Excluded and Unlicensed New Jersey Dentist Who Assumed Identity of Another Dentist Agrees to Settlement of $1.1 Million and 50-Year Exclusion to Resolve Civil Monetary Penalty Case

January 23, 2017

Contact: HHS OIG Media Communications
Media@OIG.HHS.GOV

Washington, DC - Unlicensed New Jersey dentist Roben Brookhim agreed to pay $1.1 million and accept a 50-year exclusion from participating in Federal health care programs as part of a settlement to resolve his administrative liability for presenting false claims to Medicaid, billing for services furnished by an excluded person, and owning and controlling a Medicaid-participating entity while he was excluded, the Office of Inspector General (OIG) for the U.S. Department of Health and Human Services (HHS) announced today.

"Fifty years is one of the longest exclusion periods ever imposed by our office," said Gregory E. Demske, Chief Counsel to the HHS Inspector General. "This period of exclusion, coupled with the significant monetary recovery, is an appropriate resolution for an individual who went to such great lengths to defraud a Federal health care program and put patients at risk," said Demske.

OIG alleged that from November 2005 through October 2012, Brookhim owned, controlled, and managed Associated Dental NP, LLC (ADNP), a New Jersey dental practice with multiple locations, in violation of his exclusion from Federal health care program participation in August 2000.

3rd Grader’s Teeth Removed at School by Mobile Dental Clinic; Then Had to Walk Home!

Outrageous? Indeed it is! Sadly I still hear these stories about children, in essence, tortured by unexpectedly having teeth removed by these school dental programs.  This time it’s in Baltimore. Although it’s unclear, in my opinion it’s very likely Reachout Healthcare’s Smile America Partners that is owned by Morgan Stanley investments.  I would love to see the permission slips sent home to parents. If anyone has one, please email to cckaddie@yahoo.com

Other websites include:

mobiledentists.com
smileamericapartners.com

From Smiles Programs website:

Smile Programs is currently active in 24 states and has ongoing strategic partnerships with Detroit Public Schools, Chicago Public Schools, the School District of Philadelphia, Boston Public Schools, Baltimore City Public Schools, Indianapolis Public Schools, Cleveland Public Schools, LA Unified Schools, Prince George's County Public Schools, Washington DC Public Charter Schools, Phoenix Area Public Schools, and St. Louis Pubic Schools as well as many others.

 

 

Mom Outraged, School Dental Program Removes Child’s Teeth Without Her Knowing

BALTIMORE (WJZ) — A mother is outraged after her third grader came home from school with three of his teeth missing. She says his elementary school performed a dental procedure she never knew about.

A Baltimore City mom is looking for answers: Why did the school allow serious dental work — without making a single phone call to parents.

9-year-old Michael is still brought to tears by the pain. He’s now missing three teeth — pulled out by a dental program visiting his school. His mother, Shanda Flemming, tells WJZ she never was notified that the procedure was happening.

“And then two on this side. One top and one bottom,” says Flemming.

Baltimore City Schools says Flemming signed a permission slip, but Flemming thought it was for routine cleanings.

“I’m angry about this. I don’t think that it should have happened like that,” says Flemming.

She says she was blindsided when Michael came home with a swollen mouth.

“They just said they was gonna clean my teeth,” says Michael.

Read Entire Story Here

Washington State Senator Ann Rivers Working Hard to Legalize the Already Operating DSO’s in Her State with SB 5158

It appears Washington State’s Senate Healthcare chairperson Senator Ann Rivers (R) is trying to legalize the illegal activity already taking place in Washington by introducing SB 5158 in the 2017 Session. Sen. Rivers represents, the 18th district, which happens to also be the hotbed of many DSO’s which are still considered to be practicing illegally by the current Washington law. Sponsors of the Bill besides Rivers are Senators Annette Cleveland (D) and Karen Keiser (D).

Rivers gave her bill a hearing January 19, 2017, introducing it by stating “I don’t think it is government’s job to outline the type of business structures that can exist.” She forgets, however, that the role of government is to also protect its citizens by only allowing dentists to practice dentistry. (I wonder if a racketeering business structure is also a type that government should not outline)

At the hearing Senator Rivers stated a lot of her motivation (her words, not mine) was about “young dentist starting out have an organization that they can slip into if they’ve got significant debt” and she also wants to “make sure patients have a place they can go on Saturdays”

HUH?

MB2 Dental Solutions Alaska Operations

After the settlement with MB2 Dental Solutions and Chris Villanueva, DDS et. al. I noticed a couple of states not mentioned: Alaska and Tennessee. Well, you can guess what happened then—I just had to see how much they continued to expand their business model while under investigation. What I found in Alaska was at least 3 dental clinics and 1 real estate company.

Let’s begin.

1. Frost Dental-Anchorage
3024 Mountain View Dr, Suite 107
Anchorage, AK 99501
Gentry Toone, DDS

This one was formed in May of 2016. The NPI record for Frost Dental-Anchorage states Mary Pu is VP of Finance and the mailing address is…wait for it…wait for it…2403 Lacy Ln, Carrollton, TX.  I know, right! You thought what I did—that’s the same address as MB2! Did you notice the email address, frostanchorage@mb2dental.com? Remember, Mary Pu is Trung Tang’s wife. Tang being a major player—and classmate—of Villanueva.

---

2. True North Family Dental
3708 Rhone Circle
Anchorage, AK 99508
Gentry Toone, DDS

 

 

 

True North used to be owned Charles Michael Sage, DDS, Sr. under the shingle of Alaska Center for Dentistry Anchorage, until he retired in 2014.  His son, Charles Michael Sage, DDS, Jr. operated Alaska Center for Dentistry in Wasilla until he turned it over to MB2 cohorts. C. Michael Sage, DDS, Jr continues to see patients at both clinics according to the respective websites.

True North Family Dental is owned by South Anchorage Family Dentistry, LLC, mailing address is that of MB2 in Carrollton, Texas.

South Anchorage Family Dental is supposedly owned by Gentry Toone, mailing address is that of MB2. Justin Puckett is the Organizer, with documents filed by one Mary Pu.

Whether MB2 owns Alaska Center for Dentistry Anchorage in Wasilla, is unclear. However, the two associate dentists working at the Wasilla location are husband and wife with ties to Texas. In addition, MB2 operated Sage Dental clinics, so who knows. Just between you and me, I say “yes”.

Did you note the email address for True North Family Dental? truenorth@mb2dental.com

Dr. Jason Hirsch Talks Changing the Approach in the Treatment and Care of Childhood Caries

Interview with Dr. Jason Hirsch

By: Michael W. Davis, DDS

Dr. Michael W. Davis maintains a private general practice in Santa Fe, NM. He also advocates for disadvantaged citizens, and provides expert legal work for numbers of attorney clients. His publications and lectures are on ethical and whistleblower issues within the dental profession, as well as numbers of clinical research papers. He may be contacted at: MWDavisDDS@comcast.net

 

 

Jason Hirsch DMD MPH maintains a private practice of Pediatric Dentistry in West Palm Beach, Florida. Dr Hirsch has degrees in Chemistry, Public Health, Dentistry and Pediatric Dentistry and has been a licensed dentist in his home State of Florida since 2002. Dr Hirsch's philosophy is simple, treat children like they were your own, treat the cause of the problem first and foremost and practice with principles of benevolence, non-maleficence and veracity.
Contact information: DrJ, 685 Royal Palm Beach Blvd, Suite 201, Royal Palm Beach, Florida, 33411. Phone: 561 795 7959 Email:jhirsch1971@gmail.com

Introduction

Dr. Jason Hirsch is at the vanguard of revolutionary changes in dental care for pediatric dental patients. This advancement goes far beyond progress in dental methods and materials. Dr. Hirsch examines dental disease in its totality, and arrests the causation and progression of dental caries (tooth decay). He has rejected the paradigm in restorative dentistry of continual drill-and-fill (or steel crowns), followed by pulpotomies (baby tooth root canals) and extractions. His emphasis is solidly on evidenced-based medicine and dentistry in treatment for the root causes of disease, and not simply the manifestations of disease (seemingly an endless cycle of tooth decay).

 

Question 1

Dr. Davis: Dr. Hirsch, I feel quite honored to provide this interview for our readers. Could you explain how our current mode of dental care for pediatric dental patients is irrational? We see endless cycles of restorative dental services for our nation’s children, especially disadvantaged Medicaid children. Costs to taxpayers are outrageous, with unsustainable deficit government spending. Too many parents are only given two options involving their child’s dental treatment; “juice them (sedation), or papoose them (restraints a/k/a- protective stabilization)”. Each venue has its own set of risks. How is your vision for children’s dental care different, in relation to immediate benefits for the youngster, associated cost of treatment, and the long-term wellbeing of the child into adulthood?

Dr. Hirsch: Pediatric Dentistry (or children’s dentistry) has become too focused on teeth treatments instead of disease treatments. I fully understand that dentists are trained to repair teeth. How can we achieve this lofty goal of incorporating dentistry/oral health into systemic health, if we are hypocrites and continue to myopically focus on teeth? I hear these oral-systemic connection buzzwords, but how are we supposed to connect the dots, if we don’t begin doing this in children?

You cannot take an adult in the middle of his/her life and try to convince them of the oral/systemic connection. It just won’t work. This has to be accomplished in pediatrics with mothers/moms as the gatekeepers to this paradigm change.

The care system is irrational because we have acute treatments for a chronic disease. If you look at diabetes management you will see some parallels that frankly pediatric dentistry needs to focus on. Diabetics’ needs daily insulin and a child with tooth decay in whatever stage, needs daily fluoride. I don’t see dentistry promoting fluoride as medicine and that is disturbing to me. The pharmaceutical industry has created longer lasting insulin, so we have created a longer lasting fluoride, silver diamine fluoride (SDF).

We have an opportunity to stop dental disease faster than ever before because of this SDF product and because of SDF; we can reduce the need to papoose children or sedate/ anesthetize them. What SDF buys is time, and we all know that the most precious and expensive commodity in life is time to ignore this therapy would be a great setback for children and dentistry in general.

We cannot talk out of both sides of our mouth. If we want to integrate oral health into systemic health, I’m telling you it starts and ends with this concept of care, and it starts with children. Period.

Question 2

Dr. Davis: I’d like to get into some of the “nuts and bolts” of your modalities of arresting the dental caries (tooth decay) process. Are you giving little children shots with needles, to numb teeth from pain of dental therapy? Do you generally require sedation of the child to gain patient cooperation? How long is the child sitting in a dental chair for these therapies?

Dr. Hirsch: SDF treatment requires skill, not in the delivery of the treatment, but in assessing whether or not the situation requires SDF treatment. We cannot think that we can just slather this medicine everywhere and we can sit back. On the contrary, we must identify the specific children that will benefit most from this therapy, and then we can slather it judiciously.

 

Frank conversation with Florida dentist Dr. Michael Barr

 

Frank conversation with Florida dentist Dr. Michael Barr
by Dr. Michael W. Davis

Dr. Michael W. Davis maintains a private general practice in Santa Fe, NM. He also advocates for disadvantaged citizens, and provides expert legal work for numbers of attorney clients. His publications and lectures are on ethical and whistleblower issues within the dental profession, as well as numbers of clinical research papers. He may be contacted at: MWDavisDDS@comcast.net

 

Dr. Michael Barr is a private care general dentist at Palm Beach Smiles in Boynton Beach, Florida. He began his dental career spending three years in the U.S. Navy. Two of those years were onboard an aircraft carrier, the USS Independence, which was the first response in the Persian Gulf (Operation Desert Shield).

Dr. Barr’s dental passions include Cosmetic and Reconstructive Dentistry. He served on the board of the local affiliate dental association (South Palm Beach County Dental Association) up to President. He has also served on the board and as a lecturer and clinical instructor (currently) at the Atlantic Coast Dental Research Clinic. He writes an eclectic blog about dentistry, marketing, current dental events, and frequent musings about personal safety, security, and armed self-defense at www.TheDentalWarrior.com. You can also find him stirring the pot on DentalTown.com.

 

Question 1

Dr. Davis: Dr. Barr, you’ve been very outspoken on how government administered healthcare like dental Medicaid has not served the public favorably. We’ve seen disadvantaged patients abused, taxpayer monies wasted, and ethical caring doctors forced out of this dysfunctional government program. Please give our readers an overview of your perspectives.

Dr. Barr: I have not had any personal exposure to Medicaid. But, my first “wake-up call” was when a dentist posted (on DentalTown) about his run-in “with the law” as a Medicaid dentist. He ended up doing time in prison for, if I recall correctly, $5,000 worth of administrative errors over the course of five years. He lost everything.

Another frightening case involved Dr. Morse, in New York. He was suspected of Medicaid fraud. They shut down his practice. The state attorney was intent on “cracking down” on Medicaid fraud (and make examples of the offending doctors). The short version of the story is that not only was this dentist exonerated, but the state attorney’s office was found to have fabricated false evidence against him. In such cases, the defendant can sue the state. And, so he did… and won a $7 million settlement. Of course, it dragged on for 11 years and made it all the way to the Supreme Court. (No kidding!) You can read about his case (and others) in my blog and read Dr. Morse’s own comments at the bottom of my article.

I wouldn’t accept Medicaid if they offered to pay double my fees. If you are suspected of fraud, you can be shut down BEFORE Due Process. You can have your assets frozen or seized BEFORE Due Process. It can take years to clear your name, and even then, you’ve already lost everything. No thanks. No way. Never. Too risky.

 

Question 2

Dr. Davis: Dr. Barr, could you give us your ideas on a few mechanisms, which might help ameliorate our toxic dental Medicaid program? Further, what suggestions might you offer for a financially disadvantaged parent who relies on the dental Medicaid program for their children?

Corporate Dentistry, Dental Insurance, Dental Academia, Professional Associations: Dental Professionals Game of Musical Chairs

Dr. Michael W. Davis maintains a private general practice in Santa Fe, NM. He also advocates for disadvantaged citizens, and provides expert legal work for numbers of attorney clients. His publications and lectures are on ethical and whistleblower issues within the dental profession, as well as numbers of clinical research papers. He may be contacted at: MWDavisDDS@comcast.net

 

 

There are a myriad of individuals who jump in their careers between corporate dentistry, the insurance industry, education and professional organized dentistry. This is not evidence of corruption or collusion, but often represents a disturbing appearance of conflict-of-interest. The apparent conflict-of-interest often undermines the integrity and ethical standing of professional dental organizations and academic institutions. Rank-and-file doctors, as well as the general public, should begin to question whose interests are truly represented. Some names on this list are high profile individuals in leadership roles. Others are less well known, but nevertheless highly influential.

1. James Bramson, DDS

• Executive Director Massachusetts Dental Society (1997-2001). Organized Dentistry
• Executive Director American Dental Association (ADA) (2001-2008). Organized Dentistry
• Chief Dental Officer- United Concordia Companies, Inc. (2011-2017). Insurance Industry

2. Kathleen T. O’Loughlin DMD, MPH

• President & CEO Delta Dental of Massachusetts (2001-2006). Insurance Industry
• Chief Dental Officer United Health Group (a/k/a United Healthcare, Oral Health Foundation a Medicaid managed care organization inclusive of DentaQuest) (2008-2009). Insurance Industry
• Executive Director of ADA (2009-pres.). Organized Dentistry

3. Steve M. Adair, DDS, MS

• Taught specialty of pediatric dentistry and later chaired the department at Eastman Dental Center (1983-1990). Education
• Chair dental pediatric specialty program at Medical College of Georgia (1990-2003). Education
• Board of Trustees American Academy of Pediatric Dentistry (1998-2001). Organized Dentistry
• Editor-in-Chief American Academy of Pediatric Dentistry Journal (2004-2008). Organized dentistry, Education
• Chief Dental Officer & Senior Vice President, for Clinical Quality Initiatives and Education for Small Smiles Dental (a/k/a CSHM- a disgraced and bankrupt corporate dental chain involved with Medicaid fraud and child abuses). Corporate Dentistry
• Senior Clinical Affairs Advisor for DentaQuest (a dental Medicaid managed care organization) (2016-pres.). Insurance Industry

4. Todd R. Cruse

• Senior Vice President for Development & Chief Development Officer for Small Smiles Dental (a/k/a CSHM- a disgraced and bankrupt corporate dental chain involved with Medicaid fraud and child abuses). Corporate Dentistry
• Vice President Government Relations for DentaQuest (a dental Medicaid managed care organization) (2013-2014). Insurance Industry
• Vice President of Public Affairs for DentaQuest (2014-2015). Insurance Industry
• President DentaQuest Care Group (2015-pres.). Insurance Industry

Excerpts from the recently unsealed False Claims Action against Dental Professionals of Texas, (MB2), Dr. Chris Villanueva and his pack of cohorts

Keep in mind they admitted no guilt to the claims but agreed to pay $8.45M to settle the issue. They are currently still in operation and open for business; which is scary once you read the allegations. You can read the entire Complaint by clicking here. Buyer Beware!! Never take your children to any of these clinics!  EVER!

Civil Action Number: 3:12-cv-02126-P
Filed: September 26, 2012
Settlement reached: December 27, 2016 (when the Corporate Integrity Agreement was signed)

The DEFENDANTS: CHRIS STEVEN VILLANUEVA, Individually and as member/managing member of Defendant companies; TRUNG MINH TANG, Individually and as member/managing member of Defendant companies; MAURICIO DARDANO, Individually and as member/managing member of Defendant companies; MB2 DENTAL SOLUTIONS, PLLC; DENTAL PROFESSIONALS OF TEXAS, PLLC; VILLANUEVA UNIVERSAL ENTERPRISES, LLC; PEPPERMINT DENTAL, PLLC; ARCHSTONE DENTAL, PLLC; PICASSO DENTAL, PLLC; DENTAL FAMILY CIRCLE, PLLC; VILLANUEVA PLAZA, LLC; PEPPERMINT DENTAL-MCKINNEY, PLLC; DFW FDC-REDBIRD, PLLC; PICASSO DENTAL-MANSFIELD, PLLC; ARCHSTONE DENTAL-BEACH, PLLC; VIVA ORTHODONTICS, PLLC; PICASSO DENTALCORSICANA, PLLC; CHRISS VILLANUEVA DENTAL, PA; DFW-FDC, PA; CROWN NOW DENTAL, PLLC; MINT REALTY, LLC; LEGEND DENTAL, PLLC; ARCHSTONE DENTALGRANBURY, PLLC; PEPPERMINT DENTALGREENVILLE, PLLC; CRESCENT DENTAL, PLLC; FRESH DENTAL, PLLC; ELEMENT DENTAL, PLLC; BLISS DENTAL, PLLC; SAGE DENTAL, PLLC; BLISS DENTAL-MIDLAND, PLLC; SAGE DENTAL-DEER PARK, PLLC; CRESCENT DENTAL-SAN MARCOS, PLLC; ELEMENT DENTAL-BRYAN, PLLC; ELEMENT DENTAL-CONROE, PLLC;

SAGE DENTALPEARLAND, PLLC; SAGE DENTAL-PASADENA, PLLC; TIDE DENTAL-CORPUS CRISTI, PLLC; SPEARMINT DENTALWITCHITA FALLS, PLLC; SCARLET PEGASUS GROUP, LLC; FRESH DENTAL-LONGVIEW, PLLC; LEGEND DENTAL-GEORGETOWN, PLLC; WOW DENTAL-OAK CLIFF, PLLC; BLISS DENTAL-LUBBOCK, PLLC; GALAXY DENTAL-GARLAND, PLLC; PEACH TREE DENTAL-CARROLLTON, PLLC; ARCHSTONE DENTAL-HULEN, PLLC; IRVING TOWN CENTER DENTAL, PLLC; SOUTHERN GEM DENTAL, PLLC; LUCKY DENTAL, PLLC; CRESCENT DENTAL-INGRAM, PLLC; ELEMENT DENTAL-SPRING, PLLC; VIDA DENTAL, PLLC; GULFSIDE DENTAL BEAUMONT, PLLC; DENTAL CENTERS, PLLC; SLAP-ON, INC.; PEPPERMINT DENTAL MCKINNEY, PLLC; DENTAL CENTRAL, PLLC; ARCHSTONE DENTAL-WEATHERFORD, PLLC; PEPPERMINT DENTAL-SHERMAN, PLLC; PEPPERMINT DENTAL-LEWISVILLE, PLLC; ELEMENT DENTAL-HUMBLE, PLLC; ELEMENT DENTAL-TOMBALL, PLLC; BALENTIMES HOLDINGS, LTD., PEPPERMINT DENTAL-MONTGOMERY, LLC, PEPPERMINT DENTAL-RIO BRAVO, LLC, PEPPERMINT DENTAL-SAN MATEO, LLC, RED ROCK DENTAL-FARMINGTON, LLC, FRESH DENTAL-BOSSIER CITY, PLLC, FRESH DENTAL-SHREVEPORT, PLLC;

Dental Professionals of Texas=DPT now known as MB2
Relator = Whistleblower
Dental Practices = DP

…This action is also brought under the qui tam provisions of the Texas Medicaid Fraud Prevention Law, V.T.C.A., Hum. Res. Code Ann. §36.001 on behalf of the State of Texas, the Louisiana Medical Assistance Programs Integrity Law, La. Rev. Stat. Ann. §§46:439.1 et seq.; 438.3 on behalf of the State of Louisiana and the New Mexico Medicaid False Claims Act N.M. Stat. Ann§§ 27-14-1 et seq.on behalf of the State of New Mexico.

Kevin Howard Byington ("Byington") is and was in the marketing department for DPT. Byington works directly for Frank Villanueva, Defendant Chris Villanueva's brother and head of the marketing Division of DPT. Byington and Frank Villanueva were responsible for recruiting willing marketers and paying them kickbacks for locating likely Medicaid families with children eligible for dental services and referring those patients and their families to the DP defendants.

When DPT's kickback scheme was aired by Dallas news stations, Byington formed KHB Community Outreach Associates, LLC. This was done at the request of Defendants, including DPT (a/k/a MB2), Villanueva and Tang, to cover up and conceal the illegal kickback solicitation scheme.

Frank Villanueva is the brother of Defendant Chris Steven Villanueva and the person primarily responsible for obtaining illegal referrals and direct solicitation of patients for the Defendants. He is and was an employee of DPT (now MB2) and was the person who hired Relator, coercively persuaded her to accept the "promotion" to work for KHB Community Outreach Associates, LLC and coordinated the kickback payments to the referring marketers and the Medicaid parents or family members.

Ann Villanueva, the sister of Defendant Chris Steven Villanueva, is and was the Human Resources Director for DPT (now MB2) and the DP defendants. She assisted in the recruitment of dentists and other staff and paraprofessionals for the dental offices of DP defendants and for DPT.

Mary Pu is Trung Tang's wife and the Vice President of Finance for Dental Professionals of Texas, PLLC (now MB2). In her position, Pu was knowledgeable about the illegal billing practices, the solicitation of patients, and the budgeted "promotion accounts" for every practice which were actually used for kickback payments. She was and is responsible for the entire accounting team.

John Steen is the Chief Financial Officer of DPT. Steen is shown as the "Authorized Agent" for DPT in signing the February 23, 2012 Certificate of Amendment to the Certificate of Formation of Dental Professionals of Texas, PLLC changing the name to MB2 Dental Solutions, PLLC. Steen ostensibly served as "compliance officer" for Medicaid and in

Byron’s Lens: Dental Kickbacks The Story Behind The $8.45 Million Dentists’ Settlement

There’s a McDonald’s on Garland Road in Dallas near the old Lochwood Mall, almost across the street from what used to be Galaxy Dental.  Galaxy’s florescent green and yellow paint scheme made it stick out, even in the clutter of Garland Road.

I spent several mornings at that Mcdonald’s in the spring of 2012, nursing a coffee while everybody else was dining on McMuffins. I was there to try to overhear the conversation a group of women who often met there for business. They were “community outreach workers,” they said. But what they talked about were their plans to scour low income neighborhoods for children eligible for Medicaid.  Their mission: to recruit Medicaid eligible mothers to bring their children into Galaxy Dental. The outreach workers talked loud enough that I could tell they were pumped.  

A federal lawsuit unsealed in Dallas last week alleges why they were so excited.

See the entire story by Byron Harris at WFAA’

https://creatavist-g49brf5.atavist.com/byrons-lens-dental-kickbacks-?units=us

Haunting Headline: “Hands-On Training Helps DSO’s Profit from Pediatric Dentistry”

“Hands-On Training Helps DSO’s Profit from Pediatric Dentistry” Boy, that’s a headline at Group Dentistry Now (GDN) that grabbed my full attention.

I felt no better when I read the following quotes from GDN page and The Institute for Pediatric Dentistry (IPD) website. IPD is the company offering this “training”. (more on IPD below)

“It’s often said, that children are the future, and that’s certainly true in the field of dentistry.”

“Dental benefits have increased dramatically to bring more children into dental practices, with all but 6% of children being insured by either government or private plans.”

“For DSOs and large group practices treating children, it’s hard to find qualified clinicians who can provide quality dental care while also being efficient enough to meet production goals.”

“As a leader in a DSO or large group practice, the demands on your time are constant. Developing and offering ongoing Continuing Education for your dentists and their staff that is relevant and capable of improving their skills and your bottom line is extremely challenging.”

The IPD website also asks “Why should you attend”. Their answer is “Unlock the potential of pediatric dentistry for your practice” WHOA!

TEXAS: Chris Villanueva, DDS and others finally NAILED! Sadly they are not JAILED

FOR IMMEDIATE RELEASE

Monday, January 9, 2017

Texas Dental Management Firm, 21 Affiliated Dental Practices, and Their Owners and Marketing Chief Agree to Pay $8.45 Million to Resolve Allegations of False Medicaid Claims for Pediatric Dental Services

DALLAS – Texas-based MB2 Dental Solutions (MB2) and 21 pediatric dental practices affiliated with MB2, along with their owners and marketing chief, have agreed to pay the United States and the State of Texas Medicaid program $8.45 million to resolve allegations that they violated the False Claims Act by knowingly submitting, or causing the submission of, claims for pediatric dental services that were not rendered, were tainted by kickbacks, or falsely identified the person who performed the service, announced U.S. Attorney John Parker of the Northern District of Texas.

“Today's settlement demonstrates our unwavering commitment to protect the Medicaid program and the patients it serves from unscrupulous providers,” said U.S. Attorney Parker. “Providers who waste taxpayer dollars by billing for services that were not provided, or were otherwise improper, will be held accountable.” U.S. Attorney Parker commended the Texas Medicaid Fraud Control Unit, the Civil Division of the Texas Attorney General’s Office, the FBI and the Health and Human Services Office of the Inspector General for their coordinated efforts to investigate and resolve these allegations.

This settlement resolves allegations that between Jan. 1, 2009, and Dec. 31, 2014, MB2 and affiliated dental practices submitted claims to the Texas Medicaid Fee for Service Program for single-surface fillings in children that were not provided. The settlement also resolves allegations that MB2 paid kickbacks to Medicaid beneficiaries and their families, marketers, and marketing entities, in violation of the Anti-Kickback Statute, and that MB2 and affiliated dental practices used erroneous Medicaid provider numbers misrepresenting the dentists performing the pediatric procedures.

Medicaid is funded jointly by the states and the federal government. The State of Texas paid for part of the Medicaid claims at issue and will receive approximately half of the settlement amount.

MB2 is a dental management firm based in Carrollton, Texas, that provides management services to affiliated dental offices. The dental practices included in the settlement are Dental Professionals of Texas PLLC; Archstone Dental PLLC; Bliss Dental PLLC; Crescent Dental PLLC; Dental Central PLLC; Dental Family Circle PLLC d/b/a Forney Wellness Dental; DFW Family Dental Centers PLLC; Element Dental PLLC; Fresh Dental PLLC; Galaxy Dental PLLC; Legend Dental PLLC; Peppermint Dental PLLC; Picasso Dental PLLC; Sage Dental PLLC; Spearmint Dental PLLC; Tide Dental PLLC; Vida Dental PLLC; Viva Orthodontics PLLC and Wow Dental PLLC.

As part of the settlement agreement today, Drs. Christopher Steven Villanueva, Trung Minh Tang, Mauricio Dardano, Gabriel Shahwan and Akhil Reddy agreed to pay $250,000 each to resolve the governments’ claims against them individually. They are owners or part owners of MB2 and the dental practices included in this settlement, and practice dentistry in Texas. Frank Villanueva, MB2’s head of marketing, also will pay $100,000 to resolve his alleged personal liability.

As part of this settlement, MB2, Drs. Villanueva, Tang, Dardano, Shahwan, and Reddy have entered into a five-year Corporate Integrity Agreement (CIA) with the Department of Health and Human Services Office of Inspector General (HHS-OIG). The CIA requires an independent review organization to annually assess whether claims reimbursed by a federal health care program were correctly coded, medically necessary and appropriately documented.

“HHS-OIG is particularly vigilant about potential abuses in Medicaid pediatric dental offices where patients and their families are especially vulnerable to questionable practices,” said Special Agent in Charge CJ Porter for the HHS-OIG in Dallas. “Today’s settlement should ensure other dental clinics are aware that we are watching how they operate and will pursue appropriate resolutions when profits are put before patient care.”

Part of the allegations resolved by this settlement were originally filed under the qui tam, or whistleblower, provisions of the False Claims Act by Veronica Garcia, a former MB2 employee. The act permits private parties to sue on behalf of the government for false claims for government funds and to receive a share of any recovery. It also permits the government to intervene in such lawsuits, as it did in this case. Ms. Garcia will receive $1.521 million from the United States and the State of Texas.

This settlement illustrates the government’s emphasis on combating health care fraud and marks another achievement for the Health Care Fraud Prevention and Enforcement Action Team (HEAT) initiative, which was announced in May 2009 by the Attorney General and the Secretary of Health and Human Services. The partnership between the two departments has focused efforts to reduce and prevent Medicare and Medicaid financial fraud through enhanced cooperation. One of the most powerful tools in this effort is the False Claims Act. Since January 2009, the Justice Department has recovered a total of more than $31.8 billion through False Claims Act cases, with more than $19.3 billion of that amount recovered in cases involving fraud against federal health care programs.

The matter was handled by Assistant U.S. Attorneys Kenneth G. Coffin and Scott Hogan. The claims resolved by the settlement are allegations only and there has been no determination of liability.

MB2 Corporate Integrity Agreement

All current companies under Corporate Integrity Agreement

Aspen Dental Complaints Top $1.7M in “Claimed Losses” by Consumers

One would think Aspen Dental would have cleaned up their act after it was one of the chain clinics featured on FRONTLINE’s Dollars and Dentist in 2012.  However, over at Pissedconsumer.com complaints about the horrible dental care, upcharging and down right fraud from patients continues to grow—now topping 2,000 (the additional “me too” comments to the posted complaints is off the charts). In addition, patient “claimed losses” is nearing the $2M mark. With the average loss: $3, 300 each. (personally I would say it is much more than this). Out of all the complaints only a pitiful 10 (yes, just 10!) are reported as “resolved”. Frankly, I’m shocked 10 are reported.

Doctors Selling Practices to Corporate Dentistry; or Dancing with the Devil

 

Title: “Doctor No Control” By: Vaidya Selvan, DDS

Dr. Michael W. Davis maintains a general dental practice in Santa Fe, NM. He serves as chairperson for Santa Fe District Dental Society Peer-Review. Dr. Davis also provides a fair amount of dental expert legal work for attorneys. He may be contacted via email: MWDavisDDS@comcast.net

 

Doctors Selling Practices to Corporate Dentistry; or Dancing with the Devil

More and more, dentists owning and operating private practices are approaching retirement age. In today’s dental practice sales market, and within numbers of demographics, practice buyers are limited. Younger practitioners are saddled with student loan debts between $250,000 and $330,000 upon graduation. These junior professionals usually lack adequate credit ratings to assume the purchase of a small business. They often must pay down mountains of debt over an extended period of years, to demonstrate credit worthiness.

Most states have statutes which require only duly licensed dentists may own and clinically operate dental practices. These laws were established because a doctor has a primary ethical and legal obligation to place interests of patients to the fore. By contrast, a corporate entity has a primary obligation to place generation of profits and the interests of shareholders (not patients) to the fore. The conflict of interest is obvious.

The dental service organization (DSO) industry (a/k/a corporate dentistry) has stepped into the mix seeing an opportunity to generate profits for Wall Street and the private equity investment industry. Over most of the past decade, the feds have kept interests rates artificially low for the intended purpose of economic stimulation. DSOs have moved into this buying opportunity and purchased many hundreds of dental practices.

DSOs often retain selling doctors for a limited time after the sale of their dental practices. However, with maximal profit generation being the bottom line, not patient welfare, these doctors are usually dispensed in short order. A recent dentist graduate may be retained, regardless of limited skill and clinical experience, for far less salary remuneration.

Also favorable to the DSO, the recent grad employee doctor has little emotional or professional ties to the existing patient base. These doctors are unlikely to question policies of the DSO diminishing quality of patient care. If they do raise ethical questions, they are quickly replaced with others who play along with the DSO’s practice of dentistry, with the ultimate goal of maximizing quarterly profits. Most of these young doctors are primarily focused on paying down educational loans, and moving out of the DSO clinic, as soon as reasonably possible. Most of these doctors truly do care about providing patients with the best care possible, but their hands are tied.

(Author’s note: To circumvent state statutes about only doctors owning dental practices, DSOs establish shell companies for nominee ownership of their dental practices.^1-6 These may be individual dentists who purportedly “own” one or several dental clinics, or a group of dentists who are assigned “ownership” status for an entire chain of clinics. In no case do these doctors exercise any real control or benefits of ownership of these dental practices. The “big lie” of the DSO industry is that they only control the non-clinical aspects of a dental practice and doctors contract with them for this service. In reality, doctors are employees of corporate management and do what they’re told, or forced out or fired.)

Case of Dr. Susan McMahon vs. Refresh Dental Management, LLC, et al

Legal cases arising out of disputes between selling doctors and the DSO industry is highlighting many of these problems. Dr. Susan McMahon alleged in her action against Refresh Dental Management, et. al., that she was financially and professionally damaged after selling her practice, to a shell company subordinate of a DSO.^7,8 Within a couple of years, she was terminated from employment, as is common.

(Author’s note: Dr. McMahon’s resume includes very substantial clinical achievements, as well as professional teaching assignments. Although the legal filing was against Refresh Dental Management, LLC, et al, the parent company is North American Dental Group⁹, which is in the private equity portfolio of ABRY Partners- a Boston-based private equity investment firm.¹⁰)

Dr. McMahon alleged that for numbers of months after leaving employment, her name remained on the DSO’s clinic signage and advertising from insurance companies. Clinic staff was instructed to misrepresent to patients her employment status; claim she now worked in the restaurant industry, and claim she had a license suspension for abuse of controlled substances, or had retired from dentistry, all according to signed affidavits in Dr. McMahon’s legal pleadings. Dr. McMahon further alleged that patient records were denied her, upon patient request. Allegedly, Refresh Dental staff was using the name and positive reputation of Dr. McMahon to get patients in the clinic door, but invent falsehoods as to why she wasn’t there when they got there—the classic bait-&-switch scam.

 

2016 The 32 Most Influential People in Dentistry

Incisal Edge Magazine released their very first “top 32” list.  Not shocking only 14 of the “Most Influential People” are actual dentists. Incisal Edge is published by Benco Dental.

1. Jeffery Slovin – DentsplySirona
2. Rick Workman – Heartland Dental
3. Howard Farran – Dentaltown website – Dentaltown Magazine
4. Stanley Bergman – CEO of Henry Schein
5. Martha Somerman – Dir. of National Institue of Dental and Crainofacial Research
6. Steve Bishop – Group President of Procter & Gamble
7. Marco Gadola – CEO Straumann Holdings
8. Ben Carson – Potential Secretary of Health and Human Services
9. Kathleen O’Loughlin – Executive Director of the American Dental Association
10. Michael Graham – SVP ADA Division of Government and Public Affairs
11. Gordon Christensend – Practical Clinical Courses
12. Amir Aghdaei – Group Ex. VP KaVo Kerr Group/Danaher Corp.
13. “Dr. Doe” – Some plaintiff who is suing Henry Schein, Benco and other suppliers
14. Michael Cohen – Founder of Seattle Study Club
15. Steve Thorne – Founder of Pacific Dental Services
16. Mike Simpson – U.S. Congressman of Idaho’s 2nd Congressional District
17. James Glidewell – CEO Glidewell Laboratories
18. James Ingebrand – President 3M ESPE Dental Division
19. Kevin Jackson – SVP Delta Dental of California
20. John Kois – Founder The Kois Center
21. Don Moody – Partner at Waller, Lansden, Dorth & Nashville
22. Linda Niessen – Dean at Nova Southeastern University’s College of Dental Medicine
23. Michael Helgeson – CEO of Apple Tree Dental
24. Gary Price – CEO Dental Trade Alliance
25. Susannah Schaefer – CEO of Smile Train
26. Jack Dillenberg – Dean of Arizona School of Dentistry & Oral Health
27. Ed Snyder – Managing Director of Northcoast Research
28. Gwyneth Paltrow (yes the actress) – Oral Cancder Foundation Activist
29. Roger Levin – Founder and CEO of The Levin Group
30. Ann Battrell – CEO of American Dental Hygienists Association
31. Major Gen. Rososevelt Allen – Chief of Dental Corp, USAF
32. Peter Dubois – Executive Director of California Dental Association

My list would have been much different! (or maybe it would have been the title)

Pacific Dental Services Teams with American Dental Assistants Association to Provide Additional Benefits to Dental Assistants

Huh?  Well, that’s the headline of Pacific Dental Service’s (PDS) press release dated December 28, 2016.

IRVINE, Calif., Dec. 28, 2016 /PRNewswire/ -- Pacific Dental Services^® (PDS^®) today announced that it is teaming with the American Dental Assistants Association (ADAA) to provide additional membership benefits and services to dental assistants in the PDS-supported environment.

With the common goal of ensuring the public receives the best quality dental care, PDS and the ADAA will continue their shared mission by providing hundreds of dental assistants with additional resources needed to obtain that objective. 

With their ADAA membership, dental assistants in the PDS-supported environment will be offered: free online continuing education; additional insurance coverage options including professional liability, (because they are going to need it!) accidental death and dismemberment; and participation in the ADAA Fellowship and Mastership programs. (huh?) In addition, the dental assistants will receive: a free subscription to the Dental Assistant Journal; the monthly ADAA Update E-newsletter; membership in State and Local Chapters; and leadership position opportunities.

As the oldest, largest professional association for dental assistants in the country, ADAA has been elevating the careers of dental assistants for over 90 years.  Since Juliette A. Southard formed the association in 1925, ADAA has been the foremost advocate for the dental assisting profession and is widely recognized as the voice of the dental assisting profession in America.  One of ADAA's goals is to advance the dental assisting field in a manner which will enhance the delivery of quality dental care to the public. 

Dr. John E. Kasper, ADAA Executive Director, stated, "As the premier dental assisting community in America, ADAA is proud to welcome dental assistants from the PDS-supported environment into the ADAA family.  The partnership with PDS represents a giant step towards advancing the dental assisting profession in America, and ADAA is excited about the wonderful opportunities this relationship provides." (Oh, I bet ADAA and PDS is “excited”, maybe not the actual assistants so much though)

Judith Forsythe, Director of Dental Assistant National Strategy for Pacific Dental Services said, "I am thrilled to be a part of this partnership between Pacific Dental Services and the ADAA. PDS and its supported clinicians value the role of the dental assistant and this partnership is yet another way to show we are always looking to enhance the dental assistant's career within the PDS-supported environment. "

About Pacific Dental Services
Founded in 1994, PDS^® is one of the country's leading dental support organizations, providing Supported Autonomy that allows dentists to concentrate on clinical excellence and the highest levels of cost-effective comprehensive patient care. PDS originated the PRIVATE PRACTICE + model to allow dentists to focus on their passion: serving patients.  

About the American Dental Assistants Association (ADAA)
The ADAA is America's oldest and largest dental assisting association serving over 310,000 dental assistants in the United States. It is dedicated to the development and recognition of professionalism through education, membership services and public awareness programs. The ADAA is a strong advocate for legislation mandating credentialing for clinical dental assistants and greater recognition of the assistant's role in the professional dental team.

My takeaway is PDS has sold their dental assitants to the ADAA, in return PDS plans on teaching ALL memebers of the ADAA  the PDS way of milking the cow dry. (the cow being patients).

Like always, I could be wrong.

Does The National Black Caucus of State Legislators Support Illegal Business Practices of Dental Service Organization?

Apparently so. It also appears they do NOT care thousands of children are abused and have their mouths mangled by said Dental Serivice Organization. It seems to me, the children have been sold to the DSO’s. Interesting, being that it comes from the Black Causus, right?  Just saying!

From Dentistry IQ:

“As part of its policy priorities for 2017, the National Black Caucus of State Legislators (NBCSL) has resolved to support the nation’s leading dental support organizations (DSOs) in their mission to provide affordable, quality dental services to underserved populations across the United States. The policy resolution, “HHS-17-17: A Resolution to Stand in Support of Dental Support Organizations,” was ratified during the NBCSL’s Annual Legislative Conference, held Dec. 2-5, 2016.”

Read the story here

Corporate Dental Branding- What Dental Consumers Need to Know

Dr. Michael W. Davis maintains a general dental practice in Santa Fe, NM. He serves as chairperson for Santa Fe District Dental Society Peer-Review. Dr. Davis also provides a fair amount of dental expert legal work for attorneys. He may be contacted via email: MWDavisDDS@comcast.net
 

   

Corporate Dental Branding- What Dental Consumers Need to Know

A brand is a name, term or symbol which one company uses to differentiate its products and services, from that of another company.¹ Corporations employ numbers of different strategies in branding. Healthcare professionals are generally fairly ignorant on corporate branding practices, as this is not an element of their formal education. By contrast, those parties which beneficially own corporate dental practices retain individuals well-skilled and well educated in all forms of retail sales, marketing, and finance. Their abilities include a plethora of differing and complex branding methodology.

In its simplest form, a chain of corporate dental clinics may seek direct brand recognition by consumers. They may market “outstanding dental care at reasonable prices”, all associated with their brand. Branding may be part of a marketing program to generate public goodwill via broad mechanisms, ranging from well-publicized charitable events to sponsoring a NASCAR driver.² Branding may also be associated with the business model of dental Medicaid care.

Unfortunately for the corporate dental industry, many of their more established brands have become associated with abuses to the public welfare.^3-9  

(Author’s note: References only cite a mere handful of well reported abuses generated from corporate dentistry, disclosed by government officials.) 

Dental clinics managed and directed by non-doctor corporate management often have a troubling record, which the public is witnessing. Likewise, dentists who may be employed in such workplaces are also witnessing abuses to the public interest generated and facilitated by brand-name companies in corporate dentistry. As such, many in the public are avoiding dental services offered by branded corporate dental practices. Further, these branded corporate practices are finding employee/doctor attraction and retention increasingly challenging. One corporate chain recently reported over 10% loss in total dentist staff for a one-year period.¹⁰

Crowd Sourced Branding-

Numbers of branded corporate dental groups are increasingly discovering their branded identity has negative consequences. In fact, the term “corporate dentistry” is an example of “crowd sourced branding”, in which the public assigns a company a brand (positive or negative), versus the traditional method of branding, in which a company designs their branding scheme.

Some dental corporations have fought back by explicitly marketing their distance from “corporate dentistry”. One such ad from a corporate dental chain openly states, “You Hate Corporate Dentistry and So Do We”. The veracity of their claim seems highly suspect, especially when one views their multiple settlement agreements with multiple states’ attorney generals. However, corporate dental management is evidently far more concerned with negative fallout of crowd sourced branding, versus presenting truth in the public marketplace. 

To further counter the negative public impression of corporate dentistry generated by crowd sourced branding, numbers of corporate dental chains market the misrepresentation of doctors, and not faceless Wall Street types, as owning dental practices. The reality is very different and highly disturbing. 

Numbers of dental chain corporations establish specific individual doctors to act fully as sham-owners, who have no control of management, the sale of “their” asset of the dental practice, or control of clinic bank accounts. In fact, these shame-owner dentists have no idea how the funds generated by “their” dental clinics are allocated; depositions in the Small Smiles mass action lawsuit made that abundantly clear.

Other corporate dental chains establish a group of dentists acting as sham-owners, via the accounting mechanism of a professional corporation (PC). Again, these doctors have no true and valid ownership privileges of dental practices, as beneficial ownership passes to non-doctor corporations, often private equity investment firms. Some of the world’s largest and most well-known private equity firms currently are or formerly have been the beneficial holders of corporate dental chains, which direct patient dental care. Examples include Morgan Stanley¹¹, Valour Investments Ltd.¹², Carlyle Group¹³, American Capital Strategies¹³, FFL Partners¹⁴, Gryphon Investors¹⁵, MSD Capital (holdings of Michael Dell  family)^16,17, etc. 

DentaQuest Back in the Texas Medicaid Business?

Is DentaQuest back in the Texas Medicaid business?

Apparently so.

According to DFW Dental Team, who operates out of the newly licensed (Sep 2016) DFW Children’s Surgery Center dentist can “refer” patients and right there on their very interesting website is a link to DentaQuest forms.

 

 

 

There is so much more to this story so expect an indepth look VERY soon.

Just for a sneal peek, let’s just say it involves a couple of Harvard grads (Brian Walker and Jonathan Jardine),  some Brigham Young University grads, a very proud Harvard professor and a bunch of dentists whom I would say are ethically challenged; a former Kool Smiles dentist, Dr. Diaa Zora and another “owner” dentist,  Dr. Ketan Sukkawala, being just two of the many.

It involves several business names such as:

North End Health Care http://www.nehc.com/ (Note the Harvardesque logo)
North End Capital, LLC Eagle, Idaho
Blue Cloud Pediatric Surgery Centers http://txcpa.lookupbook.net/blue-cloud-pediatric-surgery-centers-llc-houston-tx
HCDC Professionals, PLLC
San Antonio Children’s Ambulatory Surgical Center http://sachildrenssurgical.com/
SACS Professionals, PLLC
San Antonio Dental Team http://sadentalteam.com/ (ignore the statement that the surgery center is owned separtely)
DFW Children’s Surgery Center http://dfwchildrens.com/
DFW Dental Team http://dfwdentalteam.com/ (ignore the statement that the surgery center is owned separtely)
Referral Care, Inc http://www.nehc.com/affiliates.html

If you can’t wait you can check out:

North End HealthCare: Pediatric Ambulatory Surgery Center Expansion Strategy (don’t miss the disclaimer on page one)

Oh, and at the end (Strategic Decision) where Brian is asking himself questions..the answer is not only no, but hell no!

Broken Arrow, OK: Mother questions dentist's decision to cap, fill more than a dozen baby teeth at Super Smiles Dental

BROKEN ARROW - A Broken Arrow mother reached out to 2 Works for You after a popular Broken Arrow dental practice presented her with an estimate for more than $5,000 to fix her toddler's baby teeth.

Sarah Powell said she felt like she had failed her three-year-old son, Jaxon, when a dental practice told her he had 13 cavities in his temporary baby teeth.

"I was mortified," Powell said, "I couldn't fathom how he could have that many issues and no pain."

Powell said the dental assistant at Super Smiles Dental Office in Broken Arrow rattled off a list of work Jaxon needed and numbers Powell needed to call, then stopped and said, "Oh, you have private insurance. This is going to be expensive," according to Powell.

Because Powell said she had been regularly brushing Jaxon's teeth since they popped up, and that she took him for regular check-ups since he was 18 months old, she sensed something had to be wrong.

Read entire story here

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Despit Super Smiles logo, it doesn’t seem to be exactly a “Fun Place For Teeth”, does it?

Wish I could report EVAN D CLOTHIER DDS, was some sort of corporate dentistry thug, but I can’t. I guess he’s just a thug.  His Oklahoma dental license is current and there are no reported sanction listed. But that doesn’t mean much since so often they are never reported by the dental board.

TEXAS: 10.45% Reduction in Medicaid Reimbursement to Ambulatory Surgery Centers Likley To Be Catastrophic for Pediatric Dental Patients

On Wednesday of this week (November 16, 2016) at 1:30 there is to be a public hearing held by Texas Health and Human Services (THHSC) in the Brown-Heady Building, 4900 North Lamar Blvd, Austin, TX. The purpose of the public hearing is to receive comments related to a 10.45% reduction in reimbursement to Ambulatory Surgical Centers for Dental Rehabilitation and Restoration. My sourse says this reduction is spear headed by the Dental Service Organizations (DSO') whose target patients are children on Medicaid and is to take effect January 1, 2017.

(Why aren’t these “hearing” held at a time when the actual public or interested parties are available? It shall be interesting to see who is there to offer “public comments”.  THHSC website indicatged the hearing will be webcast and available to watch here: http://legacy-hhsc.hhsc.state.tx.us/news/webcasting.asp.)

The source states the long term plan is to reduce the number of licensed pediatric dentists and oral surgeons from accepting children who currently require sedation for treatment, whereby those dentists will drop out of the program thereby limiting the access to quality care for the children. This is outrageous!

I’m told the DSO's plan to hire young new graduates carrying loads of student debt general dentists to perform these procedures, The source hinted a system is already in place to make sure all children meet the qualifications to require sedation.

As it was told to me, it is planned to be much like the orthodontic scam that took place in Texas just a couple of years ago whereby nearly all children suddenly qualified for braces and the per-authorization process was to rubber stamp and approve every child!

(Let’s not forget how dentists were trained on how to scam the system by Dr. James (Jim) Orr and attorney Robert (Bob) Anderton, in Anderton’s private office.  Orr, at the time was Dental Director of the claims agent for Texas. In sworn testimony before the State Office of Administrative Hearings (SOAH) witnesses stated Orr and Anderton taught them how to “utilize” the HDL scoring system in place to qualify children for orthodontic braces. In addition the processors, who worked from home, were paid $50 for each approved application! For more on there click here.)

No doubt the Ambulatory Surgical Center’s are not going to complain too much about a reimbursement rate reduction when they expect their patient volume to skyrocket. Win, Win for everyone, right?  Well except the children who are needlessly sedated for what is likley to be unnecessary dental procedures, like 4 year old Navaeh Hall who was left brain damaged or Daisy Lynn Torres or 3 year old Marvelena Rady who both died this year.

For the public who would like to make comments by mail:

Health and Human Services Commission
Attention: Rate Analysis, Mail Code H-400
P.O. Box 149030
Austin, TX 78714-9030

Overnight mail, special delivery mail, or hand delivery:
Health and Human Services Commission
Attention: Rate Analysis, Mail Code H-400
Brown-Heatly Building
4900 North Lamar Blvd.
Austin, TX 78751
Phone number for package delivery: 512-730-7401
Fax: Attention:  Rate Analysis at 512-730-7475

 

Related Links:

November 16, 2016 Hearing Briefing Package
Link to Webcast page

Dr. Michael W. Davis on Corporate Dentistry at Dentistry Today

Dentistry Today Interview with Dr. Michael W. Davis

57 children who underwent baby tooth root canals, or pulpotomies, at Children’s Dental Group have been hospitalized

CHOC given $150,000 to treat children sickened in dental clinic infection outbreak
By COURTNEY PERKES / STAFF WRITER
Contact the writer: cperkes@scng.com 714-796-3686
So far, 57 children who underwent baby tooth root canals, or pulpotomies, at Children’s Dental Group have been hospitalized at CHOC with confirmed or probable mycobacterial infections, said Dr. Jasjit Singh, a pediatric infectious disease specialist at the Orange hospital. About 21 patients need to take a tightly regulated drug typically used to treat leprosy, she said.
Ordering the oral antibiotic, clofazimine, from the Food and Drug Administration requires a lengthy approval process for each child. CHOC will be expanding a part-time nurse’s hours to full-time to oversee the process.
“It’s a much more rigorous process than writing a prescription for an antibiotic,” Singh said. “That process requires some administrative and logistical work. It requires filling out those FDA forms.”
…“This is a nightmare,” Morales said. “I stay awake at times picturing her with a hearing aid or with kidney problems. That’s why I asked the nurse what would happen if we didn’t give this to her. She said she could die.”
READ THE ENTIRE UPDATE HERE

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In related news, Christine Curtis brought her three children to Children’s Dental Group of Anaheim and says dentists perfromed up to 11 baby root canals on her children, all while they were strapped down and restrained.  Curtis now believes the work was unnecessary and along with a growing number of parents has contacted Texas Attorney, Jim Moriarty for help.
Wayne Dolcefino, President of Investigative Communications firm, Dolcefino Consulting spoke with Moriarty:

“This assembly line dentistry uncovered in at Children’s Dental Group smacks of Medicaid Fraud,” says Moriarty. “A Full state and federal investigation is owed to U.S. taxpayers.  I believe Children’t Dental is over treating these childdren to make a buch using higher cost stainless steel crowns, and falsifying the need for baby root canals to increase the cost of taxpayers.”
“I beleive the infection outbreat in California could lead to proving Children’s Dental Group is systematically abusing children.”
Moriarty was the legal architect behind the groundbreaking lawsuit against the Small Smiles Dental chain, and now represents the family of 4-year old Neveah Hall, the little girl left severely brain damaged by a bad dentist.

Related Links:
Law Offices of James R. Moriarty Facebook
Law Offices of James R. Moriarty Website

The many schemes of four dentists accused of defrauding MetroHealth

 

 

 

By Eric Heisig, cleveland.com
Follow on Twitter
on October 26, 2016 at 9:36 AM, updated October 26, 2016 at 4:10 PM

CLEVELAND, Ohio — The schemes described in a federal indictment against former MetroHealth executive Edward Hills and three former hospital dentists undertook were complex, intertwined and lasted for years.

They also involved about $250,000, much of which was taxpayer money. Meanwhile, Hills was being paid increasingly larger six-figure salaries for his work at the hospital system.

The U.S. Attorney's Office laid out its accusations in a 93-page indictment unsealed Tuesday, following the arrest of Hills and dentists Sari Alqsous, Yazan Al-Madani and Tariq Sayegh. The charges say the men steered MetroHealth clients and resources toward their private businesses and forced prospective residents to pay them bribes in exchange for preferential treatment.

All four entered not-guilty pleas at their arraignments.

The case is the culmination of an investigation that lasted more than two years and was headed by the FBI and IRS. It involves a series of cooperating witnesses. Federal prosecutors have not said whether others will face charges.

READ ENTIRE STORY HERE

 

Related:

FBI raids former MetroHealth System's executive's home, businesses

Unlicensed Dental Hygiene Practice as a Business Model

 

Dr. Michael W. Davis maintains a general dental practice in Santa Fe, NM. He serves as chairperson for Santa Fe District Dental Society Peer-Review. Dr. Davis also provides a fair amount of dental expert legal work for attorneys. He may be contacted via email: MWDavisDDS@comcast.net

 

 

Unlicensed Dental Hygiene Practice as a Business Model

The unlicensed practice of dental hygiene is unlawful in all 50 states. In reality, enforcement is lax to nonexistent. In the infrequent event of violators charged, the bigger the violator, the more lenient the penalty. State regulatory dental boards have generally failed to address this problem, and their inaction has enabled and emboldened violators. Dental practices which conduct their business affairs within the rule of law are at a distinct marketplace disadvantage, to dental practices which engage unlawful dental hygiene practice as a business model.

Traditionally, only doctors were lawfully permitted to own dental practices and supervise the practice of dental hygiene within their businesses. Today, a dental practice may only be “owned” by a dentist(s) as a nominee figurehead. An outside corporation may truly beneficially own and manage the dental practice and the practice of dental hygienists. These beneficial owners (often private equity investment companies) pull the strings on the doctor/patient relationship, as well as the practice of dental hygiene in their clinics via dental service organizations (DSOs).

Jesus Villegas, DDS MS

Dr. Villeges, a pediatric dental specialist with clinics in Milford and West Haven, CT, settled with the US government for $1.3 million for his alleged actions of utilization of uncertified dental assistants in taking dental radiographs.¹ These patient services could only lawfully be delegated to certified dental assistants or licensed dental hygienists. This dental Medicaid fraud case was notably prosecuted in Connecticut, as were earlier federal and state criminal actions against Dr. Gary Anusavice² and later Dr. Mehran Zamani³, who operated a chain of dental Medicaid clinics, also in CT.

Phillip M. Coyne, Special Agent in Charge with the US Health and Human Services- Office Inspector General stated, “Dentists must ensure that only certified staff provide services to their patients. Cutting corners could jeopardize the safety of patients and the integrity of the Medicaid program.  Working with our law enforcement partners, our agency is dedicated to protecting patients and the government health care programs designed to serve them.”¹

US Attorney Deirdre M. Daly added, “Health care providers must utilize properly certified individuals to treat patients, and the failure to ensure such proper care for patients will have serious consequences.”¹

Douglas Macko, DMD MS

In the case of State of Connecticut versus Douglas Macko, the decision awarded $717,000 to the plaintiff, for Dr. Macko’s violations to the Connecticut Unfair Trade Practices Act.⁴ Dr. Macko unlawfully employed unlicensed personnel to provided dental hygiene patient services to pediatric dental patients. The court’s decision went into length on Dr. Macko’s efforts misrepresent facts of the case. The court also determined unlicensed staff falsified statements of fact in affidavits to support their employer. Like the aforementioned legal case of Dr. Jesus Villegas, this legal action involved a specialist pediatric dentist, and primarily dental Medicaid fraud.

Thomas P. Floyd, DMD MS

Similar to the previous cases, Dr. Floyd was a pediatric dental specialist mostly serving a children’s Medicaid population. However, his case was prosecuted in Florida, not Connecticut. In Florida, dentist violators are far more likely to receive regulatory wrist-slaps and large chain DSOs no investigation whatsoever (similar to most states).