Happy Anniversary

It was one year ago today the DOJ and OIG-HHS, as well as the same agencies in NY state, made their announcement of the $26 Million ($24 Feds, $2 NY) settlement agreement with Church Street Health Management f/k/a FORBA Holdings, LLC. 

It was also announced this day one year ago, that Church Street Health Management f/k/a FORBA Holdings, LLC had entered into a 5 years Corporate Integrity Agreement (CIA)with HHS; same with the OIG in NY.


Only four more years to go.

Ohio Regional Manager Needed At FORBA - July 2010

One just has to love this post for a position with FORBA.  They are planning expansion and now needing regional managers...  Ok, whatever.

Regional Manager, OH

If anyone does apply be sure to ask about contract changes in their future.  Consider permitting an attorney look it over before you sign it, since they are famous for 'imprisoning' employees.  

Check out the Non-Compete section if any, you may be locking yourself out of a job within hundreds of miles if you find you do not like the job.  Then what will you do?  Will you have to uproot your family;  better think about it.

Look closely at any Confidentially Agreement, remember they may require you to keep secrets that should NOT be kept.

 
Be especially vigilant; watch out for any Non-Disparagement clauses!  Not good!  I would say in most circumstances it is a gigantic red flag, and I would run like the wind.  It is like signing away your First Amendment right to free speech at a time where it could be the  most crucial.
 
Also, ask about the contract they are going to need you to sign where you have to answer to the government.  It is their Corporate Integrity Agreement, and it is a doozey.

Related Atricle

Attn: FORBA Small Smiles Employees

Uh-Oh! Dr. Richard Malouf abandoned his computer servers! YIKES!

Dr. Richard Malouf, founder of All Smiles Dental Centers in Texas, has made the news a lot over the last two years. Much of which has involved charges of Medicaid Fraud, indications of bribery, and his infamous home water park in an affluent neighborhood of Dallas and 2 private jets.

 

 

 

 

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!

Contrasting Dental Medicaid Enforcement: Florida versus Texas

Dr. Michael W. Davis

Contrasting Dental Medicaid Enforcement: Florida versus Texas
By: Michael W. Davis, 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

Introduction
Both Florida and Texas share similarities in that both states have long standing Republican state legislatures, state attorney generals, and state governors. Likewise, both states enjoy highly diverse ethnic and economic population demographics. However, each state handles enforcement of dental Medicaid very differently.

Dental Medicaid fee schedule rates in Texas are some of the highest nationally, while Florida’s are at or near the bottom.^1,2,3 Texas has attracted a huge bevy of corporate dental chain Medicaid providers, headquartered both in-state and out-of-state. Florida has a paucity of such interstate dental Medicaid corporate providers.

Although dental Medicaid fee schedule payouts are substantially higher in Texas, both states’ fee schedules fall below the UCR (usual and customary rates) of the average insurance company. With dental Medicaid remunerations below the overhead costs of most private dental practices, only a minority of licensed dentists sign on as Medicaid providers. Those doctors who obtain Medicaid credentialing generally do so to serve a limited number of patients on a charity basis, or work in the public sector. There are some disturbing exceptions.

There are a minority of “outlier” dentists whose goal is to scam the Medicaid program, and make little effort to cover their tracks.^4-7 Added to this number are many more devious Medicaid fraudsters, in which only skilled dentist auditors can identify.

Florida dental regulatory authorities have been quicker to turn over cases of suspected Medicaid fraud and abuses to their state’s attorney general’s office. This has occurred far less frequently in Texas, despite Texas being a far more populous state with far greater numbers of dental Medicaid providers.

Extent and Examination of Dental Medicaid Fraud and Abuses

We’ve already learned from the recent limited examination (four states) by federal Health and Human Services- Office of Inspector General (HHS-OIG), that approximately 9-11% of dental Medicaid providers are grossly over-the-top in abusive Medicaid billings.^4-7 These specific providers are termed “outliers”. Depending on the state reviewed, one-third to 50% is employed by large group practices (primarily corporate dental chains called “dental support organizations”, “DSOs”). One must remember, these are the worst of the Medicaid program violators, and not the majority with scams designed to “fly under the radar”. Outliers only represent the easy to identify, low hanging fruit.

Typically the cleverer Medicaid fraudsters (non-outlier cheats) upcode Medicaid services or provide gross over-treatment, which isn’t discovered as easily by a HHS-OIG audit.⁸ One common fraud technique is upcoding of dental sealants on permanent teeth, to multiple surface posterior resin restorations.⁹ Others place multiple steel crowns on deciduous (baby) teeth, which have minimal to no evidence of dental decay, or are soon to naturally exfoliate (naturally come out).^10,11  Another favorite dental Medicaid scam has been the service of a pulpotomy on deciduous teeth (baby tooth root canal), into teeth with little caries (tooth decay) near the tooth’s nerve.^12-14 In fact, the author has specifically heard this referenced as a “preventative pulpotomy”, in interviews with former corporate dental employees. Of course, the bitter cynicism and avarice towards the patient’s welfare by this terminology of “preventative pulpotomy” shouldn’t be lost on the dental profession, auditors, or the general public.

­­­­­­­

Perhaps unique to Texas, we saw an entrenched old-boy element of the dental profession work to alter and amend standard accepted dental terminology, to expand Medicaid eligibility. Texas Medicaid orthodontics (corrective movement of teeth) eligibility required “ectopically erupted teeth”. Insiders simply changed the Medicaid definition of “ectopically erupted tooth” from the dental industry standard definition, to include any tooth which may be malpositioned, angled, tipped, slightly rotated, etc.¹⁵  These schemers circumvented the intent of the law, and lined their pockets either through providing direct Medicaid services or for-profit courses to dentists, on how to beat the system.¹⁶

An additional component of Texas dental Medicaid fraud-by-design was Medicaid payments not for completion of an orthodontic case, but for payments on a per-visit basis. Obviously, financial incentive was established to continually yo-yo patients in active treatment, in and out of a dental office. No consideration was afforded to transportation challenges for disadvantaged children. Further, there was a serious disincentive to complete orthodontic treatment in a timely manner, in the patient’s best interest. In the years 2009-2011 Medicaid orthodontic payments in Texas outstripped the payments for all other 49 states combined.¹⁷

Texas declined to provide dental Medicaid oversight and monitoring on the state level, and delegated this responsibility (for a significant fee to the taxpayer) to the highly discredited Xerox Corporation.^18,19  The federal HHS-OIG agreed with Texas, that Xerox failed in their contractual obligations of dental Medicaid oversight. However, the federal Inspector General stated the State of Texas is ultimately responsible for the disturbingly remiss oversight.²⁰

In fact, services of Xerox were so egregiously lax, that’s it’s difficult to see this as anything other than political pay-to-play. All the while, dental Medicaid fraudsters, both large and small were free to ply their trade in fraud-craft. Texas state authorities provided the illusionary mantle of oversight via a wasteful model of collusion, with big business/big government crony capitalism.

The most common Medicaid unlawful scheme of non-profit dental clinics (federally qualified health centers or FQHCs) is via abuse of “patient encounters”.²¹ To date, we’ve only see this frequent Medicaid scam addressed by government regulators to much extent in Washington and New York.^22,23  This particular abuse of taxpayer money is a favorite with certain public health clinics, Native American title 638 clinics, and non-profit healthcare facilities. Generally we don’t see rank-and-file healthcare providers managing this particular fraud mechanism. Usually fraud is generated though the unlawful systems of directors and managers (some are physicians and dentists), who enjoy very inflated salaries and benefits, by cheating programs designed to serve the disadvantaged.

To its credit in Texas, the non-profit United Medical Centers Board of Directors (Maverick, Kinney, and Val Verde Counties) recently terminated employment of their Chief Executive Officer and Medical Director after an internal investigative audit.²⁴ Unfortunately, I expect another miracle from the waters of Lourdes, before I anticipate Texas authorities to file a civil or criminal case against these Medicaid cheats within the public sector.

One would like to assume nonprofit organizations are distanced from scamming taxpayers. However, that assumption has proven inaccurate and very dangerous. Schemes defrauding the dental Medicaid program are highly pervasive, lucrative, and relatively easy to pull off. Dental Medicaid fraud and abuses are ubiquitous both in the private and public sectors. The largess which comes to those who defraud American taxpayers from dental Medicaid scams has in fact become an entrenched and fully accepted dental industry model of business.  

Handling and Mishandling of Dental Medicaid Cases

Both Texas and Florida have historically operated under a failed enforcement model of “pay and chase”.^25,26 Medicaid payments are made to providers (or their corporate beneficial owners, usually DSOs) year after year without question or examination. If an audit is eventually generated, it then becomes a massive records undertaking. Government regulators usually lack funds to retain meaningful dentist auditors, to thoroughly review patient records and billings. Behind the 8-ball, government prosecutors nearly always settle cases for pennies on the dollar, and no admission of wrong-doing by violators.

By contrast, the dental insurance industry mandates pre-authorizations prior to a provider billing for a vast number of patient services. Questionable services and payments are better “nipped in the bud”. Payments are better held in check, not as easily getting out of hand.

Payment holds from the private insurance industry generally are upfront from the onset, on an individual case-by-case basis. By contrast, Medicaid payment holds are usually well down the road, and may represent many hundreds of thousands of dollars or even several million dollars. Medicaid payment holds are formulated by deviations in billings, which are assumed to represent patterns of fraud and abuse. Obviously, a long-term pattern of abusive billings must be established, prior to control of taxpayer (public) monies. Private insurance companies, which have their own set of difficulties, rarely allow fiscal problems to build to this crisis level.

Texas

Dr. Tuan "Terry" Truong

The government’s prosecution of Dr. Tuan “Terry” Truong is a case worth examination.²⁷ Dr. Truong was employed by Kool Smiles Dental in Abilene, Texas, for over a year. After conviction for Medicaid fraud, Dr. Truong was fined and sentenced to federal prison for 18-months. The statement released by Kool Smiles Dental acknowledged their full cooperation with the government’s investigation and prosecution. Yet, Kool Smiles Dental monitors daily production metrics for each of their dentist providers. It seems inconceivable, corporate management didn’t fully realize the inappropriate and unlawful activities of Dr. Truong at a very early stage. Yet, government prosecutors were very willing to accept a low level dentist Medicaid cheat for a guaranteed felony conviction, versus those pulling the strings at higher levels. One is left to wonder what real rats could be convicted, if Dr. Truong were offered a deal to finger corporate management at the DSO level, or even private equity level.

Former Texas Attorney General (today Governor) Greg Abbott gave much ballyhoo to his settlement deal with alleged dental Medicaid fraudster, Dr. Richard Malouf for $1.2 million dollars.²⁸ This settlement only represented pennies on the dollar for the true extent of the alleged fraud (many $10s of millions of dollars). Naturally, there was no admission of wrong-doing by Dr. Malouf, former owner of All Smiles Dental. 

Small Smiles Dental Centers in yet another Federal Report due out today

A new federal report will be released Wednesday showing that shady dentists and orthodontists billed the state's Medicaid program for questionable procedures on children. One dentist claimed to have provided one child 42 tooth fillings in a single visit.

BY Glenn Blain NEW YORK DAILY NEWS ALBANY BUREAU|Wednesday, March 26, 2014, 12:20 AM

The state’s Medicaid program paid through the teeth for questionable billings by shady dentists and orthodontists, a new federal report charges.

One dentist claimed to have provided one child 42 tooth fillings in a single visit.

Another dentist averaged 16 procedures per child, compared with a statewide average of five, according to the report, which is being released Wednesday.

They were among 23 pediatric dentists and six orthodontists in the state who pocketed $13.2 million in Medicaid payments in 2012 for services that appeared unnecessary or may not have been performed at all, according to the report by the Department of Health and Human Services inspector general.

“We found one orthodontist who treated almost 5,000 children in a single year,” said Lucia Fort, an analyst in the inspector general’s office.

“That’s about 10 times higher than the state average for orthodontists.”

“…Seven of the 23 dentists were associated with the Small Smiles dental chain, which shut down its New York operations in 2012 after accusations that it provided unnecessary treatments.”

Read the complete NY Daily News Story here.

 

---

CSHM/Small Smiles Dental has been changing the business entity names on file with the Secretary of State in Kentucky and Ohio. Small Smiles of Akron, LLC – Michael Crites, DDS has been changed to Akron Smiles Youth Dentistry, LLC – Michael Crites, DDS. (if you would like a look at the many name changes in Ohio, search the Secretary of State site here using “Prior Business Name”)

Small Smiles of Louisville, PSC was changed to Louisville Smiles Youth Dentistry, PCS on November 27, 2013. Since at least June of 2013,

CSHM has also been changing information contained in their dentists National Provider Identifier (NPI) records on file with the Federal government. The mailing address has also been changed in the individual clinic records. The business mailing address has been changed to a US Postal Service sub-station post office box:16 Arcade Unit 198747, Nashville, TN 37219-1994.

The “manager of licensing and credentialing, Ms. Jenell Stringer is making the changes. I’m sure at the direction of someone at CSHM headquarters.

For instance, on June 11, 2013, Ms. Jenell Stringer, Manager of Licensing and Credentialing changed the mailing address in the NPI record of Small Smiles of Worcester, LLC d/b/a Straight Smiles of Worcester-(NPI number 1487943635) to:

16 Arcade Unit 198747
Nashville, TN 37219-1994
615-750-0343

You can see for yourself by searching the NPI number here.

They did the same thing in May of 2010, just 4 months after the Corporate Integrity Agreement was put into place. At that time I believe they used a US Postal Service sub-station at 208 W. 8th Street, Ste 810,Pueblo, Colorado, 81003-3038

If you would like to check out the dentist records, click here. Below are a few names and NPI numbers:

• Merlin L. Cherian, DMD – 1922348507
• Elizabeth Kay Geier, DDS – 1134251127 (Elizabeth is the “owner dentist” of the Louisville, Kentucky clinic and some in Ohio, along with long time puppet, Dr. Jodi Kuhn, who now has her name slapped all over the clinics in Colorado.)
• Harry Huger Houston, III, DDS – 1003991050
• Todd Bernard, DMD – 1336572791
• Sujani Vellanki, DMD – 1740562610 (apparently she practices dentistry at the post office, since the physical address on her location is also 16 Arcade, Until 198747, Nashville, TN)

Catching up on Church Street and Small Smiles bankruptcy this Easter weekend finds whistleblowers still waiting on their good citizen reward.

I decided to read over some more of the thousands of pages filed on the Church Street Health Management/Small Smiles dental bankruptcy filings as we did our family travels this weekend. What caught my eye was a 140 page Affidavit of Service. The list was very interesting, and what,or should I say who, was on this listed was what really made an impression.

First, in my loose estimate there are some 800 to 1000 minor children who have lawsuits pending against this criminal enterprise for abuse, mistreatment or overtreatment and blatant malpractice.

Second, you know those whistleblowers who blew the lid off this particular criminal enterprise back in 2007 The one that finally reached a settlement in January 2010. Well, they are on the “notify” list, meaning they are to be “served” copies of all these documents, or most of them anyway.

Now, that means not only did Church Street Health Management and their host of Small Smiles dental centers fail to pay the fines (they call it a settlement) imposed by several states-some states have been paid more than others-but the whisleblowers have not received their full rewar$ for the hell they went through, filing lawsuits and turning these bastards into the Department of Justice.

There were two or three in the Virginia and DC area as well as Mr. Haney in South Carolina.

I think this issue on Whistleblowing needs some tweaking! One thing for sure, is criminals aren’t good credit risks.

Speaking of credit, Church Street Health Management and their Small Smiles centers sure have a lot of people to whom they owe a shit load of money. For a criminal enterprise to go belly up just over a year after the Feds begin keeping a much closer eye on their operations, by way of that Corporate Integrity Agreement, the CEO Michael Lindley signed, says a lot. A WHOLE LOT!

To me it says, unless we break the law, and commit malpractice on most of the children we profess to care so much about, to rip off Medicaid this business model is not for the profit minded.

I’ve not downloaded and read all the documents of the bankruptcy yet, but, I certainly will. I’ve not found their detailed list of Assets and Liabilities just yet. Last I read said basically they were working on it. I’m just guessing, but I bet this one has to be the one of the most creative “assets” lists the Federal Court system has ever seen.

I’m sure there will be some sort of “pecking” order to settle up these debts, whether there is some fool ass Wall Street firm or Private Equity scumbags to snatch up this hot mess company, which I doubt, by the way.

But the children they have abused and the ones still waiting out there to be compensated for their pain and suffering should be number one, the taxpayers number two and the whistleblowers number three and it would be a tie between, Al Smith, Michael Lindley or Steve Adair down there in Hilton Head last, and should be barred from any claim whatsoever! 

Some other notables on the list are:

Lisa DeRose;
Ameris – Lindley’s other business and the one that owns the plane and the condo in Florida; and,
Jake and Jenna Kochenberger

Small Smiles Dental Centers: Reporting of Adverse Events

The Corporate Integrity Agreement requires Church Street Health Management to self report what is referred to as “Reportable Events” that take place at their Small Smiles Dental Centers across the US. 
What is a “Reportable Event” as seen by Small Smiles Dental Clinics:

1. Billing that would generate more than $4000 in overbilling – Keep erroneous or any fraudulent bilking billing under that mark and they are good to go.  Is that per child?  Could also be defined as a matter that a reasonable person would consider a probable violation of civil, criminal or administrative law applicable to federal health care programs . Or a matter that a reasonable person would consider likely to render CSHM insolvent.
2. Quality of Care Reportable Event– Adverse Events (AE).  These are a bit more difficult to define, since they are in the eyes of the beholder.  Basically anything that involves a violation of the obligation to provide items or services of a quality that meets professionally recognized standards of care.  In my opinion, that would include unlocking the door to any of the now, 72 clinics. The great White Paper King, Steven Adair is making those decisions.  Not a good choice in my opinion.  What is his pay based on?   Does he get a “production” bonus too? It may be that these are only events reported that cause a Corrective Action Plan (CAP) to be initiated.  What is a CAP, you ask?  Well, it could be a simple letter of instruction to the treating dentist/staff member,  a DVD for them to watch, or further training that they decide will do.
3. Event that would cause law enforcement to be notified–  I wonder if that means local law enforcement or the Feds?  You know what I mean, a dentist punches a patient in the face or staff forges names and signatures on documents?  Could also be defined as a matter that a reasonable person would consider a probable violation of civil, criminal or administrative law applicable to federal health care programs .  Again I feel that unlocking the doors on these houses of horrors should be criminal since I promise something illegal happens in each one of them everyday.

If CSHM doesn’t correct the billing within 30 days or

Is “Patient Advocate” Angela Newberry out of a job at Small Smiles Dental Centers?

Here is a listing for a job opening at Church Street Health Management dated June 17, 2011.  Pity the poor fool who takes this job! YIKES!  I hope any applicant takes time to read the Corporate Integrity Agreement this company has signed with the Department of Justice and Inspector General’s Office.  Read it carefully!  Smell the jail?

Director/Patient Advocate

Duties include:
Reporting to the SVP, Chief Compliance Officer, the selected individual will be responsible for recording, remedying, and responding to comments, concerns and complaints by patients of CSHM Associated Dental Practices. The Patient Advocate is also charged with ensuring that patients and, for minor patients, patients' parents and/or legal guardians are informed of CSHM's commitment to quality care and provided with contact information for submitting complaints. The Patient Advocate will report to the Chief Compliance Officer. The Patient Advocate will also be a key member of the Compliance Department and a member of CSHM's Compliance Committee.

Angela has been the topic of conversation of late at CSHM due to her prior association with Universal Health Services (UHS) and it’s string of “youth education” treatment centers.  UHS has complaints out the wazoo about the abuses that goes on behind the doors to pre-teens and young adults.

I think Small Smiles Dental Centers and Church Street Health Management is on the verge of more sanctions

Before I get into this, let me say the following is not even close to being based on anything other than my observations. Maybe that sounds a bit odd to admit.  But according to the covey of “artful dodgers” at Small Smiles Dental Centers and Church Street Management, everything on this blog has no basis and is pure hogwash.  So I don’t know why they visit here forty ‘leven times a day.


However, I’m smelling something happening at 618 Church Street, Nashville, Tennessee.  I’ve heard “chatter”  CSHM is reviewing their “breach” of the Corporate Integrity Agreement (CIA) signed in January 2010 with the Office of Inspector General.
1.   I’m told they are scurrying to gauge exactly how far from the truth the reports sent to the OIG, as required by the CIA, with their actual patient/parent complaints from the third party call center, employee exit interviews, employee complaints via the “hotline” and Daily Patient Logs, that reveal the actual overtreatment still taking place on a daily, patient by patient basis.

$2.3 Million Malpractice Lawsuit in Filed in Virginia Against Kool Smiles

May 9, 2019

In January 2018, Dental Service Organization (DSO), Benevis, who operates Kool Smiles dental clinics across the country agreed to a Settlement of $23.9 million dollars to settle fraud charges with the federal government. Why the company was not placed under a Corporate Integrity Agreement is beyond me, not that they mean a whole lot, but still. 

“Today’s settlement sends a very clear signal:  Fraud in the federal healthcare system will not be tolerated,” said U.S. Attorney John F. Bash for the Western District of Texas. “Especially when that fraud involves performing unnecessary procedures on kids—here, unnecessary baby root canals and tooth extractions, among other procedures—we will not hesitate to use every tool at our disposal to punish those who break the law.”

“It is intolerable when health care companies seek to boost profits by defrauding Medicaid and exploiting children," said Special Agent in Charge Phillip M. Coyne, HHS-OIG. "Systematically performing and billing for medically unnecessary dental procedures undermines the well-being of these young patients, corrupts the impartiality of medical decision-making, and diverts money from taxpayer-funded health care programs designed to pay for legitimate medical needs.”

Soon after they began rebranding each clinic to appear more individually owned and operated. But did they change their ways?  Uh....nope!  

The Complaint states that at least 50 children were treated with unsterilized instruments in March and April 2019.

190509 Virginia Kool Smiles... by on Scribd

Dr. Paul Casamassimo Happy Medicaid Dental Coffers Still Open For Business - Small Smiles

Well of course he's a happy man.  He's on the advisory board of Small Smiles & Church Street Health Management.  The Governor kept the coffer open for him and his buddies today! 

There are 7 Small Smiles locations in Ohio~

Maybe Dr. Casamassimo didn't have this run across his desk.

Burns Ohio Complaint

Dr. Paul Casamassimo has been with Church Street Health Management since 2007 when it was FORBA Holdings, LLC, along with Dr. Arthur Nowak, and Dr. Joe Bernat. Other than adding Dr. Anupama Rao Tate. Dr. Tate was the only addition to the board after the $24 million fraud settlement and Corporate Integrity Agreement was implemented.

With the budget crunch in so many states, to get Governor Kasich, whom I really like, to NOT cut some of the wasted funding to adult and children Medicaid dental programs is astounding. However, like us all, he is a layperson when it comes to "dental" needs, and can't tell fact from fiction. No fault of his own. It's the perfect example of letting the "professional" take the reins.

Now, if Ohio, like all states, would cut the reimbursement fee just for stainless steel crowns by 30% it might, just might, get the Medicaid fraud from these dental mills back under control.

No, I do NOT apologize to Dr. Paul Casamassimo, he was the fool who put out this video, he's the fool who hooked up with Dr. Adair and Small Smiles all by himself.  In this video statement what was he trying to suck or kiss?

Related:

Small Smiles Quality Initiatives are Rubbish

Moriarty-Leyendecker Stepping Up To Fight For The Children Harmed

Warriors have arrived to take on FORBA and its Small Smiles chain of dental clinics in the form of the law firm Moriarty-Leyendecker . (Jim and Kevin respectively)

I couldn’t be more thankful!! It’s about time there is justice for the children who had to endure the paid from these dental mills.

As we know the states got their reimbursement for the fraudulent billing of FORBA’s Small Smiles dental clinics as did the Fed’s in the $24 million dollar settlement. (I’m thinking it probably cost more than $24 mil to do the 2+ year investigation)

So far, not one child has been compensated for the horrific mental and emotional damage, imagine the humiliation these children have suffered. Nor have they been compensated for the physical damage that may take years to repair, if it can be repaired at all. Much of the damage done will last a lifetime for these children, and there could be up to 300,000 or more of these injured children.

What about the damage done to the trust these children have in their parents to protect them from harm. Will these children ever trust their parents again? What about teachers, policeman and others of authority? At minimum these abused children will find it harder to form long lasting and loving bonds as a matter of course.

It’s likely the child’s brain development has been impaired and certainly interrupted and redirected. The way these children were abused and treated has changed who they were supposed to be, forever! This is undeniable.

__________________________

Jim Moriarty and his partners are no strangers to medicine gone wild. That’s why I’m so elated to see they are standing up and stepping in.

In 1994 Jim Moriarty took on National Medical Enterprises (NME), later known as Tenet Healthcare. This sleaze ball company was, and I quote from the book Coronary: A True Story Of Medicine Gone Awry:

“deceiving parents into allowing their children to be imprisoned in mental institutions where at best they were warehoused and at worst they were subjected to alleged therapies that resembled torture more than treatment”

Sound familiar?

I encourage you to read the excerpt from Coronary: A True Story Of Medicine Gone Awry, by by Stephen Klaidman here.

As with FORBA, NME signed a Corporate Integrity Agreement with the Feds. When the federal fraud case was over NME thought the coast was clear. They were wrong!

Enter Jim Moriarty and “a pack of ex-patients and personal-injury lawyers” Jim is described as, and I again I quote:

“a motormouthed forty-eight-year-old former Marine door gunner in Vietnam. ” (he’s a bit older now, I’m sure)

“Moriarty is not necessarily someone you would like to have on your tail. When he focuses on something — it could be anything from a big, consolidated lawsuit to racing his hopped-up go-cart at 120 miles an hour — it is with the tenacity of a junkyard dog. ”

Jim ran into Tenet Healthcare again when one of it’s hospitals in Redding, California had an usually high rate of heart bypass surgeries. Jim was a bit disappointed the case didn’t go to trial so the story would be told. By settling with the 750 patients for $395 million dollars, Tenent kept the nasty truth off the front page. You can read about this outrageous health care scam online by clicking here: Money Driven Medicine, by Maggie Mahar.

Jim Moriarty and Moriarty-Leyendecker want to hear from you.

Please, contact Jim, Kevin and the crew, tell them your story.

Contact Moriarty-Leyendecker here.

***(BTW, no top management in the NME case went to jail, but others certainly did, something you dentists, hygienists and assistants who work for FORBA and Small Smiles should give a whole lot of thought to-like who is going feed your family when you’re in the clinker? FORBA bobble heads will through you under the bus in a New York minute!)***

National Union Fire Insurance Company Files Suit Number Two in Tennessee

The latest suit between National Union Fire Insurance Company (NUFI) and FORBA Holding/Small Smiles Holding (New FORBA) was filed August 8, 2010 in Middle Tennessee Federal District Court.

In short, NUFI says FORBA failed to disclose the fraud investigation by the DOJ, HHS and several state Attorney Generals.  Nor did FORBA disclose that American Insurance, the insurance company that previously had them covered, cancelled their coverage due to "claims experience".

This took place through an insurance broker-Affinity Insurance d/b/a Dentist's Advantage.  Affinity secured the policies for FORBA/Small Smiles in the beginning.

Then Affinity told FORBA American Insurance was not renewing their policies due to "claims experience"  At that point FORBA asked Affinity to get them other insurance.  Affinity was an "authorized dealer" so to speak for NUFI.  So, Affinity secured insurance for FORBA, selling them a NUFI policy.  (Affinity knew why FORBA had their insurance canceled, didn't they?)

Affinity wrote the insurance policies in August 2009 and onward they marched, according to the Complaint.

Then, came the investigations results and a multi million dollar settlement with the government.  As well, a Corporate Integrity Agreement with Health and Human Services was made.

When FORBA Holding/Small Smiles Holding (New FORBA) filed suit against "Old FORBA" (The DeRose-Padula-Roump Bunch) crying foul, saying didn't know how bad Old FORBA really was, they ended up spilling the beans on how much they really knew and when they really knew it.  Being Gypsies, Tramps and Thieves, it's hard to keep all the deception in order. 

The Complaint against Old FORBA revealed facts that made it clear, the information New FORBA gave NUFI was, at worse, fraudulent and certainly misleading. (surprise surprise)

Basically NUFI is saying they didn't know what dirty rotten scoundrels New FORBA really was either.  Just as New FORBA claimed against Old FORBA.  In the suit New FORBA v Old FORBA, New FORBA admitting knowing in late 2007 they were being investigated.

Wouldn't it be funny if I had evidence NUFI knew or should have known all about the various investigations.  Let's just say for example website visitor logs.  Not saying I do, just saying it would be funny.

New FORBA filed suit against Old FORBA for the same reasons NUFI is filing suit against New FORBA.  Pot, meet Kettle.

NUFI is asking the court to rescind the last two years of liability insurance coverage they had on New FORBA and all of its employees.  Basically they are wanting to not have to pay up on any claims that will arise for the period 8-2008 through 9-26-2010.

Just as New FORBA is wanting to rewrite dentists employment contracts - in case the courts do not rescind and make void the NUFI insurance policies, they want the court to rewrite the policies on what is/was covered would be minimized.

Wonder if FORBA is looking for new insurance?

Good luck with that.

Click here to read the complaint.
The Policies/Exhibits are here;
No. 1 ; No. 2 ; No. 3 ; No. 4

Update:

The Tucson Inspection a few weeks ago, did NOT go well.  After all this time, they still can't get it together.  In the suit above, NUFI called it a "Raid"!

Oh where, oh where has Small Smiles gone, oh where, oh where can it be…

February is “National Children’s Oral Health Month”. Normally Small Smiles Dental Centers lead dentists (or fake owner dentists) slither from under their rock and hit local morning TV talk shows, claiming they are having free services that very morning for a couple of hours. So far, I’ve not seen hide nor hair of them in 2013. Kool Smiles Dental centers at least announced they gave away toothbrushes this year. (Geez, I hope they weren’t those chemical-laden ones from China that leave blisters in your mouth.)

Small Smiles “free services day” were a sneaky ploy. The dentists would appear on local talk shows about 6 AM announcing they were having free services that morning; from 9AM-11AM for example. They would invite the public, telling them they needed to call for an appointment; failing to mentioning the schedule was already packed tight as sardines – as they were everyday.

It was last year about this time they were preparing documents to file bankruptcy in Nashville’s Federal Court and closing several clinics (updates on that coming soon). By June the OIG forced them to divest in at least one clinic; personally I think it was more than one, Manassas, Virginia clinic for sure. (Let’s just say, whoever took over Manassas, also took the Pueblo, Colorado clinic as well. See: Violations of Corporate Integrity Agreement Triggers Divestiture Action by HHS OIG.

“It is clear that the defendants’ actions constituted more than just malpractice.” –Judge John Cherundo, Onondaga County Superior Court

By August 2012, Small Smiles Dental Centers were taking serious hits in the malpractice cases file against them. In 2011, families of at least 75 children had filed lawsuits in New York against the Small Smiles Dental Centers. Judge John C. Cherundo denied the companies request to dismiss the cases saying, “This intentional misconduct was part of the of the alleged scheme to generate revenue as quickly as possible”. 

Medicaid Fraud Penalties Are Unbalanced (that was the nicest word I could use)

Here is the perfect example of how the 1% stay there, and the %99 stay put as well.  Being the 1% has a whole lot of perks!

Quanah, Texas Dentist Sentenced
KAUZ-TV: NewsChannel 6 Now | Wichita Falls, TX

Posted: Mar 28, 2012 8:58 PM CDT

A Quanah dentist pleaded guilty Wednesday, March 28, to Medicaid Fraud. Dr.

Jay Parmer was sentenced to 10 years probation. He was ordered to pay a fine of $5,000 to Hardeman County, and ordered to make restitution in an amount of $158,000 to the State of Texas Medicaid program.

Law enforcement launched an investigation into Dr. Parmer billing practices in 2009. At the time, Parmer filed a complaint against his former office manager for theft.

During that investigation, she told police Parmer fraudulently billed for work he had not actually completed. On July 20, 2010, Parmer's former office manager pleaded guilty to the thefts.

The Texas Department of Public Safety executed a search warrant in August 2009 on Parmer's office in Quanah. DPS seized patient records and computers used for billing purposes.

Parmer operated offices in Quanah and Vernon, Texas.

Just two days prior, Dr. Richard Malouf who has “allegedly” stole hundreds of millions paid the government $1.2 million dollars to leave him alone.

Dentist settles fraud case, pays $1.2 million, takes CIA

In case you're wondering why OIG just entered a Corporate Integrity Agreement with the All Smiles Dental Center in Texas, here's a recap of the Medicaid fraud case:

All Smiles was a success story, and its founder Richard Malouf was rich; his $10 million French-style chateau put him on D magazine's "100 Most Expensive Homes in Dallas" list. Life was good -- you can watch a video of Malouf backup-dancing for a Michael Jackson impersonator at the All Smiles Christmas party here.

But the feds claimed Malouf got rich in part through Medicaid fraud. The Texas Medicaid Fraud Control Unit (MFCU) and the FBI pursued charges that Malouf "caused 'unbundled' and other improper claims to be submitted to the Texas Medicaid program for orthodontic-related items and services between 2004 and 2007."

Back in 2010, Malouf repaid $46,000 in claims to Texas Medicaid and agreed to an 18-month Medicaid claims moratorium.

Last week, Malouf settled the legal case. He admits no wrongdoing but will pay a whopping $1.2 million settlement fee to Texas and the U.S.

The CIA requires All Smiles to put in a Compliance Officer and do training, special claims reviews, etc.

But Malouf won't have to worry about any of that: He sold the company last year. And we suspect he's still pretty rich.

Pediatric Dentistry’s Revolving Door

We hear a lot about the “revolving” door in Washington, but seldom does anyone talk about the revolving door within agencies and professional organizations.  The same organizations that write the rules, regulations, tests, and guidelines that effect each of us in a more personal way. The same organizations that states and lawmakers trust to protect the public from harm. Chances of corruption are 100% when there are no checks and balances.

Their Publications and Studies

Looking are various websites including the American Academy of Pediatric Dentistry (AAPD), you find publication after publication, study after study, dating as far back as the early 1990’s to the present.  Just about all of them are, rewritten and republished studies that are merely mashups of their own previous written articles and studies.

Here is just one of hundreds of examples :

Journal of Dental Education – Vol. 68, Number 1

General Dentists’ Perceptions of Educational and Treatment Issues Affecting Access to Care for Children with Special Needs. 
Written by:
Paul Casamassimo, DDS, MS;
N. Sue Seale, DDS, MS;
Kelley Ruehs, DDS

Referenced:
Casamassimo PS. The great educational experiment: has
it worked? Spec Care Dentist 1983;3:103-6.

Seale NS, Casamassimo PS. Access to dental care for
children: profiling the general practitioner who treats
young and low-income children. J Am Dent Assoc
2003;134:1630-40.

If you get to looking at all the professional opinions, publications, studies, and continuing education courses concerning pediatric dentistry, the same names are there over and over.

EXCLUSIVE: Dental Service Organizations (DSO’s): Truth Revealed by Financial Insider

June 25, 2015

By: Michael W. Davis, DDS

Dr. Michael W. Davis maintains a private general practice in Santa Fe, NM. He chairs the Santa Fe District Dental Society Peer-Review Committee. Dr. Davis is active in dental care for disadvantaged citizens, and expert legal work. 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. Kevin Cain is an Assistant Professor of Management in the James M. Hull College of Business and guest lecturer in practice management in the College of Dental Medicine at Georgia Regents University. He teaches courses on strategy and entrepreneurship and does academic research in the fields of strategic management, organizational theory, and healthcare management. He also serves on a task force with the Georgia Dental Association and teaches continuing education courses focused on the business of dentistry. Additionally, he is a co-founder and board member of several companies serving the dental industry. He earned a PhD in Business Administration at the University of Georgia, an MBA from Wake Forest University and a BA in Economics from the University of North Carolina at Chapel Hill. He can be contacted at: kevin@kevinwcain.com.
 

Introduction from Dr. Michael Davis-

Dr. Kevin Cain has an interesting and established history in study of the dental industry, and particularly dental service organizations (DSOs). He does research and has given lectures on the risks this business model presents against the public welfare and the integrity of the dental profession. Dr. Cain effectively counters the private equity spin of unlicensed corporate managers keeping at arm’s length from clinical decisions, within the doctor/patient relationship. He confronts DSO industry misrepresentations, of which there are many, head on.

Interview

Dr. Davis: Dr. Cain, please relay the personal story of your mother, a practicing nurse, and the degradation of her once honored profession by corporate health care. How did that affect you personally and influence your fields of academic research?
Dr. Cain: My mother has been a nurse within the same healthcare organization (and its predecessor hospitals) for 40 years. Since the late 1980s, she’s seen her role increasingly shift from being a caretaker to being part of a production line. The healthcare group she works for – mind you its a not-for-profit – sets performance benchmarks for pre- and post-operative care that her and her colleagues must meet. Additionally, her organization implemented EPIC Systems as its EMR provider last year and the time it takes to document patient care further decreases the quality of care she can provide patients.
She is no longer a happy nurse, and actually tried to dissuade my sister from majoring in nursing. At the center of her frustration with her company is its inability to treat patients as idiosyncratic. There are aspects of her job that, if not performed adequately, can jeopardize patient lives. However, her company pushes for efficiency and sets limits on the amount of time allocated for intake. When you generalize patients to the extent that her company has, and minimize the time nurses have to gather information about patients, it is inevitable that those nurses will miss something critical.
My mother’s frustrations with her organization have really shaped my perspective of the dental industry. She and many other healthcare professionals I have spoken with are disillusioned by the current state of their industry. The drive for growth and profitability in healthcare has superseded the drive for quality care, and I do not want to see the dental students I have the pleasure of interacting with here face the same disillusionment for their entire careers. It is imperative that the dental community protects the general dentist from becoming marginalized in the same manner as the primary care physician.
My research on the dental industry is driven, primarily, by the desire to help dentists remain clinically autonomous. In order for the dental profession to maintain its clinical autonomy, practitioners need to understand how institutional forces shape industries. In my field, we study institutional isomorphism – that organizations within an institutional environment look the same – because it helps explains how mimetic, coercive, and normative forces influence those organizations. There are currently no coercive (regulatory) forces preventing the DSO model from becoming the de facto dental model in the U.S., and there is very little normative pressure coming from private practice dentists to change that course.
With regards to mimetic forces, you have baby-boomers selling their practices to DSOs because a friend did and got more money than they would have in a private transition, and you have dental students – year after year – going to work for DSOs because they have been told that the high guaranteed salary is the quickest way to pay off student debt. Meanwhile, a few “business savvy” – or opportunistic – dentists are building their own DSOs and acquiring other practices because they see founders of the large DSOs driving twenty-five million dollar classic Ferraris and want in on that kind of wealth. These mimetic forces are shaping the industry, and the confluence of these forces is leading dentistry down a familiar path (i.e. optometry, pharmacy, primary care medicine).
 
Dr. Davis: We continually hear and read the misrepresentations from DSO private equity managers and their hired supporters that they keep at arm’s length from the practice of dentistry. Yet, we know they establish production quotas and bonuses upon employee dentists. Every doctor’s production metric is monitored on a daily basis. Each clinic’s bank account is swept clean, at least two to three times weekly. They determine clinic scheduling, staffing, as well as purchases for dental materials, dental laboratories, and dental equipment. State regulatory dental boards and even the Federal Trade Commission (FTC) seemingly have bought into these outlandish misrepresentations. (1) What private equity firm, whose sole responsibility is towards its shareholders and not patients, would not logically control every aspect of its business, inclusive of the practice of dentistry? (2) Why do we see so little regulatory enforcement for the unlicensed and unlawful practice of dentistry? Is it a matter of laziness, corruption, or some other factor?
Dr. Cain: The short answer is that private equity (PE) firms routinely leave control of their investments to the top management of those companies, but charge those managers with generating the best possible returns. The pressure of those expected financial returns can drive decision-making by managers of those companies, which is where you would see diffusion of pressure from top managers to the level of the organization at which revenues are generated. In the DSO model, that level is the dentist. To think that PE investments in the practice of dentistry, or the legal structure – where the DSO and the professional corporation that employs the dentists are connected only via a management service agreement (MSA) – keep DSO dentists immune to this pressure for financial returns is naïve. I would venture to guess that most dentists working for a DSO would tell you that they are not told to do certain procedures or pressured based on performance, but the psychology of seeing their production and their office’s production ranked against other associates and offices in the DSO probably provides enough of a catalyst to pressure driven, competitive individuals (generalizing here based on current crops of dental students) to alter treatment plans. That pressure might cause the best-intentioned dentists to compromise their training and ethics in order to climb rankings or achieve desired results (or bonuses). Because continuing education for DSO dentists is provided at corporate headquarters in some companies, treatment plans, labs, and materials used across the company probably begin looking very similar – and profitable – over time.

Ameris Health Systems–Shifting Focus Toward Management

One day before FORBA’s Michael Lindley signed the 5 year Corporate Integrity Agreement his other associated company, Ameris sent out a press release announcing it was “shifting it’s focus to management”.  !!

Nashville Post talks about this and the “unloading” of all but one of it’s hospitals.
Read it here.

Michael Lindley bought his Florida condo from Ameris Realty of Florida, he is up to his eyeballs in Ameris.

Ameris Health Systems
1114 17th Avenue South
Suite 205
Nashville, TN 37212

From the Ameris Health Website

History:
In 1992, Sam Lewis founded Consolidated Health Corporation ( CHC ). CHC was the predecessor of Ameris Health Systems, LLC (Ameris). Ameris, a Tennessee limited liability company, was formed on June 26, 1998 for purposes of developing, owning and managing hospitals and geriatric psychiatric units.

The first project undertaken by CHC was the reopening of Morton Medical Center in Morton, Mississippi. The hospital had been closed for 4 years prior to the involvement of CHC . Ameris recruited physicians and managed this facility until 1998, when management was returned to the local hospital authority. The facility is still open and serving the needs of the community.

In 1993, CHC reopened Newton Regional Hospital, originally a 50-bed acute care facility in Newton, Mississippi. The hospital had been closed for 9 months when CHC reopened it. Over the years, Ameris had added physicians to the medical staff, implemented a 12-bed geriatric psychiatric unit and a swing bed program increasing the services provided to the community and Income for the hospital. In 2003, management was returned to the local hospital authority.

In 1996, Ameris was engaged to manage Prentiss Regional Hospital & Nursing Home in Prentiss, Mississippi. Ameris added a 14-bed geriatric psychiatric unit and a swing bed program. New physicians were attracted to the community. The facility was renovated via grant money obtained by Ameris management. In 2004, management was returned to the local hospital authority.

In 1997, Ameris purchased CareNet Health Systems, Inc. (an owner and manager of residential adolescent treatment facilities), developed and opened 2 additional facilities in Birmingham and Philadelphia, and sold CareNet to Children's Comprehensive Services, Inc. In 1998.

In 1997, Ameris purchased Smith Hospital in Hahira, Georgia. Following a bitterly contested Certificate of Need (CON) application process, Smith received approval to build a new facility In Valdosta, eight miles away. Ameris syndicated the facility to local physicians and other Investors. The new facility opened in June 2002. Ameris partners individually own approximately 30% of Smith Hospital and Ameris manages this facility. Smith Northview Hospital is very successful as an Ameris-managed facility. The hospital has undergone four expansions in its new location since opening and has a bed capacity of 54. A fifth expansion is currently underway to increase the capacity of the Women's Center and Nursery.

In 1998, Ameris took over management of a geriatric-psychiatric unit for Winston Medical Center in Louisville , MS . Ameris recruited physicians and increased the marketing efforts of the unit. Ameris continues to manage this unit.

In 2001, Ameris' founder, Sam Lewis led a group of investors who acquired Children's Comprehensive Services, Inc., a NASDAQ listed public company with annual revenues of approximately $140 million, and took the company private.

[ He tried to hide the company from scrutiny by taking it private is what he’s really saying.  Twiford Rainer, Al Smith (“Smith”), Mike White, Rodney Cawood (“Cawood”), Buddy Turner, Jeff Cross, Gail Debiec, Brad Gardner, Brad Williams, Don Wert, Rob Minor, Mike McCulla, Jim Shaheen, and Rod Gaeta were the group of investors -  Smith, Cawood, Lindley, Gardner, Williams, McCulla are the crooks who own the illegal dental clinics-Small Smiles]

The company then operated as KEYS Group Holdings, LLC ( KEYS ). Mr. Lewis was on the board of KEYS and Ameris partners owned more than 10% of the company. KEYS ' audited financials for 2004 reflected shareholder equity of $42.7 million, net revenues of $118 million and pretax income of $6.5 million from continuing operations and a $40.6 million gain on sale of discontinued operations. KEYS was sold to Universal Health Systems in 2005.

In 2003, Ameris obtained a CON to build a 70 bed replacement medical/surgical hospital in Phenix City , Alabama . Ameris contributed the CON with an appraised value of $3 million to Russell County Community Hospital , LLC ( Summit Hospital ), raised over $22 million of additional equity and obtained a HUD insured mortgage loan, which closed on May 19, 2005 , for $33.6 million needed to develop, construct and equip Summit Hospital . Summit Hospital was sold to Houghston Orthopedic Clinic in February 2008.

In late 2004, Ameris acquired the operations of two acute care hospitals ( Blytheville and Osceola Arkansas ) from Baptist Health Systems of Memphis and entered into leases for each of the two facilities with Mississippi County Arkansas. Ameris and Ameris partners own approximately 66% of the Arkansas operation and Ameris was contracted to manage each facility. Ameris returned the management of the facilities back to the County in March2009.

In April 2007, Ameris received approval from the Florida Agency for Health Care Administration for a Certificate of Need to develop a 60 bed general acute care hospital in Levy County , Chiefland , Florida . Plan developments and financing activities are currently underway.

In September 2008, Ameris assumed the management contract for Barrien County Hospital and Georgia Home Health Services in Nashville , GA. Berrien County Hospital is a JCAHO accredited facility with a licensed capacity of 63 beds. Ameris added a 12-bed geriatric psychiatric service to the hospital in January 2010. Georgia Home Health Services operates three offices – Nashville , GA ; Valdosta , GA ; and Tifton , Georgia . Ameris returned operations of the facilities back to the owners in August 2010.

In January 2010, Ameris began a management engagement and turnaround of the 50-bed acute care hospital in Montezuma , GA. A financial turnaround is currently underway, as well as plans to sell the facility’s assets to a newly formed 501( c ) 3 corporation under an Ameris management agreement.

Ameris Health Systems and Ameris Management Services continue to explore new opportunities for management, development, and consulting for general acute and psychiatric health care entities. Please contact us for more information at (615) 327-4440 .

Ameris of Georgia -

CEO – Sam J. Lewis
CFO – Michael G. Lindley
Sec – Luther Ramsay

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

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.