Thursday, February 04, 2010

New Improved Taste and Less Filling FORBA, I Think Not

Here is a story of how things went in a Small Smiles office just yesterday, February 3, 2010. The child's name was changed for obvious reasons:

This morning the kids and I headed to the Small Smiles dental clinic for Katie's first ever dental visit. We had read some dentist-type books and almost every mom I talked to (or that commented on FB) reassured me of what would happen on the first visit. According to them, the first visit would be a simple tooth-counting and comfort-building chair sitting experience for Katie. And of course a brand new toothbrush to culminate the event. Sounded pretty non-threatening and even sort of fun!

This morning at breakfast, I was giving Katie the expectation run-down again so she'd know exactly what would happen. Katie is a sweetie but she is a girl that doesn't roll with the unexpected well. She needs time to feel comfortable and letting her know exactly what will happen seems to ease her fears.

Anyways, Katie was excited about the dentist visit and said animatedly, "I sure hope I get a new princess toothbrush at the dentist!" She even dressed up her favorite teddy bear in baby clothes and brought him along for the occasion.

As soon as we walked into the clinic door, I had a foreboding feeling. The lobby was VERY crowded and felt more like a daycare center than the comforting low-key lobby experience I had envisioned. Nonetheless, the kiddos settled in to play while I filled out the paperwork. And then we waited. And waited. And waited some more! It was 45 minutes before Katie's name was called.

After a brief introduction, the dental hygienist took us back and instead of asking us anything curtly stated she would start by taking x-rays of Katie's mouth. Sphincter say what?!? I tried not to let my hyper-mommy-alarm bells go crazy and decided instead to go with the flow and see how Katie did. My girl was all smiles until the hygienist shoved the x-ray slide into her mouth. And then Katie lost it -- with good reason too. The hygienist did NOT prepare Katie for what was happening and I tried my best to comfort her from out in the hallway. Needless to say, the x-ray photography session did not happen. Katie kept crying and was obviously scared.

The WORST part was the hygienist's impatience and obvious frustration with Katie's meltdown. She just kept telling Katie to stop crying and to be a good girl or she wouldn't get a toy. Hello?!? What 4 year old is going to stop crying on a dime for a stranger who is doing foreign things and is telling her she's not being good? I was starting to get seriously ticked off. I asked the hygienist to stop and that we'd have to do the x-rays on our next visit.

Moving on, the hygienist brought us to a huge room with about 8 dental chairs all filled with kiddos having various procedures done. Again, the mommy-alarm-bells started ringing like crazy. Talk about a distracting, loud and scary place! Katie, unnerved and whimpering by this point, was not trusting this hygienist chic. It didn't help that the lady lowered Katie in the dentist chair without warning. Katie's tears started again (and so did my tears - I hated seeing my baby girl fall apart) and I quickly saw that wisest course of action was to split. I told the hygienist we were going home and we'd reschedule.

UGH. What a yucky experience! I truly think the worst part of it was the hygienist's use of bribery and her scolding impatient manner. I spent the entire ride home reassuring Katie that I was not mad at her and she was not "bad" for being scared. I think it was perfectly natural and reasonable for Katie to be frightened given the circumstances.

We will NOT be going back to that crazy clinic again. We're taking my little girl's teeth elsewhere!

What have your kids' dental experiences been like?

FORBA has promised before to get it's act together and has failed each time. FORBA has known they were being looked at by Federal and State agencies since 2007 at the minimum. Here it is, 2010 and there are still complaints. Most of the complaints on this website and all the video reports have been since 2007.


Now we have FORBA Holding, (referred to as New FORBA in the legal proceeding filed last week) suing FORBA (referred to as Old FORBA in the legal proceedings), and all I want is one of two things:


1. Their doors locked shut

or

2. A much friendlier, improved taste and less filling FORBA!

Toledo Parent Furious with Small Smiles Dentist and FORBA

Tuesday, February 02, 2010

Lawsuits Abundant In The Land of FORBA

I've been wondering how long it was going to be before 'New FORBA' (FORBA Holding, LLC, whose members are listed on the right sidebar of this blog) sued the hell out of 'Old FORBA' or as I call it, DeRose FORBA.

... I've said from the very beginning of my investigation, the DeRose's were still in this up to their eyeballs and now there is proof I don't care how many people they told that has sold it. They sold the assets, and continued to run and profit from the clinics to this very day.

It's all laid out right here, here, and here, in a lawsuit file in Colorado Federal District Court, January 22, 2010.

I do find it odd, by looking at the case number (09-cv-02305)it appears to have been filed in 2009. Oh, I just noticed this particular document is an 'amended complaint' so this probably was originally filed last year. Yes, indeed it was filed on 9-28-2009.

Defendants:
LICLAC, LLC
DD Marketing, Inc
DeRose Management, LLC
LICLACNY, LLC
Danny E. DeRose
Edward J. DeRose
Michael A. DeRose
Michael W. Roump
Richard B. Lane
William A. Mueller
Adolph R. Padula
Padula Famly Partnetship, LLLP


Relief New FORBA is asking the court to assess on DeRose FORBA:
$50,000,000 for breach of contract
$50,000,000 for liable to FORBA Holding (New FORBA)
$50,000,000 for liable to FORBA Holding (New FORBA)
$50,000,000 for monetary damages FORBA Holding (New FORBA) and incurred
...and anything else they can get the judge or jury to hand over to their dirty little hands.

In my opinion, New FORBA (FORBA Holding) is just trying to cover their butts, by saying "it wasn't me"... but in all honesty, they (New FORBA) knew exactly what's been going on and for how long. These people found each other for a reason, ya know. Plus, Smith, Green, Cawood and Gardner are in this Keystone thing too.

Just saying, I don't think "New FORBA" has unclean hands", if ya know what I mean...

Man, this is odd, whose side should I take in this battle. Hmmm... 'New FORBA' is the one who sued me for spilling their dirty beans, yet those DeRoses make me wanna puke just to look at any of them... Gosh, this is hard... Shoot, I really need to send 'New FORBA' a HUGE bill for all the research I did for them...and laying down all the crumbs for them to follow.

Shoot,shoot, shoot...this is gonna be hard. NOT!! I hope they both tear each other to shreds. But my main goal is for the doors to shut on all 69 of the torture chambers, they call dental clinics.





I'm just at page 19 of the Amended Complaint. I knew Dan DeRose looked like a slimball. I was right. In this complaint, I quote from page 12, paragraph 38.

"...instituted a 'contest' to encourage greater production by the dental centers..."

"personnel continued to have regular communications with the Lead Dentist and Office Manager in each of the Small Smiles Centers regarding production."

"...For example, defendant Michael Roump sent emails to Small Smiles Centers emphasizing that 'production per patient' should be an area to focus on with your dentists ...as we have discussed, our focus needs to be on increasing production per patient"

...personnel also ran a series of reports for Old FORBA's (speaking of FORBA, prior to sale) use in managing the Small Smiles Centers, including 'Dentist Efficiency Reports' and 'Dentist Daily Average Reports."

"Dan DeRose recognized the sensitivity of certain of these reports, denying the existence of these reports to Sanus and suggesting that such reports were the 'number one trigger point for fraud'.


Also thinking about that beautiful Ed and Neta DeRose football stadium built with blood money to honor the dishonorable DeRose's. Wow, it's gonna be hard to not pass this thing, and not think about all the children tortured and abused to line the pockets of the entire DeRose-Padula-Mueller-Roump families. Even the death of one of their tiny innocent patients didn't slow these guys down.




Page 25, paragraph 68 lays out what 'old FORBA' or as I call it 'DeRose FORBA', was supposed to do, in which clinics they were supposed to do it and what they failed to actually do.

I guess this is the section where 'New FORBA' points it's finger and cries, 'he did it' or it could be called the Obama defense. Ya know.. 'Bush Did It, It's Bush's fault, or 'I (we) inherited this'.....


Wow, I'm at paragraph 69 and low and behold there is mention of Dr. Robert Andru and Dr. Kenneth Knott and Toledo Ohio center dentist Dr. Swapna Kakarla. Here it mentions the 'falsification of the Credentials. Geez, I thought that 'New FORBA' did that one.

Paragraph 70 talks about all the expenses 'New FORBA' has incurred due to federal and state investigation, wonder if that includes the $60k attorney fees they said they racked up trying to shut me up? Hmm...

Evidently, New FORBA is saying DeRose FORBA didn't comply with accepted standards for charting. There must be an email from Richard Lane dated August 24, 2005 telling DeRose FORBA that 'poor charting will cause problems in the future'. Not only did DeRose FORBA not see to it that the charts were in good order, they didn't correct it, nor did they disclose to the poor innocent unwitting people of 'New FORBA'.

Looks like 'New FORBA' has a lot of 'DeRose FORBA' emails they've uncovered. Wonder why New FORBA is just now getting these emails. They speak of one, in the Complaint dated 12-29-2004 were Dan DeRose said the Atlanta center

"is a mess, a disappointment, a total disaster" and "I've looked the other way and allowed it to happen. Our employees don't care, our Dr's have no leadership and no professional conduct. Our Office Manager is a train wreck, immature little girl with a huge mouth. Our systems are not in place. Medical histories are not being signed, x-rays suck, referrals are being made daily that is not a FORBA clinic and no one to blame but myself... This email is not to be forwarded to anyone printted or duplicated in any way without my permission."
It also appears people in the DeRose FORBA camp warned of investigations in progress or that would be coming. It's stated in the complaint that Dr. William Mueller (who is a defendant in this case) warned of certain

"things we do which have caused concern on the part of parents, dental boards or media."


In this email, Dr. Mueller makes a list explaining the above statement:

1. Parents in the back
2. patients 'Immobilization'
3. use of 'Stainless steel crowns'
4. Amount of work done


I'm just wondering why New FORBA is just now getting their hands on these emails. I just can't buy what they are selling here. So if DeRose FORBA did all of this prior to the purchase of the assets by New FORBA, and DeRose FORBA continued doing business in this fashion and DeRose FORBA clearly knew it was either illegal or immoral, New FORBA wants us to buy, that they didn't know. Well, that is BS. They've been told just about on a daily biases for at least 3 years and they are just now upset about it!! C'mon! They just want the DeRose's to fork over the $24 million dollars New FORBA now owes the government. Todd Cruse worked for the DeRose FORBA and is right in the office everyday at the New FORBA!

Clearly New FORBA (FORBA Holding) who owns the dental clinics Small Smiles are trying to scrub their dirty grimy little hands. Amazing how this comes out just after they get nailed with the $24 million dollar settlement. What about last, year, the year before that, what about in 2007...New FORBA (FORBA Holding) didn't care then, and they damn well knew what was going on!

Any due diligence at all by the New FORBA would have revealed all the troubles of DeRose FORBA, Michael DeRose, Dan DeRose, Ed DeRose, Mark DeRose, William Mueller, Adolph Padula and more. Did they not know about 'google' in 2006?

They could have found out about Michael DeRose's nasty little business in North Carolina as far back as 2003!!!!!!! Stuart Watson at a Charlotte, NC TV station reported on this that far back!!!

By the time you get to paragraph 96 it's clear new FORBA has filed this just to present to the public their hands are clean and Small Smiles clinics are a safe and wonderful place now for children. They have to keep the income coming in, right? New FORBA want's to smell like the 'rose' they've presented themselves to be for year.

New FORBA (FORBA Holding) says they have incurred $1 million dollars in expenses responding to the state and local government inquiries. I would say it's $1,000,060,000.oo...lol

New FORBA also wants DeRose FORBA to pay them for the expenses they incurred in 2008 due to a civil RICO suit filed in Tucson, Arizona where a search warrant was executed. This suit was looking into thing that went down as far back and July and August 2004 to May 2005.

During the past 2 plus years I can't count the times I've said, "Oh, what a tangled web we weave, " well I'm saying it again.

update:

It appears this case has been dragging on and on and on and on. Motions galore. We are at doc 41 and the DeRose bunch, aka Old FORBA are just now filing a motion for an extension of time to file their Answer to New FORBA's complaint. A judge has even had to recuse herself due to socially knowing the defendants.

Monday, February 01, 2010

Lobbying For Dental Dollars

FORBA Lobbying Firms:

Strategies: Scare tactics, Gain public trust in order to have an audience

Lobbying in Idaho see here

Georgia Stategies, FORBA Lobbying Group see here


WojDak Lobbying Firm in Pennsylvania see here
Wojdak & Associates helps clients form partnerships with government. Our lobbyists are experienced in cultivating cooperative relationships with public officials and other governmental representatives whose oversight could impact the clients or their industries. Our firm helps clients anticipate legislative and regulatory developments and policy trends as well as expand or refine their ability to incorporate government relations into strategic planning.

Wojdak & Associates has a niche as an effective representative of provider and institutional interests within the complex world of health care. Our firm offers highly specialized technical advice, support and assistance to clients whose business relies on regular, productive interaction with state agencies such as the Department of Public Welfare and the Department of Health. Our health care practice has the extensive experience with health-care structures necessary to develop workable initiatives and solutions to problems, and the skill to guide initiatives through legislative, regulatory and political processes.

Wojdak & Associates, recognizing the influential role the media play in government affairs, often turns to its subsidiary, Bellevue Communications Group, for public relations expertise for clients. Bellevue offers a wide range of services – media relations, strategic planning, community PR, grassroots correspondence, editorial support, crisis communications, media training and news conference/news event management. Bellevue's skilled professionals have worked as reporters and editors with the region's leading print and broadcast news outlets, and as spokespersons for public officials.

Kool Smiles Dental As Bad As Small Smiles Dental According To Report

Medicaid dental clinic defends itself against critics
Dan Stockman
The Journal Gazette
Thumbnail
Laura J. Gardner | Journal Gazette

Kool Smiles Dental Clinic on Bluffton Road saw more than 6,000 Medicaid patients last year.


Deanna Vasquez – with 4-year-old twins, Jakob and Kylie, and Brianna, 7 – took her children to Kool Smiles in Fort Wayne, where workers persuaded her to restrain Jakob for a cleaning.
By the numbers
Kool Smiles has 84 dental clinics nationwide, including six in Indiana, and focuses on treating children on Medicaid. Here’s a look at its Medicaid work in Indiana in 2008:
Kool Smiles patients
Indianapolis 2…7,195
Indianapolis 1…6,949
Fort Wayne…6,013
Evansville…5,733
Highland…2,890
Terre Haute…2,055
Medicaid reimbursements
Indianapolis 2…$2.7 million
Indianapolis 1…$2.5 million
Fort Wayne…$2.4 million
Evansville…$1.7 million
Highland…$1.1 million
Terre Haute…$746,000
Indiana$11.1 million
Percentages
•Medicaid and CHIP patients treated by Kool Smiles: 7.8 percent
•Medicaid and CHIP claims filed by Kool Smiles: 6.6 percent
•Medicaid and CHIP reimbursements paid to Kool Smiles: 6.8 percent
Deanna Vasquez said she realized something was wrong when she found herself helping a dental assistant hold down her 4-year-old son’s arms and legs as he writhed and screamed.
“You’re basically brushing his teeth,” she said. “I thought, ‘I could do this at home without holding him down.’ ”
But it wasn’t just her son’s screams that left her queasy, she said. It was also the screams of other children – from behind the closed doors of other rooms at Kool Smiles dental clinic, 1852 Bluffton Road.
“Kids were screaming their heads off,” Vasquez said.

She saw one girl emerge. She was 8 or 9 years old, Vasquez said, and had obviously been sobbing. Her parent was in the lobby.

Five sets of parents told The Journal Gazette that Kool Smiles does not allow parents to be with their children during cleanings or procedures. Vasquez’s presence with her son was allowed, she said, only because she insisted she could help calm him down and that they would leave otherwise.

Kool Smiles denies barring parents from its procedure rooms and says its staff acted appropriately.
The national chain of 84 clinics has been accused of overtreating its patients, of prohibiting parents from procedure rooms and of being too quick to restrain the children it treats. Kool Smiles denies any wrongdoing.
Vasquez worries she did the wrong thing in helping Kool Smiles restrain her son – something she now regrets.


Crystal Allen understands.
She had taken her children to the dentist every six months, she said, until financial problems made it impossible. A year after their last appointment, her daughter had a toothache, and Kool Smiles in Fort Wayne was the only practice she could find to see her immediately.
“They made me feel about this tall when they told me how badly I had neglected their teeth,” Allen said. “I left there thinking I didn’t deserve to have kids if I couldn’t take care of them.”
Then came the hard sell, she said.
Kool Smiles said her daughter, 10, needed stainless-steel caps put on four of her baby teeth, and her son, 5, needed six stainless-steel caps. Immediately.

“They were like, ‘This is so important, you need to get it done now. We can make time today; you don’t know when these other teeth are going to go,’ ” Allen said. “I was like, ‘You’re kidding.’ And he was like, ‘No, she’s here, she needs to get it done.’ ”

Then Allen looked around the waiting room.
“There were two kids there, and every tooth in their mouth was stainless-steel caps, including their front teeth,” she said. “Top, bottom, front and back.”
Dropped in home state Kool Smiles specializes in treating children on Medicaid, a federal health insurance program for the poor run by individual states.
That means taxpayers cover the cost of most of the care provided.
Kool Smiles, based in Atlanta, lost its authorization to do Medicaid work in its home state two years ago because of allegations it was overtreating its child patients and questions about its practice of strapping children down.

According to WellCare Health Plans, the company that handles Georgia’s Medicaid program, Kool Smiles dentists were performing 17 percent more procedures per patient than other dentists.
When compared with patients of other dentists, WellCare said, a child treated by Kool Smiles was:
•Five times more likely to receive crowns.
•Four times more likely to receive five or more crowns.
•Forty percent more likely to have their teeth pulled or extracted.
•Three times more likely to be physically restrained during dental procedures.

While Kool Smiles patients were about 5 percent of WellCare’s dental clients in Georgia, those patients accounted for about 20 percent of the Medicaid money spent on dental care in the state, WellCare claimed.

Dr. David Strange, chief dental officer for Kool Smiles and the company’s national spokesman, said the company has been cleared of all allegations. Doral Dental covers dental work for WellCare.
“We have letters from Doral, the third-party provider in Georgia, really, that we’re quite proud of, stating that they did not have any clinical issues with the charts that had been reviewed,” Strange said.

“We received numerous letters, numerous accounts from Doral stating that they don’t have issues and don’t have concerns with the care provided by Kool Smiles associate dentists.”

But the letters Kool Smiles provided as proof it had been cleared do not refer to the allegations made by WellCare. The letters, written in January, refer only to specific Kool Smiles locations and say they are in response to audits requested by WellCare in September and October 2008.

The allegations that led to Kool Smiles’ contract with WellCare being dropped were made more than a year before, and the audit was being conducted by the Georgia Department of Community Health’s Inspector General.

That audit, according to Georgia Department of Community Health officials, found Kool Smiles had performed a “large number” of tooth restorations on children without anesthesia; excessive treatments during the same visit without some type of sedation; large amounts of local anesthesia given to patients below the proper weight; and one treatment in a Kool Smiles clinic that should have been performed in a hospital. Kool Smiles settled the charges with the state in January 2008 for $193,508.

A follow-up statement from Kool Smiles says its contracts were dropped “without cause” and that the allegations made by WellCare were unfounded. Georgia officials said Kool Smiles as a group is still a Medicaid provider, but the 18 locations involved in the investigation are not.

Investment-firm owned Kool Smiles was started in 2002 by Dr. Tu Tran and Dr. Thien Pham. Today, the chain of clinics is run by NCDR, a limited-liability corporation formed in Delaware, headquartered in Atlanta and owned by the San Francisco investment firm Friedman Fleischer & Lowe, state records show.
Most states require dental offices to be owned by dentists. Tran and Pham own Kool Smiles – and incorporate a new Kool Smiles company in each state where clinics are located. The clinics are then run by NCDR or DPMS Inc., also owned by Friedman Fleischer & Lowe.

According to Indiana Secretary of State records, NCDR should not be operating in the Hoosier State: It has not paid its annual business license fee in two years, and in February, the secretary of state revoked the company’s authorization to do business here. State law provides for a $10,000 fine for operating without authorization.

Strange said he was unaware NCDR cannot legally do business in the state and would look into the situation. The company later said it appeared to be a paperwork problem that would be resolved.

The corporate structure means Tran is listed as the lead dentist on each of the dozens of Kool Smiles clinics across the country, though he does not practice at any location. Pham is in the process of retiring from the corporation, Strange said.

Kool Smiles’ 84 clinics span the nation, and so do the allegations against the company, especially from parents who say their children were given – at taxpayer expense – dental work they didn’t need (See related story).
Crowns are ‘routine’ Strange said allegations of over-treatment by Kool Smiles are unwarranted, and he says its patients are often children who are not receiving regular dental care and have severe tooth decay.
“I get asked all the time, does my child really need a crown? And the answer to that is very, very often a resounding yes,” Strange said. “A stainless-steel crown that’s placed on a tooth that’s severely decayed, that has inter-proximal caries (cavities between teeth), on a child that’s at high risk for additional dental (cavities), a stainless-steel crown is oftentimes the most effective, most reliable and most well-suited dental treatment that can be provided.”

Dr. Bradley R. Smith, a Colorado dentist and a spokesman for the American Academy of Pediatric Dentistry, said it is difficult if not impossible to make blanket statements about placing crowns as opposed to fillings on teeth, even on baby teeth that will fall out within a few years.

“If the patient has never been to a dentist and I have very little confidence I’m ever going to see that patient again, I’m much more likely to do a crown because I know it’s more resistant to decay in the future,” Smith said. “That’s a reasonable decision the doctor has to make for each individual patient.”
Smith said it comes down to informed consent: Do the parents understand all the options and the implications of each one?

If not, “then that’s not a good thing,” Smith said.  Strange said the patients Kool Smiles sees might never have been to a dentist and might never return, so it makes sense they would do more crowns.
“We’re seeing children for the first time at age 4, 5 and 6. They have extensive needs without a dental home.

… We’re seeing children where the effects are really quite devastating throughout the entire oral cavity,” Strange said. “Crowns are very much a part of routine children’s pediatric dental care.”
‘He passed out’
Noah Fedele-Woodley, 4, went to the procedure room alone at Kool Smiles’ location in Newport News, Va., because his mother and grandmother were not allowed to accompany him, said his grandmother, Carol Fedele.

“They brought him out screaming. He was soaking wet,” Fedele said. “He was literally saturated from head to toe from crying and sweating. … Once his mother was holding him, he collapsed. He passed out in her arms.”
Burst blood vessels were found on Noah’s face and neck, known as petechial hemorrhaging clusters, which can be caused by trauma to the skin or stresses such as intense vomiting.

“(The dentist) said it happens all the time; they get it from crying,” Fedele said. “He said, ‘They all do that; they just showed up on him because he’s light-skinned.’ ”

Noah’s Kool Smiles records from that visit show the boy was restrained for 25 minutes. Noah’s mother had signed a consent form six months before, in July 2008, but had no idea she was giving permission for Noah to be strapped down, she said. The form is labeled “Pediatric Dental Patient Guidance Techniques.”

Noah also had bruises on his cheeks, Carol Fedele said, as if his mouth had been squeezed open.
Kool Smiles employees reviewed Noah’s records “and continue to believe we provided medically necessary dental treatment,” the organization said in a written response. “Kool Smiles adheres to the treatment policies and guidelines of the American Academy of Pediatric Dentistry and the American Dental Association.”

The American Academy of Pediatric Dentists’ guidelines say restraints should be used only as a last resort and are meant only for medically necessary treatment. “The use of protective stabilization has the potential to produce serious consequences, such as physical or psychological harm, loss of dignity, and violation of a patient’s rights,” the guidelines warn.

Strange did not deny that Kool Smiles patients are three times more likely to be restrained but said it was “an apples-to-oranges comparison” because Kool Smiles sees only children. “We see a patient population that is, generally speaking, younger than the other dentists’ in the community,” Strange said. “It’s kind of like saying a preschool compared to grade school uses more crayons and that using more crayons is somehow inappropriate.”

So younger patients are going to require more restraints?
“Younger patients require different types of treatment. Protective stabilization happens to be that type of treatment,” Strange said.

Strange said that with parental consent, it can be appropriate to restrain a child for any treatment, even an exam. “This needs to get back to the focus, and the focus is really on the children, and if you can’t do an exam, then you’re not focusing on the child,” Strange said. “From my perspective, from a clinician’s perspective, that’s key.”

An assembly line?
For years, advocates for the poor have complained it is difficult to get dental care because so few dentists are willing to accept Medicaid patients, at least in part because of low reimbursement rates.
But Kool Smiles has found a business model specializing in Medicaid patients. The corporate information Web site Hoovers.com estimates NCDR has 500 employees at its Atlanta headquarters and did $20.1 million in sales nationally in 2008.

In 2008, the Indiana Family & Social Services Administration, which administers Medicaid, reimbursed $2.4 million to Kool Smiles in Fort Wayne. Statewide, the six Kool Smiles locations were paid $11.1 million in Medicaid reimbursement last year.

Unlike the statistics in Georgia, Indiana FSSA figures show reimbursements to Kool Smiles in line with their number of patients.

Still, the Kool Smiles business model thrives on volume. FSSA said the Fort Wayne clinic had more than 6,000 separate patients in 2008.  Dr. Todd Parco, a dentist in New Mexico, even placed a help-wanted ad for dentists tired of the fast pace at Kool Smiles.

“If you are wanting to get out of the dental mill scene like Kool Smiles … and want to find something infinitely better, give us a call,” the ad said. The Fort Wayne Kool Smiles hygiene bay contains six dental chairs, so six cleanings can be performed at a time.

Kool Smiles rewards its dentists for working fast – they can earn bonuses of more than $10 an hour for production, according to a help-wanted ad the company placed in a trade publication. “In any profession, the more productive you are, the higher your compensation,” Strange said.

“The point that really needs to be made is at Kool Smiles, we are very, very particular and very committed to ensuring that all of the dentistry that’s provided is quality dentistry.”  Strange also disputes claims the company keeps parents out of Kool Smiles treatment rooms.

“The company doesn’t have a policy where parents are excluded from participating in treatment with their children,” Strange told The Journal Gazette. “The company does have a philosophy that most children do well without the presence of the parent. However, we do have an open door when it comes to treating children, and our parents are actively encouraged to participate in the Kool Smiles dental experience.”

But parents from five different families contacted by The Journal Gazette said they were told it was company policy they could not accompany their children and that children whose parents insisted on staying with them would not be treated.

A sign in the waiting room of the Fort Wayne Kool Smiles on July 21 stated: “Parents MUST remain in the waiting room while your child is being treated or they will NOT receive treatment.”

Strange said the sign meant only that if parents choose not to accompany their child during treatment, they cannot leave the premises. That sign has since been removed.

“I was not allowed to go back” to the treatment room, Crystal Allen said of her children’s visits to Fort Wayne Kool Smiles. “I was unable to see anything.”

Christina Bergbower took her children to the Terre Haute Kool Smiles and was told it was company policy that she could not accompany her children. “I said, they’re a minor, and by law I can be there with them, and they told me it was their policy – it was on the wall that it was their policy,” Bergbower said. “They make it very clear to you that parents are not allowed in the back.”

Strange said that is not true at any Kool Smiles location.

“The short answer is absolutely no, we do not have a policy that precludes parents from being in the back or in the operating treatment facilities with their children,” he said.
BBB grade changed A dentist at the Terre Haute Kool Smiles told Bergbower that her 6-year-old son Cody’s tooth was so decayed he had to have a stainless-steel cap put on it.

When she took him to another dentist, however, the cavity was found to be so small they were able to fill it without using Novocaine.  Bergbower’s 16-year-old daughter, Shauna, was told by Kool Smiles she needed fillings for four cavities. Another dentist could not find any.
“I showed them the paper from Kool Smiles,” Bergbower said. “She said if she would have had those teeth filled, it would have caused pain and discomfort and set her bite off.”

Strange said Kool Smiles has a vigorous internal-review process that investigates any complaints made, but it gets few – just one-half of 1 percent of their patients complain, he said.  The Better Business Bureau in Fort Wayne gave the Fort Wayne Kool Smiles a grade of F because a customer had filed a complaint and the BBB never got a response from the company.

“An unanswered complaint is a big deal in the BBB system,” said Michael Coil, president of the BBB of Northern Indiana. “All you have to do is respond. We’re not saying they’re wrong or right. All we’re trying to do is get their side of the story.”

Kool Smiles says it did respond, but the BBB somehow never received it. It refiled its response after being asked about it by The Journal Gazette, and the grade was changed to a B-. It was later changed to a B+ when the company responded to a BBB survey asking for basic company information.

Strange said the situation appeared to be an oversight.

“That’s certainly uncharacteristic that we wouldn’t have responded,” Strange said. “We really, truly are people interested in doing the right thing.”


One thing not noted and probably not known by the reporter is Dr. Todd Parco is related to Dr. Adolph Padula, one of the founders of Small Smiles.  Currently Dr. Parco operates a clinic in Las Curses, NM with another [former?] Small Smiles executive, Dr. Ken Knott. 

Sunday, January 31, 2010

Class Action Filed Against FORBA Small Smiles

.... or as it's put in Cause number

3:10-cv-00172-JGC
IN THE U.S. DISTRICT COURT
FOR THE NORTHERN DISTRICT OF OHIO
WESTERN DIVISION
Defendants:

FORBA HOLDINGS,
LLC; FORBA SERVICES, INC.;
SMALL SMILES HOLDING
COMPANY, LLC; SMALL
SMILES OF TOLEDO
LLC; JOHN/JANE DOES 1
THROUGH 75 (Identities and
addresses unknown)
Defendants.

A class action suit was filed January 25, 2010.

Here are a few excerpts of the Complaint:

1. This case arises out of Defendants’ nationwide conspiracy to perform medically
unnecessary dental procedures and use unnecessary or excessive nitrous oxide sedation and physical restraints upon children at their pediatric dental clinics located in at least 23 states, in order to defraud their parents/guardians and third party payors, and obtain additional compensation.


2. Through this action, Plaintiff and others similarly situated seek recovery for damages
stemming from said conspiracy and fraud, including, but not limited to, medical expenses, pain
and suffering, severe emotional distress, trauma and psychological injuries.

....Plaintiff further proposes the following subclass:
Any child and/or the parent/guardian of any child who resided in the State of Ohio and received medically unnecessary or excessive treatment, x-rays, sedation and/or restraints at any of Defendant’s Ohio clinics.



....As to this subclass, Plaintiff asserts Ohio state law claims, including, but not limited to,
claims for fraud, Ohio RICO, assault and battery, intentional and/or negligent infliction of
emotional distress, violations of Ohio’s Consumer Sales Practices Act, loss of consortium and
punitive damages.


...There are common questions of law and fact in the action that relate to and affect the rights of each Class member, and include, but are not limited to:
a. Whether Defendants issued and enforced through their nationwide clinics
guidelines, policies, procedures, practices and “billing production goals” that
were specifically designed to defraud their minor patients’ unsuspecting
parents/guardians and third party payors by performing medically unnecessary
and painful dental procedures and/or x-rays upon the children, including, but not
necessarily limited to, pulpotomies (baby root canals), extractions, filings,
crowns, and improperly, unnecessarily or excessively using nitrous oxide sedation,
physical restraints and/or behavior management techniques on the children during
surgery in order to obtain additional compensation.



For example, upon information and belief, during their training in Pueblo, Colorado,
employees of the nationwide clinics, including, but not limited to, employees of Defendant Small
Smiles of Toledo, LLC, were taught Defendants’ policy called, “conversion.” “Conversion” was
a term used by Defendants to describe their attempt to convert their routine care Medicaid eligible patients to patients receiving medically unnecessary procedures beyond routine checkups
and cleanings. Specifically, employees were taught that it was Defendants’ policy to
“convert” all child patients requiring simple cleanings and check-ups into child patients requiring
extensive and more expensive additional procedures, such as pulpotomies, the dental process of
removing pulp from the pulp chambers of the teeth, and the implant of steel crowns.
Defendants’ employees were taught and in fact performed pulpotomies, and then placed steel
crowns over the teeth instead of installing simple fillings, which is the usual procedure, in order
to obtain additional and more expensive grounds to bill the patients’ parent/guardians and third
party payors.

You can read the Complaint in it's entirety here: Class Action Against FORBA /Small Smiles

Wednesday, January 27, 2010

New Mexico Join 22 Other States in $24 Million Settlement

New Mexico Attorney General Gary King announced today:

New Mexico joins 22 other states and the federal government to settle allegations against FORBA Holdings, LLC., a dental management company that provides management services to Small Smiles dental clinics nationwide. Under the agreement,FORBA agrees to pay the participating states and the United States $24 million, plus interest, to resolve allegations that it caused bills to be submitted to these states’ Medicaid programs for medically unnecessary dental services performed on children insured by Medicaid. Medicaid is funded jointly by the federal and state governments.

New Mexico will receive $361,970.88 under the settlement, which is less than the amount the SIC (State Investment Counsel)invested in Small Smiles. That investment was made under the New Mexico Private Equity Investment Program, a venture capital initiative designed for New Mexico start-ups. As we revealed, though, Small Smiles was not a New Mexico company, but is owned by an Arabian investment bank. As the result of our reporting, the SIC removed Small Smiles from its list of New Mexico companies receiving equity investments, but has not recouped its investment.

Read complete story here.

Small Smiles Dentist's Still Abusive After $24 Million Settlement

A grandmother made this comment on a blog post this morning and thought it deserved being posted right up front. According to her this happened Mon. January 25, 2010. I advised her to contact HHS and report it. Personally I wouldn't waste my time with FORBA's hotline. If you call it, it's likely they will just have a heads up to cover up. You would think after the national attention Small Smiles got AGAIN last week, the dentists and assistants would have gotten the word to do better, guess not.

I have never had a problem with the billing situtation. But what about the nurses and Dentist that fill like they can get away with abuse toward our childern. I'm a grandmother raising 4 granddaughters all go to Small Smiles until today. My 10 year old has asthma they know this and also knows she is scared of Dentist and Doctor from treatment on her asthma. They have always been pretty good about calming her down and making her fill safe. But when a Dentist goes in and belittles her because she is crying and scared and another (the Dentist Assitant) grabbes her arms and shakes her back and forth and all 3 of them laugh at her afterwards. She then makes a comment "You will probably get me fired". My granddaughter tells the Dentist she needed her inhaler because she was having a hard time breathing, instead of getting her inhaler the Dentist tells her "I think your doing this just to get attention". Then she says " Let's all stare at her and give her the attention and see if she will stop crying". I ask again who is protecting our children behind closed doors at Small Smiles. I went up and talk to some supervisor and she pretty much said my granddaughter was lying.

Thursday, January 21, 2010

FORBA Forced To Change? Doubtful !

Reported by: Jane Flasch
Email: jflasch@13wham.com

1/21/2010

Rochester, N.Y. / Washington D.C. -- After 13WHAM News raised questions about the use of restraining devices and unnecessary root canals on children, the parent company of Small Smiles promised changes.

In a two-page statement, FORBA Dental Management CEO Michael Lindley detailed the changes including a reversal of a policy to never allow parents into the same room with their children while their teeth are being pulled or drilled. That was December 2007. Yet 13WHAM News has received a dozen e-mails from parents who say as recent as last month those policies were not in place.

Nadine Dukes says her 10-year-old daughter’s calls for “mom” were ignored. "She was screaming. I heard it, but I didn't know who it was. They never got me,” says Nadine. When she next saw her daughter Kitana six of her teeth were gone -- pulled out.

Fast forward three years. Small Smiles will pay a $24 million settlement to the US government, promising changes once again so its clinics won't be forced to close.

read more...


After a report by 9News in Denver reporter, Deborah Sherman and subsequent state investigation, of the Small Smiles clinics owned by the DeRose family, laws in Colorado were changed and took effect in 2005.

Strict guidelines were put in place to limit the number of root canals that could be done on a child in one office visit and when it's appropriate to use the dreadful papoose board. Yet here we are in 2010 and we find the Small Smiles Clinics and other clinics owned by Forba Holding, LLC are still mistreating, over-treating, and down right abusing children for profit.

Michael Lindley, Alfred Smith, Rodney Caywood of the Nashville, Tennessee area, Jack Draughon, William C. Miller, Jr. and Charles H. Ogburn of Atlanta, GA, Bowen Diehl of Dallas Tx and Charles Griffith of Englewood, Colorado should be tarred, feathered and ran out of town on a rail, after they write that $24 million dollar check to taxpayers. These people are listed as the 'Managers' of FORBA Holding, LLC 618 Church Street, Suite 520, Nashville, Tennessee.

Texas, Nebraska, Ohio, Colorado, Kansas and Kentucky Portions of 24 Million Dollar Settlement

Oklahoma to get $700,000 as it's part of the $24 million dollar settlement.

State to get $70K in case
Oklahoma will get $700,000 as part of an agreement with FORBA Holdings LLC to settle a Medicaid billing dispute. Oklahoma has joined 22 states in the deal with the dental management company. The states and federal government alleged FORBA billed state Medicaid programs for medically unnecessary dental services on children insured by Medicaid. Under the agreement, FORBA will pay the states and federal government $24 million, plus interest, and enter into a five-year corporate integrity agreement with the Department of Health and Human Services’ Office of the Inspector General. FORBA provided management services to Small Smiles dental clinics nationally, including three in Oklahoma.

JULIE BISBEE,



Nebraska to get $270,000.

Attorney General Jon Bruning announced today that Nebraska has joined twenty-two other states and the federal government to settle allegations against FORBA Holdings, LLC., a dental management company that provided management services to Small Smiles dental clinics nationwide.

Under the agreement, FORBA agreed to pay $24 million, plus interest, to resolve allegations that it billed state Medicaid programs for medically unnecessary dental services performed on children. Medicaid is funded jointly by the federal and state governments.

“Taking advantage of taxpayers is bad enough,” Bruning said. “But to do so by performing unneeded dental work on children will not be tolerated.”

Nebraska alleged that FORBA, which operates dental clinics under the name of “Small Smiles,” submitted claims for a wide range of dental services provided to low-income children that were either medically unnecessary or performed in a manner that failed to meet professionally-recognized standards of care.

Nebraska’s portion of the recovery is more than $270,000. In addition, FORBA has agreed to expanded oversight from the federal Department of Health and Human Services.

A team representing the National Association of Medicaid Fraud Control Units (NAMFCU) participated in the investigation and conducted settlement negotiations with FORBA on behalf of the settling states. Team members included representatives from Ohio and South Carolina. Nebraska Assistant Attorney General Mark Collins is the president of NAMFCU.

Courtesy: Nebraska Attorney General's Office


Texas gets $546,000 from FORBA settlement


Kansas to get $1.2 million.

My question here is, why are they in Kansas in the first place. Isn't corporate dental practices illegal in Kansas. Oh, wait, I forgot the story they tell...they don't own it. It's own by, ....well last person to be named as owner was Dr. Mohammad Akbar. Funny thing though, FORBA says it's 'firing' dentists over this. How can they fire dentists in clinics they just 'manage'? If I were to do the bookkeeping for a company that got into deep doo doo, I doubt I would have the power to fire the workers at the company.



Ohio will receive $2.3 million of the $24 million dollars. FORBA/Small Smiles settlement.

Ohio is taking a $2.3 million chunk of a $24 million multi-state settlement with a chain of pediatric dental clinics accused of making Medicaid foot the bill for unnecessary procedures.

Attorney General Richard Cordray on Wednesday said Ohio along with 22 other states and federal officials have struck a settlement with Nashville, Tenn.-based FORBA Holdings LLC, which runs the 23-state Small Smiles chain. In Ohio, the company has pediatric clinics in several cities, including locally in Roselawn and Colerain Township.




Kentucky gets $124,000 of the $24 million dollars.

Kentucky is one of 23 states that reached a $24 million settlement with a chain of pediatric dental clinics accused of billing Medicaid for unnecessary procedures.

Under the terms of the settlement, Kentucky will receive about $124,000 from Nashville, Tenn.-based FORBA Holdings LLC, the parent company of Small Smiles dental clinics. Of that settlement, about $44,000 will go to reimburse Kentucky’s Medicaid program, according to a news release.

In Louisville, Small Smiles has a clinic at 3438 Taylor Blvd. (Home of Dr. Melenie R. Abrams, DDS).

According to the release, some of the procedures billed to Medicaid included extractions, root canals, fillings and crowns. The company, which serves children in low-income families, also allegedly used improper techniques to restrain children.

Through the settlement, FORBA has signed an agreement to change policies at its clinics and establish procedures to detect and ultimately avoid performing unnecessary dental work.

FORBA said in a statement that the agreement “encourages us to continue to focus on vital, high-quality dental care for children in America’s low-income communities and allows us to build on the improvements implemented since the company was acquired in September 2006.”

The $24 million settlement is set to be paid out over a five-year period.



Colorado gets $1.2 million

Colorado is to receive $1.2 million as its share of a $24 million multistate settlement of a series of whistle-blower lawsuits against dental-management company

FORBA Holdings LLC, parent of the Small Smiles chain of pediatric dental clinics, state Attorney General John Suthers announced.

Nashville-based FORBA — which focuses on serving low-income children eligible for state-paid dental care benefits — had been accused in the suits of making Medicaid foot the bill for unnecessary procedures.

The 23-state settlement resulted from lawsuits filed in Maryland, Virginia and South Carolina.

The suits alleged FORBA submitted claims for reimbursement “for a wide range of dental services that were either medically unnecessary or performed in a manner that failed to meet professionally recognized standards of care,” Suthers’ office said in a statement.

As part of the settlement, FORBA signed an agreement to change policies at its clinics and establish procedures to detect and ultimately avoid performing unnecessary dental work.

In a statement Wednesday, FORBA said the agreement “encourages us to continue to focus on vital, high-quality dental care for children in America’s low-income communities, and allows us to build on the improvements implemented since the company was acquired in September 2006.”

FORBA was acquired in 2006 by Arcapita Bank, a Bahrain-based investment firm with an Atlanta-based U.S. unit,

The $24 million settlement is set to be paid out over a five-year period to states where FORBA has clinics.

In Colorado, FORBA operates Small Smiles outlets in Denver, Aurora, Thornton, Greeley, Colorado Springs and Pueblo, according to its website.











New York will get $1.1 million as it's share of the settlement. Steve Flamisch reports below.

Wednesday, January 20, 2010

The Announcement, $24 Mil. Settlement


All I can say, is WOO HOO!

After two plus years and hundreds of hours compiling info and haphazardly posting the bits of what I found here, as well as the great work by several reporters across the US, whose reports you find on this site. Justice has finally come.

After being sued in Federal Court by FORBA for libel, trade secrets and something else (been so long I forgot) (as one put it "I took a bullet for the cause.") Justice has finally come.

After staying strong, a few sleepless nights, and a lot of legal research, (felt like I could pass the bar exam before it was over) but I hung in there and wore them down to drop the suit. Justice has finally come.

Anything we've gone through to get this story told can NOT compare to the mental, physical and emotional abuse hundreds of thousands of children have suffered at the hands of these dentists and FORBA Holding, LLC and it's execs over the years, at least since 2003 and probably further back. My hope was the place would be shut down completely. That they would never get their hands on another child and not receive another penny of our tax dollars. I'm not sure what it's going to take to make that happen. Mike DeRose and Tish Ballance in the North Carolina offices were fined $10 mil two years ago, and Tish is right back at it, in Wayneboro, NC. (Carolina West Dental) and still living high.
FOR IMMEDIATE RELEASE
Wednesday, January 20, 2010
National Dental Management Company Pays $24 Million to Resolve Fraud Allegations
Medically Unnecessary Dental Services Allegedly Performed on Children

WASHINGTON - The United States today announced that it has settled False Claims Act allegations against FORBA Holdings LLC, a dental management company that provides business management and administrative services to 69 clinics nationwide known as "Small Smiles Centers." Under the agreement, FORBA will pay the United States and participating states $24 million, plus interest, to resolve allegations that it caused bills to be submitted to state Medicaid programs for medically unnecessary dental services performed on children insured by Medicaid, which is funded jointly by the federal and state governments. FORBA has further agreed to put in place various remedial measures designed to prevent similar unlawful conduct from occurring in the future. The government’s investigation of individual dentists is ongoing, and FORBA is cooperating with that investigation by providing information about dentists who may have violated professional standards.

The United States alleged that FORBA was liable for causing the submission of claims for reimbursement for a wide range of dental services provided to low-income children that were either medically unnecessary or performed in a manner that failed to meet professionally-recognized standards of care. These services included performing pulpotomies (baby root canals), placing crowns, administering anesthesia (including nitrous oxide), performing extractions, and providing fillings and/or sealants.

"We have zero tolerance for those who break the law to exploit needy children," said Tony West, Assistant Attorney General for the Civil Division of the Department of Justice. "Illegal conduct like this endangers a child’s well-being, distorts the judgments of health care professionals, and puts corporate profits ahead of patient safety."

Assistant Attorney General West praised the collaborative efforts of the federal and state agencies that made this result possible. The Justice Department’s Civil Division and the U.S. Attorneys’ Offices for the District of Maryland, the Western District of Virginia, the District of South Carolina, and the District of Colorado handled these cases. The Civil Division led the nationwide investigation, which was conducted by the Office of Inspector General for the Department of Health and Human Services, the Federal Bureau of Investigation, and the National Association of Medicaid Fraud Control Units.

To resolve the allegations against it, FORBA will pay $24 million, plus interest. The federal share of the civil settlement is $14,285,645, and the states’ Medicaid share is $9,714,355.25. In addition, as part of the settlement, FORBA has agreed to enter into an expansive five-year Corporate Integrity Agreement with the Office of Inspector General of the Department of Health and Human Services. The agreement provides for procedures and reviews to be put in place to avoid and promptly detect conduct similar to that which gave rise to this matter. Specifically, FORBA must engage external reviewers to monitor its quality of care and reimbursement processes. In addition, the chief dental officer must develop and implement policies and procedures to ensure that the Small Smiles clinics provide services consistent with professionally recognized standards of care. FORBA has also agreed to cooperate in the government’s continuing investigation of individual dentists.

"We will not tolerate Medicaid providers who prey on vulnerable children and seek unjust enrichment at taxpayers’ expense," said Daniel R. Levinson, Inspector General of the U.S. Department of Health and Human Services. "This settlement reaffirms our commitment to protect the health and well-being of Medicaid beneficiaries and to ensure the integrity of this essential health care program."

"Health care providers must be held accountable when they mistreat patients and overcharge insurers," said Rod J. Rosenstein, U.S. Attorney for the District of Maryland. "We are committed to using our affirmative civil enforcement authority to protect patients from inadequate care and protect governmental health coverage programs from fraudulent charges."

The government’s investigation was initiated by three lawsuits filed under the qui tam, or whistleblower, provisions of the False Claims Act, which permit private citizens to sue on behalf of the United States and share in any recovery. These actions are pending in the U.S. District Courts for the District of Maryland, the Western District of Virginia, and the District of South Carolina. As part of today’s resolution, the three whistleblowers will receive payments totaling more than $2.4 million from the federal share of the settlement.

"In this case, FORBA put greed and profits before the well-being of children," said Timothy J. Heaphy, U.S. Attorney for the Western District of Virginia. "It endangered the health and safety of innocent children and defrauded the taxpayer of millions of dollars. Today’s settlement addresses these egregious acts and sends a clear message that Medicaid fraud will be expeditiously addressed by this Department."

This settlement with FORBA is part of the government’s emphasis on combating health care fraud. One of the most powerful tools in that effort is the False Claims Act, which the Department of Justice has used to recover approximately $2.2 billion since January 2009 in cases involving fraud against federal health care programs. The Justice Department’s total recoveries in False Claims Act cases since January 2009 have topped $3 billion.

The settlement is to be paid over a 5 year period.


Here is FORBA's response. Never seen such a short statement in my life!!

“This comprehensive resolution encourages us to continue to focus on vital,
high-quality dental care for children in America’s low-income communities,
and allows us to build on the improvements implemented since the company
was acquired in September 2006. We look forward to fulfilling our
commitment to the dental health of underserved children for years to come.”


Nothing but empty words.

Tuesday, January 12, 2010

Small Smiles Dental Sexual Harrassment Suit Filed in 2006

I found this the other day and thought it was worth keeping in the Archives for later use.  Wasn't it the NM clinics where they were playing "wheel barrow", "69" and "chicken fight".  I bet if the plaintiff had these videos back when she sued, things might have turned out differently.  One of the videos is below, the others are here:

Employees at play 1
Employees at play 2

One last comment, someone was waaaaayyy off when they referred to Dan DeRose as a Dr! 

Suit targets alleged sexual harassment, discrimination
Sent on 26-09-2006.
The clinic, which caters to poor children, is one of many offices operated by Colorado-based FORBA. The company's attorney described the plaintiffs as four disgruntled former employees.
``We have conducted one thorough investigation of all of those exact allegations, as set forth in the letter from their attorney, and (found them to be) absolutely unsubstantiated,'' Joe Bower said. He said FORBA interviewed more than 20 employees at the St. Michael's Drive office, but no patients.
The attorney spoke on behalf of Drs. Patrick McQuitty and Melvin Takaki, who continue to work at the Santa Fe office; dental assistant Josh Neil, who now works at Small Smiles in Albuquerque; and Dr. Daniel DeRose, who works in the company's Colorado office.
_One dentist using physical force to stop patients from crying, on one occasion causing one child to gag.
_Dentists touching workers in one sexual manner, such as cupping one breast underneath one plaintiff's bra.
_Dentists groping themselves and making lewd sexual comments about workers and patients.
_One dentist engaging in sex on the job with consensual workers and maligning those who refused his advances.
Instruments were not properly sterilized between patients, the lawsuit says, and unqualified workers were allowed to write prescriptions and operate the X-ray machine.
``Absolutely, 100-percent untrue,'' Bower said. ``It's one general fabrication. Unbelievable.''
The women were fired out of retaliation and have suffered financially, the lawsuit says. Bower, however, said two were fired for allegedly violating attendance policies. He said the others resigned voluntarily.



Sunday, December 27, 2009

FORBA/Small Smiles paying $10k Sign Up bonus. Buyer Beware!

It appears Small Smiles/FORBA Dental is looking for dentists. They are willing to pay relocation money and a $10,000 signing bonus. BUYER BEWARE, if you as a dentist, decide your conscience won't let you do what they ask you to do you'll end up paying them the $10k back as well as a $500 a day penalty for not giving them a 90 day "I'm gonna quit" notice.

Sunday, December 20, 2009

States Get Bonus To Enroll More Children

It amazes me that HHS Secretary Kathleen Sebelius has handed out millions to states for enrolling more children into the SCHIP programs knowing full well the abuse children face at the medicaid dental mills. You would think after at a minimum of 2 years of investigating FORBA's Small Smiles clinics as well as other dental clinics aimed at children on medicaid, HHS and the DOJ would clean that mess up before subjecting more children to the torture and abuse from these mills.

Small Smiles has locations in at least two of the states: Alabama, New Mexico
Ocean Dental has a few location in some of the states, as does Adventure Dental and Vision and the other mill in the news, Kool Smiles. I can see them drooling, can't you?




December 18, 2009

States get bonuses for boosting enrollment in children's health coverage


U.S. Department of Health & Human Services release



HHS Secretary Kathleen Sebelius today announced the award of more than $72 million to nine states for making significant progress in enrolling children in health coverage through Medicaid and improving access to children’s coverage through Medicaid and the state children’s health insurance program.
Funding for the “performance bonuses” was included in the Children’s Health Insurance Program Reauthorization (CHIPRA) law. CHIPRA also set performance goals that states must meet to qualify for a bonus.
“Today, we’re happy to reward states that have taken important steps to help insure more children and made a real difference in the lives of families across the country,” said Secretary Sebelius. “These awards will provide crucial support and help states continue to serve children and families.”
States receiving funds today include: Alaska, Alabama, Illinois, Louisiana, Michigan, New Jersey, New Mexico, Oregon, and Washington. (See below for a complete list of state awards.) Awards vary by state according to a formula set out in CHIPRA but total $72.6 million this fiscal year.
To receive these performance bonuses, states had to meet two types of performance goals set forth in the CHIPRA statute. States had to qualify by adopting at least five of eight listed program features—like providing 12 months of continuous eligibility, using a joint application for both Medicaid and the Children’s Health Insurance Program (CHIP) and streamlining eligibility renewal processes—that are known to encourage enrollment and retention of eligible children. States also had to document significant increases in Medicaid enrollment among children over the course of the year.
Performance bonuses are not the only federal incentive for states to maintain and expand their Medicaid programs. A short-term boost in Medicaid reimbursement rates authorized by the American Recovery and Reinvestment Act (ARRA) also provided relief to states with suffering economies, enabling them to extend care to eligible children.
“In the midst of the worst economic downturn since the Great Depression, decisive action in ARRA and CHIPRA, along with focused state activity, helped ensure that children got the health care they need,” said Cindy Mann, director of the Center for Medicaid and State Operations within the Center for Medicare and Medicaid Services (CMS). “We are pleased to see the success these states have achieved as well as the actions to enroll eligible children taken by other states that we expect may qualify for the bonus next year.”
Today’s announcement closely follows the release of a study by the Kaiser Family Foundation’s Commission on Medicaid and the Uninsured which also credited ARRA and CHIPRA with enabling States to expand access to care for low-income, uninsured children. In a 50-state survey, the Commission concluded that 26 states expanded and/or simplified their Medicaid and CHIP programs in 2009. A copy of the complete report can be found at http://www.kff.org.

State award amounts today are:
Alabama $39.1 million
Alaska $789,000
Illinois $9.1 million
Louisiana $1.5 million
Michigan $3.7 million
New Jersey $4.2 million
New Mexico $5.1 million
Oregon $1.6 million
Washington $7.5 million
Total: $72.6 million
CMS today also released a letter to state health officials providing more detailed guidance on the criteria for qualifying for a bonus payment for 2009 and in future years. That letter will be available on the CMS web site at www.cms.hhs.gov/CHIPRA and also on the Insure Kids Now website at www.insurekidsnow.gov

Monday, December 14, 2009

Dr. Tish Ballance Still Getting Horrible Reviews in 2009

After getting wrapped up with Michael DeRose and being fined $10 Million Dollars as well as named in various lawsuits Dr. Tish Ballance hasn't learned one lesson but did anyone really expect it?

Stay away from Smile Starters, Access West Dental and any other dental clinic Dr. Tish Ballance is associated with!!

CORRECTION: Tish Ballance's clinic is named Carolina West, sorry 'bout that. It's original intended name was Access West when it was planned for Asheville.

Reviews are here:
  • terrible experience
  • My 5 year old daughter went to smile starters for an appointment to get some dental work done. I was told that bc she was nervous if they could not calm her down then they would stop and refer her to a sedation dentist. This did not happen, when she came out of her appointment after well over an hour later, she was very upset, crying, the back of her clothes were wet from sweat her hair was messy and wet from sweat and i was told that she had been combative and struggling but they still pulled 2 teeth from her like that. They should have stopped and just refered her. I have learned my lesson mothers and fathers never take your children to a dentist where you are not allowed to go in the room with them and be with them. They were terrible. (blessedme123, 12/03/2009)


  • IRATE MOM
  • by: Mark Boone CHARLOTTE, N.C. -- The owners of a chain of dental clinics, with offices in Charlotte, will pay more than $10 million in response to a federal investigation into alleged Medicaid fraud, the U.S. Attorney’s office said Wednesday. The owners of the company formerly known as Medicaid Dental Center did not admit to any wrongdoing as part of the settlement, said attorney James Wyatt. As first reported in a WCNC investigation, some parents complained they took their children to the Medicaid Dental Centers on Freedom Drive and N. Tryon Street for what they believed to be routine visits. The Charlotte offices are now operating under the name ‘Smile Starters.’ Wyatt said the clinics are under new management. Christy Dillbeck, a west Charlotte mother, said she was asked to wait in the lobby of a Medicaid Dental Center as a dentist placed her then-four-year-old son on a papoose board, a device used to restrain children. The dentist then drilled into 16 of her son’s baby teeth and installed steel caps, without her knowledge, she said. “That’s a lot, a lot of work,” Dillbeck said. “And to imagine all of the children that had to go through what my son went through, it breaks my heart to even think of it.” At least six other families contacted WCNC with similar allegations. In a statement issued Wednesday morning, U.S. Attorney Gretchen Shappert said Medicaid Dental Center performed “baby root canals,” which were not medically necessary. The procedures were performed between 2001 and 2003, Shappert said. “The dentists subjected their child patients to invasive and sometimes painful procedures, often for the sake of obtaining money from the North Carolina Medicaid program,” said Jeffrey Bucholtz, an N.C. Assistant Attorney General. Dentists Letitia Ballance and Michael DeRose are named in the government settlement as co-owners of the Medicaid Dental Center. Wyatt, who has represented Ballance and DeRose in both federal and state inquiries, said they are no longer working as dentists in Charlotte and are in the process of selling their North Carolina dental practice. Federal authorities said Medicaid Dental Center and its owners will reimburse the government at least $5 million for the allegedly false claims and another $5 million in fines. A portion of the settlement amount will be distributed to the N.C. Education Fund. None of the settlement money will go to the parents of the children who underwent the treatment, said attorney Darren Dawson, who represents five families which are considering a lawsuit against the company formerly known as Medicaid Dental Center. (momofthree, 03/13/2009)