letter from Dr. R. Quinn Dufurrena as posted on the Dental Group Practice Association (DGPA) and the DGPA’s press release, I think it’s clear what the plan is for the group; more “creative” dentistry —i.e. teledentistry (whatever the hell that is)—and changing state dental practice acts to be more revenue generating friendly, despite any loss in patient quality of care. After reading excerpts of several articles and interviews with Dufurrena published over the years, it appears he’s wishy washy on many issues, other than teledentistry. Other than that, he will be whatever they need him to me. Of course, I could be wrong.
From Dufurrena’s Welcome Letter at the DGPA:
- Nearly 20 years ago, I first learned of the dental support organization (DSO) model.
- DSOs financial benefits, administrative capabilities and group structure truly resonated with me.
- I’ve practiced dentistry in many different arenas, from the military and government to private practices and the non-profit sector.
- …dental professionals are still unable to circumvent the financial and time limits that have restricted them for years.
- …problem that requires collaboration and unity throughout the dental community.
- It has become a mission of mine to help answer the many challenges dentists are facing in this economic and regulatory environment, and my first step is creating awareness on the advantages of the DSO model.
- …my course of action for DGPA revolves around three key contentions: ethics, metrics and innovation.
- …build on the DGPA’s current code of ethics.
- …offer innovative ideas to dentists around the country
- I believe with the help of our member organizations, we can achieve a level of awareness for DSOs that will diminish the misinformation that has plagued our model and shed new light on the success DSOs
From the March 3, 2014 DGPA Press Release:
- “Much as the Affordable Care Act strives to increase patient access to quality care through innovative approaches to the health care system, the DSO model strives to do much the same.” – Doug Brown, co-president of the DGPA
- “…confident that Dr. Dufurrena will lead our association during an exciting period of evolution in the field of dentistry, one where more dentists are shifting from solo practitioners to group practices and the DSO model” – Doug Brown, co-president of the DGPA
- Use of the DSO model has shown success.
- "Dr. Dufurrena's background – ranging from work as a solo practitioner working on policy for the ADA to serving as executive director of a state dental association – provides him unparalleled insight into the role DSOs and their supported dentists can and must play in helping to bridge our nation's growing dental divide" – Steve Thorne co-president of the DGPA.
- Beyond his chair-side duties, Dr. Dufurrena served an associate professor at the University of Colorado School of Dental Medicine and worked at the ADA as a Hillenbrand Fellow.
- Dufurrena will officially begin his role as executive director on March 3 and will be based in Denver, Colorado.
- "I've been committed to promoting and providing affordable, high quality oral health care throughout my entire career. These are the same values shared by all members of DGPA and their supported dentists.- Dr. R. Quinn Dufurrena
- "I am honored to have been selected and look forward to working with all stakeholders at the state and federal levels to help them better understand the role and value a DSO plays in supporting quality dental care to millions of Americans every year." Dr. R. Quinn Dufurrena
- He is replacing Dr. Ed Meckler who served as executive director since DGPA's inception.
Doug Brown is president of Affordable Care, Inc. Steve Thorne is president of Pacific Dental Services. Neither are dentists.
Dr. Richard Quinn Dufurrena hasn’t been interested in the actual practice of dentistry in years; if ever. But he has been interested in the business of dentistry. So he is going to fit right in the DGPA and the DSO business modeling they promote.
From the June 2008 article about Dr. Dufurrena’s Hillibrand Fellowship and him taking the position as Executive Director of the Idaho State Dental Association:
- The 12-month program comes with a stipend and focuses on non-clinical organizational experience and education and allows fellows to select a special project and area of study. It provides fellows with an intensive orientation to all ADA agencies and departments, orientation to other organizations serving oral health, a basic orientation to federal and state government agencies playing key roles in oral health, academic courses and project experience
Antoine Dental Centers to remain on payment hold
Judge finds credible evidence of Medicaid fraud by Texas clinic
By Donna Domino, Features Editor
The 36-page ruling was issued February 28 by Judge Rick Gilpin, an administrative law judge for the Texas Health and Human Services Commission (HHSC).
Reimbursements for Medicaid claims by ADC, which has two clinics in Houston, have been on hold since 2012, pending an investigation by the HHSC and the Texas Office of Inspector General (OIG) for Medicaid fraud involving orthodontic care. ADC ranked in the top 25 providers for Medicaid payments; about 70% of ADC's patients were Medicaid recipients, the ruling stated.
Tuesday, March 04, 2014
What happened to Richardmalouf.com?
In February 2013, Dr. Richard Malouf of All Smiles and home waterpark fame started his own website, richardmalouf.com. Below is his press release about all the issues he was addressing.
New Website Released for Dr. Richard Malouf of Dallas
Successful Dallas dentist and entrepreneur sets up own news portal at http://www.richardmalouf.com.
Amazingly, it’s gone poof!
His facebook page is barebones, so is his youtube channel.
- Richard Malouf Facebook - https://www.facebook.com/DrRichardMalouf
- Richard Malouf Youtube Channel - http://www.youtube.com/user/DrRichardMalouf
But no Richardmalouf.com.
Saturday, March 01, 2014
Houston dentist, Behzad Nazari, and Antoine Dental to remain on 100% “pay hold” due to fraud investigation
UDATED 03-03-2014
The scammers running the Texas Dentists for Medicaid Fraud Reform (TDMR) website have boasted time and time again, over rulings made against Texas taxpayers and for Antoine Dental. Heck, they have a whole section of their website devoted to their “wins”. They have also had their cronies on this website, commenting about how they are winning their cause; which appears to be “Let us continue to defraud taxpayers.” Frankly, I think their name should be “Friends of Dental Medicaid Fraud”. I’m not sure what they consider a “win”. Apparently, it’s not what you and I call a “win”. Their headlines over there are outright false! So imagine the bullshit contained within! I especially love their comment section, entitled “Speak Your Mind”, amazingly what is on my mind doesn’t seem to make it, maybe yours will. Click here.
Examples:
On November 5, 2013 their headline read, “OIG Loses Another Medicaid Fraud Court Battle” an article they were happy to assist with in the Texas Tribune.(Battle, yes, WAR, NO!)
Then on November 6, 2013 their headline read – Antoine Dental Center Innocent of All OIG Allegations of Fraud and Misrepresentation.
(This is especially galling, since it is an outright lie! Lie!!! Lie!!)
Again, on January 17, 2014—SOAH Judges Again Reject OIG Arguments in Antoine Dental Case
(Laughable!)
Today, what’s missing from their website is the headline of this blog post;or something close to it.
It appears the Applet Court and Judge Rick Gilpin disagreed 100% with all other rulings in the Antoine defraud Texas taxpayers case. He issued a “Final Order” on Friday (February 28,2014) that walked through this case and all the hearings and ruling step by step and ruled completely opposite of all other rulings—Antoine Dental to remain on 100% pay hold.
You don’t want to miss reading the Final Order. He all but called them all, Antoine owner, Dr. Nazari—including the Administrative Law Judges—criminals and at the best—imbeciles. You read it and decide.
Thursday, February 27, 2014
Dr. Daniel Chaparro III, owner of Smile By Design, under investigation by FBI
I found Dr. Chaparro’s concerns over his investigation by the FBI a bit odd.
Apparently, he has enough wrong doings on the radar of authorities to result in a raid by the FBI. Yet, his concerns seems to me a bit misplaced, but I could be wrong.
The icing on my cupcake was his apparent frustration of having to deal with the government’s “spider webs of government red tape” He seems to think he was forced to see Medicaid patients.I doubt he was grumbling when he was receiving taxpayer monies for those services.
Looking at the 2011 data made available by the 2012 Kool Smiles funded Art Laffer DSO Study, Smiles By Design was way down on the list of outrageous billers in Texas.
However, Chaparro has been in trouble before.
See: http://cqrcengage.com/capg/app/document/1697422;jsessionid=klTJmUc7gY-oFKgGZsWXQeAF.undefined
"Chaparro has faced criminal charges in the past including aggravated and domestic assaults between 1995 and 2000, practicing dentistry without a license in 2003 and injury to a child in 2004. He was convicted of domestic assault in 2002, according to court records."
He was also disciplined by TSBDE in 2000 & 2006.
Lubbock dentist warns of 'Big Brother' as FBI investigates Medicaid billing Posted: Feb 20, 2014 12:03 PM CST Updated: Feb 20, 2014 10:45 PM CSTBy Shaley Sanders - bio | email
LUBBOCK, TX (KCBD) -
A Lubbock dentist is voicing concerns about patient privacy and complaining about "Big Brother" after the FBI seized his patient records on Thursday morning.
The FBI executed multiple search warrant around 8 a.m. Thursday at the home of local dentist, Dr. Daniel Chaparro III and at his business, Smile by Design.
"They didn't need a warrant, they could come ask for anything they wanted and the record room is always open to them. I don't know why they escalated this to a drama, basically," Chaparro said.
Dr. Donald P. Prohovich pays $400,000 to settle fraud allegations in Massachusetts
By Maria Papadopoulos
The Enterprise
Posted Feb. 25, 2014 @ 12:39 pm
Updated Feb 25, 2014 at 6:17 PM
An Easton dentist has agreed to pay $400,000 to the state’s Medicaid program to resolve allegations of improperly billing for visits to MassHealth members living in nursing homes, Attorney General Martha Coakley announced Tuesday.
An investigation found that Dr. Donald P. Prohovich, a dental provider in the MassHealth program, violated a regulation established in 2010 that limits payments for providers to one “house call” to a facility per day, Coakley said in a statement.
Investigators found that from July 2010 to September 2013, Prohovich allegedly improperly billed for house calls to elderly MassHealth patients in nursing homes in eastern Massachusetts on a per-patient, per-day basis.
Wednesday, February 26, 2014
UPS Employees targeted by California dentist
Calif. dentist indicted for $1M in fraudulent billings
February 25, 2014 -- A California dentist has been indicted on federal healthcare and mail fraud charges of billing more than $1 million for work never performed, sometimes for teeth patients didn't even have.
According to the U.S. attorney's office, Sacramento dentist David M. Lewis, DDS, 60, began targeting United Parcel Service (UPS) employees in 2008 for dental treatment. The UPS healthcare plan provided 100% coverage with no annual limits. Dr. Lewis offered cash and other incentives to UPS patients for getting dental care from him or for recruiting other UPS employees to receive treatment.
The grand jury's 18-count indictment alleges that Dr. Lewis submitted claims to Delta Health Systems, which administered the UPS healthcare plan, and falsely billed the plan for work that was never performed. In many instances,
Tuesday, February 25, 2014
Dr. David Timothy “Ty” Turbyfill, accused of sexually molesting 3 teens is back in business in Florida.
Dr. David Timore Turbyfill, accused of sexually molesting 3 teens is back in business in Florida. Among claims in the complaints, witnesses alleged that Turbyfill was “seen moving his hips and pelvic region suggestively near patients and seemed to be sexually aroused in the presence of some patients — covering his groin and leaving the room on more than one occasion.”
I guess it’s possible he was just “twerking”. (sarcasm)
Blessed by the Florida Board of Dentistry, he now has access to patients at Orange City Surgical Solutions
2574 S. Volusia Ave.
Orange City, FL 32763
386-744-2999
info@orangecitysurgicalsolutions.com
It’s also noted he has dropped the “Ty” nickname and using his real name, David Tim (Timore) Turbyfill.
His bio at the website lists numerous titles and awards, but fails to include any mention of the accusations and settlement.
According to his settlement agreement,Turbyfill is required to be “monitored” by a “licensed health professional” when using anesthesia or conscious sedation. I wonder exactly who is doing that “monitoring” and how the “monitoring” is being “monitored”.
Sunday, February 23, 2014
Flora Mounessa, DDS and husband—Shahram Sharif—arrested
Flora Mounessa,DDS husband, Shahram Sharif then and now.
According to Great Neck, NY District Attorney, the couple defrauded Medicaid out of $70,000, but this couple did it with a “twist”, not seen much here on DTM.
This couple underreported income and assets to obtain benefits. Dr. Flora must not be well schooled on the proper defrauding of Medicaid by dentists or this is the new “bonus” system.
According to reports, the couple actually had income of $2.74 million during the 5 year period. Just looking at the numbers it might look like they left out some zeros on their reports. I don’t know, and this is just a guess, but I bet there was some other Medicaid defrauding going on over at the dental clinic. Take a look at the “store front”, looks more like a pawn shop to me.
A husband and wife face felony fraud charges after underreporting assets and raking in more than $70,000 in Medicaid benefits, according to the Nassau County District Attorney's office.
Flora Mounessa, 39, and Shahram Sharif, 45, both of Great Neck, were each charged with one count of second-degree welfare fraud, one count of second-degree grand larceny, and one count of first-degree offering of a false instrument for filing.
The couple is accused of underreporting their assets enough to be able to claim Medicaid benefits for themselves and their daughter. They allegedly reported an annual income between $23,400 and $31,200.
Between January 2005 and October 2010, the defendants received $70,193.64 in benefits. During that time, Mounessa worked as a dentist and Sharif was self-employed, buying and selling real estate. Their jobs raked in $2.74 million over the five years they were given benefits.
The couple was arrested and charged Friday after an investigation.
If convicted, the couple faces possible 15 years in prison, plus restitution and fines. The smallest consequence they could face is a conditional discharge, said the DA.
They were released by a judge and put on probation until they return to court March 11.
Dr. Flora Mounessa’s facebook pages says she works for Nora Family Dental, studied at NYU and prior studied at Yeshiva University (SCW)
Monday, February 17, 2014
Interview with Dr. Mark Malterud — Academy of General Dentistry Region-10 Trustee
Interview with Dr. Mark Malterud
By Michael W. Davis, DDS | February 17, 2014
INTRODUCTION
Dr. Davis: Dr. Malterud, I’m honored to bring forth this interview. You’ve done a great deal facilitating education for the dental profession, which eventually serves the public interest. Services dentistry can provide patients today is greatly advanced, from 10-20 years ago. You have personally contributed to this wonderful progress, some of which I hope to expand upon with our discussion.
INTERVIEW
Dr. Davis: The dental profession today is exposed to newer concepts, such as “minimally invasive dentistry”. Over time, these principles are becoming accepted into dental university curriculums and the general practice of dentistry. Please explain to the average person, what is meant by minimally invasive dentistry and how it may benefit them. Please give a few specific examples, in our rethinking of traditional treatment protocols.
Dr. Malterud: I appreciate being asked to be interviewed for this column. As far as the meaning of Minimally Invasive Dentistry (MID), I can sum it up fairly easily. It is a philosophy that tooth structure is sacred and once removed it cannot be brought back. So, treat every lesion and problem from the perspective that we remove the problem (pathology) and restore it as definitively as we can with modern technology.
The reality is that whatever we place in the mouth to restore what has been lost will break down, and, in time, given enough use, will fail. However, technology, materials and techniques are constantly being developed, and, when the time comes for restorations to be replaced, we will have better materials to restore the tooth. I heard it once described as tooth banking by Dr. Ray Bertolotti and that is a good description.
Thursday, February 06, 2014
Kool Smiles Dentist—Dr. Tuan “Terry” Truong, DDS— sentenced to 18 months in jail
Let me get this straight, private equity firm FFL’s corporation—NCDR, LLC/Kool Smiles—hired Dr. Troung, trained him to be a thief, gave him quota’s to meet, and now want their money back for legal expenses. OMG!
Here is what I want to know:
1. Why was Dr. Tuan Truong not on his hands and knees begging to spill his guts about this crooked company?
2. If he did who stopped him and why?
3. Was he here on a work visa?
PS: Don’t choke and puke when you read out “Kool Smiles” cooperated with the investigation! You bet your ass they did, and directed investigators to only what they wanted them to know apparently.
Abilene Dentist Sentenced to 18 Months in Federal Prison and Ordered to Pay Nearly $58,000 in Restitution in Medicaid Fraud Scheme
February 5, 2014
Defendant Worked as a Pediatric Dental Provider at Kool Smiles
and Personally Benefitted From SchemeABILENE, Texas — Dr. Tuan Truong, aka “Terry Truong,” of Abilene, a dentist who practiced pediatric dentistry at Kool Smiles in Abilene, was sentenced this afternoon, by U.S. District Judge Jorge A. Solis, to 18 months in federal prison. Truong pleaded guilty in August 2013 to an Information charging one count of making a false statement in connection with a health care matter. Truong was also ordered to pay $57,969 in restitution to Kool Smiles. Today’s announcement was made by U.S. Attorney Sarah R. Saldaña of the Northern District of Texas.
According to documents filed in the case, in summer 2008, Truong began working for Kool Smiles, which paid him a base salary and offered opportunities for bonuses based on additional procedures he performed in excess of daily targets set by Kool Smiles management. Dentists were required to use professional judgment in the treatment and management of patient care.
Wednesday, February 05, 2014
Uh-Oh! Dr. Richard Malouf abandoned his computer servers! YIKES!
Last week, (January 31, 2014) Dr. Malouf was back in court, this time in front of the bankruptcy judge. Under an earlier Agreed Order (Doc 637) Malouf agreed to abandon the property to the state, with the “provision that a neutral third party” would serve as Special Master of the bankruptcy estate.
Apparently Malouf was more concerned about the proper functioning of his waterpark than what incriminating evidence might be on the computer servers he happily “abandon” to the state of Texas. He recently tried to block the State of Texas access, but in an Order issued January 31, 2014 (Doc 762) a judge “clarified” the previous Agreed Order telling Malouf, tough titty.
Ok, so the judge didn’t say exactly that but did say:
“To avoid further doubt, the Court further clarified that the property was abandoned with this Court’s approval to The State Of Texas and simply appointed the Special Master to provide fair access and control, but not as owner of the property.”
“It was the Debtor’s prerogative to decide what to do with the property. The Debtor decided and this Court approved abandonment. The Malouf entities agreed to the abandonment.”
I bet you don’t see this over on the TDMR website!
Wednesday, January 29, 2014
NCDR, LLC–Kool Smiles-Resolution Dental wants you and your practice.
The private equity firm, FFL, who owns Kool Smiles Dental and Resolution Dental is moving away from opening their own clinics and moving toward the Heartland Dental business model—what I call the F & S business model. (S for suck, so you can figure out what the F stands for).
F & S Business Model - This is where they come in, offer practice owners an unrealistic amount for their established practice, put the current owner and staff under employment contracts, then set unrealistic income quota’s that forces dentists and staff to make decisions not necessarily good for the patient. See A peek under the sheets of Heartland Dental
Rumors last years indicated Kool Smiles Dental had their highly questionable but lucrative Medicaid income stream reduced significantly due to what was apparently questionable dental treatment and billing practices. In 2013 they began switching many of their practices to Resolution Dental.
Now, they want to purchase already established dental centers. I’m sure this is a much faster way to increase the dwindling revenues.
They advertise:
Are you considering selling your practice? Let's talk.
They want locations “not in the hood” and are offering a “fast and furious” “too good to be true” amount cash for said locations. They want dentists willing to sign restrictive 2 years employment contracts, which will no doubt include a stiff penalties, especially for disparagement of the company. They also offer bribe your staff to stay on, but make no promises.
Tuesday, January 21, 2014
Any updates on Kool Smiles and Resolution Dental Clinics
I’ve not heard anything about this guys lately. Well, not since they sent warning letters out to current and past employees.
Anyone have any idea what’s happening down in Atlanta?
Pat on the Head or Slap on the Wrist
AG Gansler Secures Settlement from Baltimore County Dentist
Owner of Baltimore city practice must repay $25K to Medicaid program
Baltimore, MD (January 3, 2014) - Attorney General Douglas F. Gansler announced today that the State of Maryland has reached an agreement with Lisa Valentine, D.D.S., of Woodstock, for her to repay the Medicaid program $25,000 in civil damages for services that were billed, but never rendered. The Medicaid Fraud Control Unit (MFCU) of the Office of the Attorney General conducted an investigation into the practice of Dr. Valentine, which included numerous interviews with her former patients and staff.
"The hardworking taxpayers who fund the Medicaid program deserve to know that their money is benefiting those it is intended to help," said Attorney General Gansler. "Our office took swift and decisive action against this dentist who was trying to abuse the system."
The investigation showed that Dr. Valentine's husband, Spencer Brown, in his capacity as an employee of the practice, billed the Medicaid program for services that were not provided.
Brown previously pleaded guilty to one count of Medicaid fraud for submitting the fraudulent claims to the Medicaid program from January 2008 through November 2010. He received a sentence of five years incarceration, with all but one year suspended, and was ordered to pay restitution of $156,918 to the Medicaid program.
Attorney General Gansler thanked Assistant Attorneys General Tom Rafter and Shelly Martin, as well as Investigator Mark Holback, all of the Medicaid Fraud Control Unit, for their work on this case.
Thank you e-mails always appreciated
It all turned out well for this little 3 year old after panicked mom decided to do some research and ask questions.
January 15, 2014
Hi Debbie
I just wanted to give you an update. I took my daughter for a second opinion. Syosset, NY.
I would have never imagined the dentist would look like a housewife of Beverly Hills. But she had a brain, so that was great.
She told me that my daughter DID NOT have three cavities in her mouth as indicated by the first dentist.
As you mentioned in our previous correspondence, it was deep groves and discoloration in her back teeth.
This doctor was able to get perfect images of the teeth.
My daughter did have one cavity in the front which was a result of her teeth being too close together.
The doctor advised it was too small to go through the trouble of filling it, gave my daughter a toothpaste that would slow the growth of the cavity and told me to bring her back in six months.
Had I taken the other dentist word for it, my daughter would have had work done on teeth that were perfectly fine.
Sometimes, we doubt ourselves believing that these doctors are smarter than us, because they were able to study longer and go beyond four years of college. Sometimes these doctors are overly confident in their craft, believing they aren't capable of making a mistake.
Erasers and malpractice insurance was made for a reason.
So, THANKS! for your blog. I hope other parents find it, read it and understand that it's okay to challenge the doctors.
Below is this thankful mother’s original email:
January 5, 2014
Hello
I have 4 four year old that was recently seen by a dentist. I was told she has three cavities. My heart dropped. I wanted to cry for my daughter. I am 34 years old and I HATE going to the dentist.
After being told my daughter had cavities, I immediately went home and started to read. The article of the day was a 3 year old in Hawaii that died from a cocktail of drug while at the dentist. My heart sank even deeper. I am dealing with so many things in my life but, the news of my baby having cavities has hands down been the worst.
What would be the proper procedure (in your opinion) for treating children so small with cavities? It seems as if death by the death is very common.
I don't want my child to be in pain and have a fear of the dentist however, i don't want her to be one of the unlucky children that don't make it out the chair.
Please respond. I look at my daughter and start to cry.
Saturday, January 18, 2014
Indiana taxpayers pick up the tab for shafted Allcare Dental patients
Customers of Allcare Dental get money back
Updated: Thursday, January 16, 2014, 12:09 PM EST
INDIANAPOLIS (WISH) - Many patients who lost money when a dental business closed its doors without notice got some of their money back, Indiana Attorney General Greg Zoeller announced Thursday.
Allcare Dental closed in 2011, leaving customers in Avon, Evansville, Fort Wayne, Indianapolis, Lafayette, Mishawaka and Muncie without a provider and with a lot of questions.
The dental company declared bankruptcy. Eventually, the nearly 300 customers who filed complaints in Indiana received some or all of their money back. The patients lost anywhere from $69 to $9,125 but the state could only pay back a maximum of $3,000 per person by state statute.
Wonder if Greg is related to Linda Zoeller of Small Smiles fame?
Thursday, January 09, 2014
Dr. Chris Salierno: Good Dentists Can Make Bad Decisions
Interview with Dr. Chris Salierno
Dr. Chris Salierno Introduction
Education
Dr. Salierno received his B.S. from Muhlenberg College and his D.D.S. from SUNY Stony Brook School of Dental Medicine. He completed his formal training at Stony Brook Hospital’s General Practice Residency program where he focused on implant prosthetics. Dr. Salierno practices general dentistry in Melville, New York.
Leadership
Early in his career Dr. Salierno served as president of the American Student Dental Association. He has continued to lend his leadership skills to serve his colleagues, as well as the public, by serving on a variety of committees that promotes enhanced professional ethics for the dental profession—including advocacy for new dentists.
His published professional papers and educational lectures have elevated quality care in dentistry. He writes and lectures internationally on a variety of subjects including, implants, occlusion, TMJ disorders, and practice management.
Much of his lecture content is available on his blog, The Curious Dentist, which also features candid discussions about everyday dentistry. Dr. Salierno is co-editor of The Surgical-Restorative Resource, which focuses on the team approach to complex dental care. He is a past Chair of the ADA New Dentist Committee, and is currently the President of the Suffolk County Dental Society.
Interview Questions
Dr. Davis: Dr. Salierno, your blog, “The Curious Dentist”—directed at our 
One example, of course, is transferring the tax burden of federal FICA taxes from the employer, to the employee dentist, therefore increasing the employer’s bottoms line. Employers habitually misclassifying “employees”, as “independent contractors”. This, of course, is illegal and in direct contradiction to well established and routinely enforced IRS Guidelines.
We have seen employers configure employee dentist compensation, using a convoluted structure of percentage of collections or billable services which would require a doctorate degree in economics and quantum mechanics to decipher. In numbers of cases, employee dentists are not getting a fair deal.
There is also indisputable evidence of the pressure experienced by our junior colleagues to provide high-skill services, such as molar endodontic therapy in a rapid cut-rate manner. None of this serves the best interest of the patient, nor the dental profession.
Dr. Salierno, could you please highlight a few of these problem areas for dentist employees. In fact, I’d love for you to publish a paper specific to these issues, and give a lecture to every senior dental school class, prior to graduation.
Dr. Salierno: I’ve actually participated in an initiative just like you’ve suggested. The ADA’s Success Program brings leaders into dental schools to give presentations on subjects like ethics, practice management, and career choices. Programs are offered for first through fourth year and I’m happy to say that the majority of schools take us up on it. The main message to students is that they are not alone, no matter what challenges may face them in the years to come.
The changing landscape of dental Medicaid: Part 2
By Michael W. Davis, DDS, DrBicuspid.com contributing writer
January 9, 2014 -- In the first of this two-part series, Dr. Davis explained how the present degree of dental Medicaid fraud, waste, and abuse is not sustainable and how it is slowly changing. Read that part here.
In reaction to the public's concern about the excessive abuse of child restraints, a number of Medicaid mills have jumped onto the conscious sedation bandwagon. The best option of treatment is to sedate in a hospital setting with IV sedation, a properly trained anesthesiologist to continually monitor the child's vital signs, with reversal medications at the ready, and the capability of nearly instantaneous airway resuscitation. Since Medicaid often doesn't pay adequately for hospital cases, the children's safety is too-often compromised.
Too often, the dentist has little-to-no advanced life support training. A child going into shock from an adverse drug reaction already has tiny blood vessels in which to attempt to stick an IV line. Their airway is small and often further compromised by enlarged tonsils, with a natural anatomy that already appears anatomically constricted and funnel-like.
I won't say it's not feasible to do this care properly, but a doctor has to deliver conscious sedation (often involving multiple drugs) and monitor all vital signs, while simultaneously roundhousing sedated children with steel crowns and pulpotomies. However, under the present Medicaid program, there are huge financial disincentives to provide this style of care properly. Corners get cut and children get harmed, too often permanently.
So, what is the fallout for the dental profession? Certainly the negative press has added a degree of distrust from the public. Trust is difficult to obtain and easily lost. And once lost, it's even more difficult to regain.
Wednesday, January 08, 2014
The changing landscape of dental Medicaid: Part 1
The changing landscape of dental Medicaid: Part 1
By Michael W. Davis, DDS, DrBicuspid.com contributing writer
January 8, 2014 -- Some experts examining the Affordable Care Act (ACA) have estimated a 25% to 33% increase in eligibility. What they may miss is that enrollment eligibility for potential patients does not necessarily equate into actual patients having access to dental care. Eligibility for services is a different element than access to those services. While this makes perfect logic to small or large healthcare business owners or managers, it may be outside the comprehension abilities of Washington bureaucrats.
In 2007, the U.S. Health and Human Services Office of Inspector General (HHS-OIG) issued a troubling report, which stated 31% of reviewed dental Medicaid submissions were improper. Again, please take note of that number -- 31%!
That degree of dental Medicaid fraud, waste, and abuse is not sustainable. The taxpayer cannot and should not fund such a dysfunctional program, no matter how well intentioned. Throwing limited public money at problems of disadvantaged children with dental needs, without adequate oversight, regulation, and enforcement represents an abuse to the American taxpayer. That unfortunate reality is slowly changing
Crime Watch
In New Holland, Pennsylvania a woman admitted stealing $3,743 from the dental office of DRr. Robert-Bers Techer, where she was employed. She also altered some bookkeeping records so family members could received $1,608 in dental treatment. She has been arraigned and released on $25,000 bail and faces a preliminary hearing on January 16, 2013. Total $5,351.
In Maryland, Spencer Brown, husband of Lisa Valentine, DDS, who worked for the practice billed Medicaid for services that were never provided totally more than $156,000. Maryland’s Attorney General “settled” with Brown for $25,000 in damages and restitution of $156, 918 in restitution and will spend one year in jail. (probably less).
Let’s see how it turns out for the lady in New Holland, Pennsylvania.
Tuesday, January 07, 2014
Corporate dentistry’s latest attempt to silence critics and trample on the 1st Amendment–Comfort Dental sues professors.
Dr. Melvin Ball is a part time professor at the University of Colorado School of Dental Medicine. In December 2013 Dr. Ball was speaking with colleagues in teacher’s lounge at the university. During the conversation it’s alleged Dr. Ball voiced his opinion and confusion about Comfort Dental’s business model. Outrageous! (sarcasm). Comfort Dental is also targeting three other professors, Sally Preston, DMD; Thomas Borris, DDS, and James Woolum, DDS seeking $2.45 million in damages.
[My God, where were these campus speech police back in the 60’s. Berkley would have to close the campus if professors weren’t allowed to voice their opinions!]
Comfort Dental and it’s founder, president and CEO Rick Kushner, feel “they” were defamed when Dr. Ball spoke of his own experience as a doctor of dentistry saying, “I know you cannot provide consistent, quality dental care when all you care about is your bottom line.”
[I use the word “feel” loosely, since I’m not sure how a corporation actually “feels” anything. ]
Comfort Dental is also claiming they suffered damages because Dr. Ball stated he “can’t understand how he [Kushner] gets away with it.” God help those of us who do not hold an MBA! Comfort Dental also claims they suffered damages when Dr. Ball invoked Godwin’s law; allegedly Dr. Ball referred to Kushner as being “like Hitler”.
[Don’t ya wonder who the snitch is or how many there are? Must be several since they cover the entire campus apparently. Oh, wait, was all this detail obtained from surveillance cameras? Wouldn’t that be interesting. hmm… That could open up a while new area of law, criminal, tort and “s”ort…]
The complaint against Dr. Preston states she told her class it was typical of Comfort Dental dentist to do shoddy work after of her students related a story from a Comfort Dental patient who had come to the dental school’s emergency clinic for treatment after two trips to Comfort Dental where the patient was less than satisfied and left in pain.
[ I suspect any dental care provided by Dr. Rick A. Kushner would be highly illegal and unethical since his dental license is expired nearly 2 years ago – February 2012.]
Monday, January 06, 2014
3 year old Finley Boyle has died after careless sedation by dentist and staff in Hawaii dental office.
This is the saddest picture I think I’ve seen in many years and should be the one that comes to mind the next time ANY dentists want to sedate a child. Sadly these deaths are more common than you may think. In 2011 there were 8 that were reported, who knows how many were not.
Court documents say when Dr. Lilly Geyer discovered Finley had gone into cardiac arrest, the doctor ran down the hall to a pediatrician’s office in the building to get him to come and perform CPR.
The AAPD Guidelines recommends vital signs should be monitored and documented at least every five minutes for patients who are sedated. However, as was learned in the dental malpractice case in Syracuse, NY the AAPD guidelines are “options”. Dentists on the stand testified under oath, the AAPD guidelines have little influence in the decisions many dentists make in treatment. (sorry, I tried not to do there)
According to the Boyle’s attorney, Rick Fried, only 3 notations were made as to Finley's vital signs and they went unchecked for 26 minutes after the technician sedated her.
I can only conclude Dr. Geyer and staff as careless idiots.
As promoted by the Raven Marie Blanco Foundation, every dentist office should be prepared to handle a medical emergency and recommends The Six Links of Survival.
However, dentists are fighting this “tooth and nail”. State dental boards are doing little to protect the public and everything to make it easier for dentists to increase their income stream by offering sedation.
Below are several links to various stories, don’t miss out on the comments. As you will see in the comments, the first thing people do is blame the victim or in this case the victim’s parents. What is usually not stressed in the stories is that the child probably did NOT need such extensive treatment, if at all.
Thursday, December 19, 2013
WFAA-TV Dallas with reporter Byron Harris and team win award for “Denticaid: Medicaid Dental Abuse in Texas”
Kudos to WFAA-TV Dallas for supporting Byron and his team.
“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.
Don’t miss this enlightening discussion between Byron and his team.
Behind the Story - WFAA from Alfred I. duPont Awards on Vimeo.
Tuesday, December 17, 2013
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.
Monday, December 16, 2013
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.
Thursday, December 12, 2013
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.