Tuesday, November 17, 2015

Warrant Issued for LaTosha Bevel-Hillsman, Dental Assistant of Dr. Howard S Schneider

JACKSONVILLE, Fla. —

    The Jacksonville Sheriff’s Office has issued a warrant for one of Dr. Howard Schneider’s former dental assistants.

    LaTosha Bevel-Hillsman is accused of practicing dentistry without a license, defrauding the Florida Medicaid program and child abuse.

    Bevel-Hillsman is facing a child abuse charge and the state says she practiced dentistry without a license at Schneider's former office. The state also said she defrauded the Medicaid program while she worked at the office.

    The embattled pediatric dentist Schneider was arrested Monday for Medicaid fraud by submitting claims for dental procedures he performed without parental consent. 

    - See more at: http://www.actionnewsjax.com/news/news/local/schneiders-former-dental-assistant-accused-practic/npPjK/#sthash.Hwi9N95M.dpuf


    Duval County Pediatric Dentist Arrested for Medicaid Fraud

    TALLAHASSEE, Fla.—Attorney General Pam Bondi’s Medicaid Fraud Control Unit and the Jacksonville Sheriff’s Office today announced the arrest of former pediatric dentist, Dr. Howard S. Schneider, 78, for defrauding the Florida Medicaid program.

    The MFCU’s investigation revealed that Schneider, the sole owner of Howard S. Schneider, D.D.S. P.A., defrauded Florida Medicaid by submitting claims for dental procedures he performed without parental consent. The procedures allegedly fell below the standard of care and produced unauthorized claims submitted to the Medicaid program for reimbursement.

    In conjunction with Schneider’s arrest, the MFCU and the Jacksonville Sheriff’s Office have an active arrest warrant for one of Schneider’s former dental assistants, LaTosha Bevel-Hillsman, for practicing dentistry without a license, defrauding the Florida Medicaid program and child abuse. Hillsman, 39, allegedly performed an extraction on a pediatric patient; a procedure that Hillsman is not authorized to perform. The investigation revealed that this procedure caused harm to the child and produced unauthorized claims submitted to the Medicaid program for reimbursement.

    Schneider faces 11 counts of Medicaid provider fraud of $10,000 or less, a third degree felony. If convicted, Schneider faces up to 55 years in prison and more than $825,000 in fines and restitution.

    The State Attorney’s Office for the Fourth Judicial Circuit will prosecute this case. Hillsman faces one count of practicing dentistry without a license, one count of Medicaid provider fraud of $10,000 or less, and one count of child abuse, all third degree felonies. If convicted, Hillsman faces up to 15 years in prison and more than $15,000 in fines and restitution.

     

     

    Mugshot of LaTosha Bevel-Hillsman from a previous arrestLaTosha Bevel-Hillsman Mugshot for writing bad checks

     

     

     

     

    Howard S Schneider Mugshot

    Mugshot of Howard S. Schneider Nov 2015 arrest

    Monday, November 16, 2015

    Dr. Howard S. Schneider Arrested for 11 Counts Medicaid Fraud

    Nov. 16, 2015

    Dr. Howard S. Schneider of Jacksonville, Florida has been arrested this afternoon.

    Pediatric dentist accused by a group of parents of hurting children, was arrested Monday.
    According to the Jacksonville Sheriff's Office Inmate Information Search, Schneider was arrested on 11 counts of unauthorized Medicaid claims.
    Schneider turned himself into to JSO around 4 p.m. Monday, according to the office of Attorney General Pam Bondi.

    His total bond is listed at $110,033, according to JSO's Inmate Information Search. Schneider does not have a court date scheduled at this time.

    - See more at: http://www.actionnewsjax.com/news/news/local/dr-howard-s-schneider-arrested-medicaid-fraud-char/npPGs/#sthash.5rQ156kR.dpuf

    On November 13, 2015, Schneider filed for an emergency distribution of marital funds in anticipation of his arrest.

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    Charges:

    Howard Schneider Charges.pdf by Dentist The Menace

    Business Service Agreements: A Tool for Deception within the Corporate Dental Support Industry

    Business Service Agreements: A Tool for Deception within the Corporate Dental Support Industry
    Dr. Michael DavisBy Michael W. Davis, DDS

    Business Service Agreements (BSAs), also called Business Service Contracts or Management Service Agreements (MSAs), are a tool created by the dental support industry (a/k/a dental support organizations) to mask their true business operational models. These contracts are generated between the unlicensed ownership (corporate beneficial owner) and the sham figurehead owner (nominee owner dentist(s)).
    These agreements contain a variety of misrepresentations specifically designed to circumvent the rule of law. These BSAs serve as a lynchpin supporting the unlawful house of cards, of largely unlicensed and unregulated healthcare entities. Please note: the term “dental support organization” is also an intentional misrepresentation, to mask beneficial ownership.
    Case precedent was established in federal Fifth Circuit ruling 07-30430)1., in which the court determined a Dental Support (Service) Organization (DSO), Orthodontic Centers of America (beneficial owner of dental clinics), was engaged in the unlicensed and unlawful practice of dentistry. The court also ruled the business agreements with so-called “owner” dentists were unenforceable and non-severable (denying one part could be enforced while another could not), because elements in these contracts were unlawful, the entire contract was rendered unenforceable.
    Nationally, every DSO has created different BSAs. And, within different states, different DSOs will produce different agreements. However, there exist common features worth examination in the vast majority of these contracts.

    Dental Clinic Ownership
    The DSO generally will deny ownership of the dental practice. Yet, the DSO usually owns the facility or is the landlord on the lease agreement. The DSO owns the dental equipment, supplies, and any possible leasehold improvements.
    The DSO enjoys contract rights to control what dentists or entity may be artificially designated as “owners”. An owner dentist(s) may not freely sell “their” asset of a dental practice, and thus are merely façade nominee owners. The DSO controls the bank accounts of the “owners’” clinic bank accounts, which are swept out several times per week, or daily. These are central points in the lawsuit against Dental One Partners, DentalWorks, et al, by 14 duly licensed North Carolina dentists enjoined by the North Carolina Board of Dental Examiners, in 2013.2.

    Thursday, November 12, 2015

    Ben Carson Wants Jail Time For Health Care Fraud -- Except For Dentist Friend

    Huffpost

    "We became friends about a decade ago because we discovered that we were so much alike and shared the same values and principles that govern our lives."

     

    "…Pittsburgh dentist Alfonso A. Costa pleaded guilty to a felony count of health care fraud after an FBI probe into his oral surgery practice found he had charged for procedures he never performed, according to court records."

    "At Costa's 2008 sentencing hearing, Carson described the dentist as "one my closest, if not my very closest friend...”

    "We became friends about a decade ago because we discovered that we were so much alike and shared the same values and principles that govern our lives," Carson told the judge, adding that their families vacationed together and that they were involved in "joint projects."

    "Next to my wife of 32 years, there is no one on this planet that I trust more than Al Costa," Carson said."

    Read The Entire Story Here

    Wednesday, November 11, 2015

    AOL Accuses Dr. Richard Malouf of Gaming The Texas Judicial System

    DTM Avatar 140517Everyone remember the Texas dentist, Dr. Richard Malouf, who sued nearly everyone in sight that had the gall to report or offer comment on the “House That Medicaid Built”?  The place got so big he had to purchase the house next door and he installed his own personal waterpark; dubbed here as 6 Flags Over Malouf.


    malouf3











    The story won investigative reporter Byron Harris and WFAA a 2013 Edward R. Murror Award:
    water-park1Screen-shot-2012-04-21-at-7.00.24-PMWFAA won a 2013 Edward R. Murrow Award for its investigation of Texas Medicaid fraud, including the allegation that Malouf used taxpayer money to build his personal waterpark. Texas law generally prohibits the seizure of one's home, even in the event of wrongdoing, but there is a loophole.
    "If that home is purchased with stolen money, or that home is purchased based on money that has been earned by falsehood or deceit, then that home is not protected at all," attorney Jim Moriarity told WFAA.
    Malouf sued a long list of folks, including actor Owen Wilson’s mom, who lived next door, for trespassing, invasion of privacy, and defamation which included America Online (AOL) for publishing the story.
    Apparently Malouf , and his wife LeAnne find themselves in the 11th hour of trial without legal representation in his defamation suit which continues with AOL, Graham Wood and Candace Evans
    AOL is basically calling “bullshit”, saying Richard and Leanne Malouf have a pool of a dozen or more attorney’s across Texas and should not need 4 months to hire another one.
    I agree!
    This is a must read! Enjoy!

    PS. That is not the only system Mr. and Mrs. Richard Malouf gamed.  Just saying.

    Malouf v AOL_Wood - Response to Motion for Continuance

    Friday, November 06, 2015

    Grassley Welcomes Exclusion of Two Pediatric Dentists from Federal Health Care Programs

    Nov 06, 2015

    Earlier this year, Sen. Chuck Grassley of Iowa asked key government agencies what they’re doing to prevent and punish Medicaid dental fraud, including billing for unnecessary and painful treatments for children, in light of inspector general audits and related media reports documenting worrisome practices.  This week, the Department of Health and Human Services Office of Inspector General notified Grassley that it has excluded two pediatric dentists from federal health programs.  One dentist is in Florida.  The other dentist is in Colorado.  Grassley made the following comment on the exclusions.

    “The taxpayers pay for quality health care services.  If doctors and dentists are bilking the taxpayers and mistreating patients, they need to be shut out of Medicare and Medicaid, period.    The inspector general is right to use this tool whenever it’s appropriate.”

    The Department of Health and Human Services Office of Inspector General provided the following details of the two newly excluded dentists:

    On September 30, 2015, OIG excluded Howard Sheldon Schneider, DDS, from participation in all Federal health care programs because his license to practice in the State of Florida was revoked, suspended, or otherwise lost for reasons bearing on his professional competence, professional performance, or financial integrity.  OIG conducted an investigation of Dr. Schneider which revealed that the State of Florida Board of Dentistry issued a Final Order for a Disciplinary Voluntary Relinquishment of his dental license after the Florida Department of Health opened an investigation into allegations of Dr. Schneider’s abuse of his pediatric dental patients.  Dr. Schneider cannot apply for reinstatement until his dental license is reissued by the State of Florida.  

    On August 12, 2015, Dr. Robert E. Hackley, Jr., DDS, agreed to be excluded from participation in all Federal health care programs for a period of three years. OIG conducted an investigation of Dr. Hackley for dental care he provided to patients at Small Smiles Dentistry for Children in Colorado Springs, Colorado. OIG's investigation revealed that Dr. Hackley furnished dental services to patients of a quality which failed to meet professionally recognized standards of care, including: performing medically unnecessary dental procedures, failing to treat existing dental conditions, and performing dental procedures that were below professionally recognized standards of care.

    Grassley’s letters to the Justice Department and the Department of Health and Human Services Office of Inspector General from June are available here and here.

    In 2013, following a year-long investigation, Grassley and then-Finance Committee Chairman Max Baucus of Montana issued a report and recommendations urging the administration to ban dental clinics from participating in the Medicaid program if the dental clinics circumvent state laws designed to ensure only licensed dentists own dental practices to prevent substandard care.  In 2014, the inspector general moved to disqualify a firm from Medicaid. 

    Tuesday, November 03, 2015

    Grassroots Efforts of Texas Dentists Challenge Activities of the American Dental Association

    Dr. Michael Davis
    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.
     
     


    A newly formed group of grassroots Texas dentists has challenged activities of the American Dental Association (ADA), with the Association of Dental Support Organizations (ADSO). In an open letter to ADA House of Delegates members, Concerned Dentists of Texas, Inc. has expressed their concerns about ADA leading officials meeting with ADSO representatives. The ADSO has gone so far as to highlight these meetings in their public online marketing. Concerned Dentists of Texas contend these clandestine meetings were unsanctioned and violate established ADA rules and protocols.  They also express that the ADA’s appearance of collusion is highly evident and problematic.
    Membership of the ADSO raised more than a few eyebrows. Of note in the ADSO membership is Aspen Dental Management, Inc. Aspen Dental in recent months has formally signed individual and separate legal settlement agreements, with the state attorney generals of Massachusetts, New York, and Indiana. These settlements allege specific violations ranging from unlicensed practice of dentistry, violations to consumer protection laws, false and misleading advertising, violations to full disclosures in consumer borrowing, bait-and-switch business schemes, etc.
    Another ADSO member, Heartland Dental Care, Inc., in 2008 settled with the federal government for alleged Medicaid fraud for falsification and misappropriation of doctors’ Drug Enforcement Agency (DEA) numbers. This DSO also settled with the State of North Carolina in 2011, for alleged unlawful attempt to purchase a dental practice.
    To follow is the open letter of Concerned Dentists of Texas, Inc. to ADA House of Delegates membership:
    October 27, 2015
    Dear ADA Delegates and Alternate Delegates,
    Approximately 80% of ADA members practice as independent dentists in small local offices. We are a concerned part of that group. There is an effort by our ADA to support a corporate form of dentistry that we believe is counter to the best interests of our members and our patients. We must ask ourselves, will the ADA support its members or will it support organizations controlled and owned by hedge funds, private equity firms, and public pension plans? The increased proliferation of this type practice model poses serious risks to our 175 year established philosophy of patient care and the doctor-patient relationship.
    By not taking a stand to inform and represent the majority of its current members the ADA actively supports the DSO philosophy. This is a membership gamble that the ADA cannot afford to take.
    See attachments (pages numbered 1-4) documenting these major changes in the focus of ADA activities:
    Page 1 &2. Breaking News Notable Joint Meeting: ADSO & ADA … Several workforce group meetings were held with ADSO (Association of Dental Support Organizations) and ADA representatives seeking a memorandum of understanding.
    Page 2 & 3. The last 2 pages of a presentation asking for “collaboration”, “harmony”, and “input” between the ADA and DSOs given at the 2015 ADSO Summit that demonstrates the position ADA is taking regarding the DSOs mode of practice.
    Page 1 & 4. The ADSO website screen shots showing proof of this presentation given by the ADA at the 2015 ADSO Summit and then subsequently removed from the website while the other presentations remained.
    These changes are affecting the future of the private practice of dentistry and are occurring without bringing it before the House of Delegates for your vote or discussion.
    • What does our House of Delegates want in regards to support of the private practice of dentistry?
    • What do 80% of our practicing members want in support from their Association? Will the Tripartite support its members?
    • What are our ADA candidates’ opinions and beliefs on the future models of dentistry?
    • Will they be willing to support the majority of our ADA members and their autonomy?
    Over five years of steadily decreasing membership will not be corrected by failing to inform and represent our current practicing members. Rather, the reversal of the trend will be affected by building relevancy and reason for belonging based on representation, transparency, accountability and adherence to long-established principles of professionalism, patient care, and enhancement of the traditional doctor-patient relationships.
    Thank you for allowing us to express our concerns and personal opinions. Opinions are our own, but facts are facts. Please look forward to a blog, Concerned Dentists of Texas, which will further address these issues. The blog will serve as an informational source and reference site in order that members may stay informed. Please feel free to contact us at concerneddentistsoftexas@gmail.com.
    Sincerely,
    Concerned Dentists of Texas, Inc.
    Attachments











    Link to the entire letter including attachments








    Friday, October 30, 2015

    Agency Capture: Association of Dental Support Organizations (ADSO) main goal to get corporate dentists appointed to state dental boards

    The Association of Dental Support Organizations, (ADSO) governmental affairs committee, chaired by non-dentist Heartland VP and 6 other non-dentist corporate guys decided that their number one priority is getting corporate/chain friendly dentists appointed to state dental boards.  

    Read the article and tell me this isn't flat out corruption.  They are asking for volunteers in states where they have lobbyists.  They want to influence regulatory decisions.  And you've got to love the whole "often political preferences will apply to the candidate selection process".  

    Government of the corporations, by the corporations and for the top dogs at the corporations.


    October 2015 Association of Dental Support Organizations Quarterly Newsletter:

    ADVOCACY UPDATE

    The Importance of Getting DSO-supported Dentists on Dental Boards

    The ADSO Government Affairs Committee was formed this summer.  The committee, chaired by John Pantazis, Heartland’s Vice President, General Counsel and Secretary with representatives from 6 other ADSO member companies, meets monthly and is charged with providing the ADSO with strategic guidance on state and federal legislative and regulatory issues.  Among the committee’s top priorities is promoting DSO-supported dentists for appointments to state dental boards. 

    Board appointments are a top priority for the ADSO government affairs team because many of the state issues the DSO industry faces grow out of dental board actions.  We strongly believe that having one or more DSO-supported dentists or strong public sector members on the board involved in discussions and rule-making will go a long way in mitigating state legislative and regulatory issues we have faced in recent years. 

    While we are happy to promote candidates in any state, we recognize that we are much more likely to have success in one of the 13 states where we have a contract lobbyist on the ground to assist in shepherding the candidate(s) through the process. So make a committed effort when openings are coming up to reach out for potential candidates.  We include in our Government Affairs Weekly Round-up, which is distributed every Friday, the list of states with lobbyists where we need our members help to promote candidates (if you are not on the distribution list for the Round-up and would like to be, please contact Wendy Chew).  The lobbyists are able meet with the governors’ appointment staff and follow up throughout the decision-making process.  They can also assist the dentist in getting letters of support from state legislators or other recognized leaders in the state to support their nominations.

    With few exceptions, Board appointments are made by the governor of the state.  Dental boards generally consist of dentists, hygienists, public sector (non-dental related) members and sometimes academics.  All states have rules around the appointments and can include: how long the term of service lasts; requirements on how long the candidate has been a resident of the state; how long the dentist/hygienist have practiced in the state; what area of the state the appointee needs to be from; as well as many other possible requirements.  Since the appointments are made by the governor of the state, often political preference will also apply to the candidate’s selection process.  

    In the past year, the ADSO has helped get DSO-supported dentists on the dental boards in Colorado, Iowa and Florida and are actively working on appointments in every other state where we have lobbyists. In addition to supported dentists, the ADSO has also promoted public sector members for state dental board appointment.

    If you haven’t already done so, please participate in the ADSO database project.  Your dentists’ information is confidential and will not be shared in any way, but having the information in the database allows us to identify potential candidates in states where there are openings on the dental board. Participation in the database also helps us when we have legislative issues in a state.  We are able to reach out through a contact at your company to activate supported dentists on issues of concern to our industry.

    Tuesday, October 27, 2015

    Dental Hygienists Struggle In Corporate Dentistry

    Deborah Lynn Malone StewartDeborah Stewart is a dental hygienist, author, mentor, office manager, coach, consultant, and popular speaker for dental hygiene schools. She holds degrees in dental hygiene, organizational behavior and coaching as well as an MBA. She is author of the 2014 book Perspectives on Dentistry: An Insider’s Guide to the Professional Business of Dental Hygiene (available here).

    Deborah passionately promotes collaboration, ethical standards, and high achievement in both hygienists and the dental industry she loves. A proud member of The Daughters of the Republic of Texas, she is also an historian and a civic and community advocate. 

    What Do Dental Hygienists Do to be Employed?
    by Deborah Stewart

    North Texas, the area where I live, was once roamed by Frank and Jesse James, and home to one of the top ten feuds in American history. The Lee-Peacock Feud was a continuation of the Civil War. North Texas was very prosperous with cotton agricultural growth after the Civil War, so a feud developed whether North Texas would continue to have slaves. Fighting a Civil War apparently was not enough for the additional 200 lives that were killed in the feud. 

    To say North Texans are a bit hard headed is an understatement.  

    One hundred fifty years later, North Texas dental hygienists are fighting another war. Striving to maintain respect for their profession, they fight the battles of what preventive dental hygiene services are to be performed and how they are to work in dental offices. Faced with very few options, what allies do dental hygienists develop in this fight to stay employed? 

    What is obvious is disrespect and disregard for the dental hygiene profession by Texas dentists. This behavior by dentists provided a growth opportunity for corporate dentistry business models.  

    You don’t have to have multiple offices and a logo to become corporate dentistry, you just have to have a mindset of disrespect. Texas dentists began disrespecting the profession of dental hygiene in the 1980s when the Texas Dental Association (TDA) decided that the Texas Dental Hygiene Association (TDHA) needed to have their own convention.

    Since then, the industry has progressed to a corporate way of thinking that now thrives in North Texas. The “dental business” has a checklist for employment of dental hygienists.

    Those items include: 

           1)  Businesses will set minimum production dollars per day 

           2)  “CREATE URGENCY” to pressure patients/parents to consent to procedures immediately

            3) Identify 3 patients that need SRP each day 

            4) Use intraoral camera to identify 3 patients per day that need dentistry with $1200-1900 per day. 

            5) All patients seven years and up need an orthodontic appointment    

            6) All patients 14-20 years of age need a wisdom tooth evaluation 

            7) All patients requiring Scaling and Root Planing (SRP) need to be referred to in-house Periodontist 

            8) Call 5 people per day to come into the clinic for treatment

            9) Clean the bathroom 

           10) No employment benefits with longevity  

           11) Hiring through temporary employment agencies; having no intention of providing full-time employment 

           12) Abusive employment policies.

    Does anyone think this list of job duties is appropriate?  

    Tuesday, October 20, 2015

    DSO Business Model Includes Violating State Labor Laws

     
    Dr. Michael DavisDr. 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.





    David Sohn David Sohn is the principal attorney at SOHN LEGAL GROUP, P.C., which prosecutes and defends employment and business disputes on behalf of individuals, small businesses, and non-profit organizations.  Prior to starting his own law firm, David worked at several prominent national law firms in San Francisco.  He received his bachelor’s degree in Economics from Stanford University and his law degree from Harvard Law School.  Due to the successful results he has achieved for his clients, David has been recognized as a Northern California Super Lawyer by Super Lawyers Magazine. David can be reached at 415-421-1300 and david@sohnlegal.com.
     
    INTRODUCTION
    David Sohn is an attorney in San Francisco specializing in employment litigation matters. Last year, he represented a dentist in his wage and hour lawsuit against Western Dental Services, Inc. (“Western Dental”) for misclassifying him as an exempt employee and not paying him overtime wages and providing proper meal and rest breaks, among other things. Mr. Sohn tried this case in San Francisco Superior Court against an army of big law firm lawyers hired by Western Dental – and prevailed. As a result of his trial victory, the overwhelming majority of dentists in California are now misclassified. They should be receiving overtime wages, proper meal and rest breaks, and all of the benefits and protections of California’s employment laws.
    The case is entitled Nanda v. Western Dental Services, Inc . (Case No. CGC-13-529601).

    Dr. Davis: Mr. Sohn, I sincerely thank you for taking the time and effort to address matters of this case. I understand much of your legal work involves labor workplace rights. The public may not appreciate how even a licensed dentist may have their rights violated in the workplace. Could you give our readers an overview of the merits of this case and how your client was damaged? 

    Mr. Sohn: Thank you, Michael, for giving me an opportunity to discuss with you and your readers my trial victory against Western Dental. This is a very important, game-changing case that all dentists and to-be-dentists need to know about so that they understand what their workplace rights are.

    When I decided to take on this case back in 2013, I didn’t know anything about the dental industry. I took it on because I saw a very interesting legal question. That question was: are dentists employed by Western Dental compensated in the form of a “salary?” Western Dental compensates its dentists by a fixed daily rate and/or a percentage of their production. They are not guaranteed in advance a minimum weekly or monthly amount of compensation.

    This legal question is important because in order for dentists and other licensed professionals to be exempt from all of the benefits and protections of California’s employment laws – such as overtime wages and proper meal and rest breaks – they must be paid in the form of a “salary.” If they are not, they must be provided these benefits and protections.

    California law does not provide a definition for the term “salary.” Instead, California courts look to federal regulations for the definition of “salary.” The pertinent federal regulation, 29 C.F.R. § 541.602(a), states that an employee is paid on a “salary basis” if he or she “regularly receives each pay period on a weekly, or less frequent basis, a predetermined amount constituting all or part of the employee's compensation, which amount is not subject to reduction because of variations in the quality or quantity of the work performed.” This same federal regulation also explains that if an employee is ready, willing, and able to work, but he or she does not work due some reason occasioned by the employer, he or she is not being paid on a “salary basis.”

    At the conclusion of trial, the judge held that the dentist I represented was not paid in the form of a “salary.” The dentist never received on a weekly, or less frequent basis, a predetermined amount of compensation which was not subject to reduction based upon variation in the quality of quantity of work performed. He was only paid for the days that he worked and on occasion received a percentage of the production he generated. On numerous occasions, even though he wanted to work, if he was not called into work, he was not paid. Given these circumstances, he was entitled to overtime wages and proper meal and rest breaks like other non-exempt staff employed by Western Dental.

    As a result of the judgment issued in my case, all dentists – and for that matter any licensed dental healthcare professional (such as orthodontists, periodontists, etc.) – in California paid on any basis other than a salary basis are “non-exempt” employees who are entitled to overtime wages, and proper meal and rest breaks.   

    Dr. Davis:  The defendant in this case, Western Dental, is the largest employer of dentists in the state of California. They also operate dental clinics in Nevada and Arizona. They are the largest provider of dental Medicaid services for California. As large of a dental industry operation as is represented by Western Dental, is it reasonable to speculate on the pervasiveness of dentist/employee workplace labor violations (both in Western Dental and the dental service organization (DSO) industry, as a whole)?   

    Mr. Sohn: During the course of my case against Western Dental, I discovered that Western Dental’s approach to how it compensates its dentists is not unique. I spoke to a number of dentists and specialists who worked for other practices large and small, including other DSOs and small private practices, and the impression I received was that the overwhelming majority of dentists and specialists in California – and in the country – are paid on a similar non-salary basis. That’s when I realized my case could have significant industry-wide consequences.

    Wednesday, August 19, 2015

    Sending A Message to Texas Gov. Greg Abbott

    They need 75 more signatures guys, let's make this happen. Texas is the worst state in the nation for dental fraud and lack of action by it's dental board. It's the state where criminal dentists thrive in administrative protection! Remember for every $1 of fraud in Texas, .50 is stolen from taxpayers of the other 49 states.

    Capture

    Friday, July 31, 2015

    Another one of those “studies” paid for by Kool Smiles parent company suggests more Medicaid money is needed for dental benefits to serve children in Texas!

    I know it’s hard but try to stop laughing and read this ridiculous press release.
    (Benevis was formerly NCDR (Kool Smiles), owned by private equity firm FLL Partners.)

    Study Finds Only 26.5% Of Texas Children Eligible For Medicaid Dental Coverage Frequently Visit Dentist.

    PRNewswire (7/30) carries a release announcing that a new survey by the Benevis Foundation, conducted by Kennesaw State and Emory University researchers, finds that “only 26.5% of Texas parents with children eligible for Medicaid dental coverage consistently bring their children to the dentist as frequently as they should,” with parents citing financial hardships as the primary barrier to more frequent dental visits. Geoffrey Freeman, spokesperson for the Benevis Foundation, said, “This suggests that parents may not be aware of the complete coverage of their benefit, or that there may be secondary costs – such as transportation or unpaid time off work – that keeps these families from visiting the dentist as often as they would like.”

    Thursday, July 02, 2015

    Grassley Seeks Key Agency Updates on Medicaid Pediatric Dental Fraud

    These answers should be interesting don’t’ ya think? I can answer. Little to nothing to “prevent” and even less to “punish”.

     

    Jul 02, 2015

    WASHINGTON – Sen. Chuck Grassley is asking key government agencies what they’re doing to prevent and punish Medicaid dental fraud, including billing for unnecessary treatments for children, in light of inspector general audits and related media reports documenting worrisome practices.

    “Some dentists are clearly performing unwanted and unneeded medical procedures on children without the consent of parents and bilking Medicaid for the privilege,” Grassley wrote to Attorney General Loretta Lynch and Department of Health and Human Services Inspector General Daniel Levinson. 

    Grassley’s letters cited Health and Human Services Office of Inspector General audits of questionable billing practices for Medicaid pediatric dental services in four states: California, New York, Louisiana and Indiana.  All of these audits identified questionable billing practices that suggest Medicaid dental providers are performing medically unnecessary procedures on children.  Grassley wrote that this conclusion has been echoed by a variety of news sources that have reported on troubling practices performed by dentists treating children in Medicaid, including a Florida-based dentist who allegedly subjected hundreds of children to unneeded tooth extractions, improper dental fixtures, and other troublesome procedures.

    Grassley asked Lynch for the number of criminal and civil fraud referrals from the Health and Human Services Office of Inspector General related to Medicaid dentistry chains in the past five years, with a listing of the referrals by state and how each criminal and civil case was resolved; details of the number of ongoing Department of Justice Medicaid dental chain fraud investigations by state; and a description of the Department of Justice’s plan to address the findings by the Health and Human Services Office of Inspector General that indicate health care fraud in the context of dental procedures provided to children in Medicaid. 

    Grassley asked Levinson for the steps the inspector general’s office will take, or has already taken, to increase the auditing of dentistry offices that are recipients of federal dollars; the number of criminal and civil fraud referrals from the inspector general’s office to the Department of Justice relating to Medicaid dentistry chain activity in the past five years; details of the Medicaid dentistry audits the office performed by state in the past five years, with a note on whether the audit resulted in criminal or civil referral to the Department of Justice; the number of ongoing Medicaid dental fraud investigations by state; and a description of the progress on following up on billing fraud and unnecessary procedures in Medicaid pediatric dental services. 

    In 2013, following a year-long investigation, Grassley and then-Finance Committee Chairman Max Baucus of Montana issued a report and recommendations urging the administration to ban dental clinics from participating in the Medicaid program if the dental clinics circumvent state laws designed to ensure only licensed dentists own dental practices to prevent substandard care.  In 2014, the inspector general moved to disqualify a firm from Medicaid.  

    Grassley’s latest letters are available here and

    Thursday, June 25, 2015

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

    June 25, 2015

    By: Michael W. Davis, DDS

    By Michael W. Davis, DDSDr. 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 CainDr. 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.Capture
    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.

    Thursday, June 18, 2015

    NY Attorney General says Aspen has to change it’s ways; or did he?

    What apparently escaped the NY Attorney General is that the parent company is the actual owner of the dental practices and the "owner dentist” doesn’t own diddly-squat. 

    Hey NY AG! The  "Dental Management Companies" hires individual dentists as salaried employees who then pretend to "own" the clinics!  But you know that, right?

    In the case of Small Smiles, the original "owner dentists" paid $10.00 per clinic or less. But when we caught on the price went up to a whopping $100. That's a pretty sweet,,, "owning" a business that generates millions of dollars a year, for $100.  Sign me up!

    June 2016 New York State Attorney General Settlement Order With Aspen Dental

    Tuesday, June 09, 2015

    Wondering how the Small Smiles Dental Malpractice Settlement Stands?

    This pretty much covers where the settlement is today.

    Small Smiles Settlement as it stands June 2010

    Friday, June 05, 2015

    Basic Economic Models of Large Scale Corporate Dentistry

    Basic Economic Models of Large Scale Corporate Dentistry
    By Michael W. Davis, DDSBy: Michael W. Davis, DDS
    June 5, 2015





    The first misnomer and misrepresentation which must be addressed is dental service organizations (DSOs). These are primarily business structures designed to circumvent state laws relating to ownership of dental practices. Most state statutes require only licensed dentists in their states may lawfully own a dental practice. DSOs falsely allege they restrict management to non-clinical areas.

    In reality, the corporate entity DSOs own the dental practices they manage. Doctors in those practices are merely employees, whose employment may be terminated at the will of their employer, the DSO. The DSO fully controls the bank accounts of each and every clinic they manage, with accounts usually swept into Delaware banks at least bi-weekly. They establish monetary production quotas and bonuses for patient services. They establish the hours of operation and staff. They usually dictate office equipment, patient clinical supplies, and dental laboratories for patients. They supervise and control patient scheduling. They also dictate numbers of clinical protocols bypassing the doctor/patient relationship, such as mandating crowns over fillings, often unnecessary and more costly “deep cleanings”, antibiotic therapy into alleged “deep gum pockets”, etc.

    Most “owner” doctors in these larger corporate practices are sham figureheads. They provide the corporate managers a layer of liability protection, for their unlicensed and unlawful practice of dentistry (see: Federal Fifth Circuit ruling 07-30430). These alleged “owner” doctors are not allowed to freely sell their asset of the dental practice, under their contract service agreements with the DSO. They aren’t as “owners” allowed discontinuing services with the DSO, and must retain the DSO’s services into perpetuity. In effect, the doctor owner(s) represent a façade of nominee ownership. The valid beneficial owner of the dental practices is obviously the DSO.

    Wednesday, June 03, 2015

    ADSO and Gryphon Investors: OneSmile to buy existing dental practices.

    We are all F’d!

    June 3, 2015

    Gryphon Investors and dental industry vets launch OneSmile

    Gryphon Investors has teamed up with dental industry veterans Steven C. Bilt and Bradley E. Schmidt to form OneSmile. No financial terms were disclosed. OneSmile will initially focus on buying existing dental practices in the western U.S.

    PRESS RELEASE

    June 3, 2015, San Francisco –Gryphon Investors (“Gryphon”), a San Francisco-based private equity firm, announced today that it has formed a partnership with Steven C. Bilt and Bradley E. Schmidt to establish OneSmile, LLC (“OneSmile”). The new company will initially focus on acquiring existing dental practices and groups in the western United States, as part of a strategy to build a comprehensive Dental Services Organization (“DSO”) platform.

    Mr. Bilt, a seventeen-year veteran of the dental industry, is OneSmile’s CEO. He previously served as the president and CEO of Smile Brands, Inc., one of the largest providers of support services to general and multi-specialty dental groups in the United States. Brad Schmidt will be OneSmile’s CFO, a position he previously held at Smile Brands, Inc. Together with Gryphon’s financial backing, Mr. Bilt and Mr. Schmidt built that company from inception to over 250 locations with revenues of over $350 million before Gryphon sold a majority of its shares in 2005. The executives continued to lead the company for subsequent investors, eventually expanding it to more than 400 locations and over $500 million in revenues.

    Mr. Bilt, who is a founding member and former director and president of the Association of Dental Support Organizations (ADSO), said, “There is a compelling opportunity to build a leading DSO in the Western U.S., and I look forward to working with Gryphon again in this exciting new venture. Their experience helping to build Smile Brands’ predecessor starting in 1998, along with their financial and operational support, will benefit us as we establish a unique model bringing comprehensive general, pediatric and specialty dental care and healthy, happy smiles to millions of people.”

    Monday, June 01, 2015

    Dentist the Menace Reader Quiz, June 1, 2015



    June 1, 2015 Dentist the Menace Reader Quiz
    Designed to test readers knowledge and add a bit of humor while educating others

    By: Debbie Hagan and  Michael W. Davis, DDS

    The dental profession has a good number of abusers to the public welfare. Dentist the Menace readers are well aware of these violators, the companies they represent or work for, and complicit state and federal regulators. This quiz will test your knowledge of the dirty dark underbelly of the dental profession.

    Multiple Choice Questions
    1.    The following is true for Dr. Eddie DeRose of Pueblo, CO:
    A.    He has a history of gambling junkets on private jets to Las Vegas to visit his goomarahs and play a Vegas gambling “whale”.
    B.    His favorite clinic quote in reference to female staff is, “I could train monkeys to do a better job than you girls.” This led to wild speculation that Dr. DeRose’s Italian ancestors may have been trainers of organ grinder monkeys.
    C.    As a dentist primarily treating low-income disadvantaged Medicaid children, he also owned a stake in DD Marketing, which placed junk food and soda pop vending machines in low-income public schools.
    D.    All of the above.

    2.    The following is true for Dr. Michael DeRose of Pueblo, CO:
    A.  He has special-needs & mentally challenged younger brother, who formerly played football for the LSU Tigers. This formed the basis for the Adam Sandler movie, Water Boy.
    B.   As part of a consent agreement with the State of North Carolina for alleged Medicaid fraud, Dr. DeRose agreed to surrender his dental license and agreed to pay the State of North Carolina several million dollars.
    C.   This is an individual who enjoys the simple things in life, and today continues to live         in the modest 3-bedroom home he purchased 20-years ago.
    D.  All of the above.

    3.    The following is true for criminal defense law firm of Waller Lansden Dortch & Davis LLC of Nashville, TN:
    A.    They are an industry member of the Association of Dental Support Organizations (ADSO).
    B.    This law firm has previously represented Dr. Richard Malouf, an alleged Medicaid fraudster of Dallas, TX notoriety.  
    C.    This law firm has previously represented Church Street Health Management (d/b/a Small Smiles Dental, today bankrupt & disgraced), with law partner, Sheila Sawyer formerly acting as Chief Administrative Officer.
    D.    All of the above.

    2004 Cease and Desist Letter from Colorado Dental Board: Michael A. DeRose, Eddie DeRose, William (Bill) Mueller

    I've heard the Michael DeRose out there in Pueblo under oath say he did not "train" dentists. They were simply there to "observe" for a few days.  Yet, here is the 2007 C & D letter from the Colorado dental board where he admits the dentists performed general dentistry and it was the program offered by his father, Eddie DeRose and William Mueller as well as himself.

    Sunday, May 31, 2015

    Howard S. Schneider of Jacksonville, Florida files Motion to Dismiss and asks for Sanctions against Gust Sarris attorney-Adsum Law Firm

    Jacksonville, Florida

    On May 22, 2015 Howard S. Schneider's attorney Richard E. Ramsey of Wicker, Smith, O'Hara, McCoy and Ford, has filed a Motion in Jacksonville Circuit Court asking the court to Dismiss the lawsuit filed, Expunge it from court records and Sanction attorney Gust Sarris of Adsum Law Firm.  I read it as they firmly believe Gust Sarris / Adsum Law Firm failed to follow proper procedures before the filing of the suit.


    Saturday, May 30, 2015

    Previously Indicted Dentist Gilberto Nunez Arrest for Perjury. WHAT?

    Seems things continue to worsen for dentist Gilberto Nunez. After his April 2015 Indictment of Grand Larceny, Insurance Fraud, and 5 counts of Falsifying Business Records he was released on $15,000 cash bail ($30,000 bond). (court documents below) According to Mid Hudson News, he's been arrested on charges of perjury brought by the Ulster County Sheriff's Office. I seldom hear of perjury charges these days! The original Indictment stems from a February 2014 fire in which he claimed an $8,400 loss.  I'm serious.
    Poughkeepsie dentist arrested for perjury
    May 29, 2015


    Nunez
    KINGSTON, NY – A Poughkeepsie dentist was arraigned on Thursday (May 28, 2015) in Kingston City Court on a felony complaint charging him with two counts of perjury, two counts of offering a false instrument for filing, and making an apparently sworn false statement.
    Gilberto Nunez, a dentist with offices in Kingston, is also under indictment in Ulster County Court on charges of grand larceny, insurance fraud, and falsifying business records.
    Both cases are being prosecuted by the Orange County District Attorney’s Office acting as special prosecutor.
    The latest charges, brought by the Ulster County Sheriff’s Office, stem from several allegedly false statements contained in a pistol permit application Nunez filed in February 2014. They pertained to his previous military service.
    The complaint alleges Nunez was AWOL from the US Marine Corps from August 1987 until he was apprehended in July 1990, and that his subsequent “Separation in Lieu of Trial by court Martial” was a “discharge for cause” that had to be reported on the application.
    In his 2014 pistol permit application, Nunez checked off the “no” box in answer to questions as to whether he had ever been “terminated/discharged from any employment or the armed forces for cause” and whether he had ever “been arrested… anywhere for any offense.”
    Kingston Judge Lawrence Ball released Nunez on his own recognizance pending a future court appearance in county court on the indictment charging him with grand larceny, insurance fraud and falsifying business records.

    Wednesday, May 27, 2015

    Dr. Behzad Nazari, "talented Houston general dentist". Really?

    Dr. Nazari’s dental practice, Antoine Dental Center, recently partnered with SmartBox Web Marketing to build the state-of-the-art website and provide online dental marketing.

    "This new partnership allows us to have a beautiful new website that provides our patients with detailed information about our practice," Dr. Nazari said. "When it comes to having a good presence on the Internet, convenience and accessibility are both key. We want our patients to have the ability to access information anywhere and schedule their appointments at any time or place."
    The new website, www.antoinedental.com, includes video testimonials from staff and patients; comprehensive information about practice services; a smile gallery filled with Antoine Dental Center patients, and convenient scheduling options. Patients can access free eBooks about the power of dental implants and orthodontics, and the website will be updated monthly with blogs relating to services at Antoine Dental Center and recommendations about at-home oral hygiene.

    "I'm excited for patients to visit our new site so they can see our superior dental work and hear from patients who have absolutely had their lives changed after becoming a patient at Antoine Dental Center," Dr. Nazari said.

    Tuesday, May 26, 2015

    DeRose / Padula Family - FORBA files Objection to $39M Settlement

    So today was the deadline to file Objections in the $39M Small Smiles Dental Center's settlement. I'm perplexed. How the hell did this thing even get filed?!?! At least 3 Objections were filed today! Old FORBA (The DeRose/Padula family) don't like it, the victims don't like it (neither do I) and one Insurance Company doesn't like it! So who the hell liked it enough to call it "Settled" Honestly! Who was it?!?!?! Could it be the a select group of attorney's wanting their money and run, or the Trust Administrator who will snatch up a quick million or two within days of it's approval? Could it be AIG, who has filed so many pleadings courts have had to reprogram their systems or maybe AIG ran out of "stalking" attorneys to follow jurors around.

    Apparently they know children will be seeking compensation for their abuses for years to come and low and behold, old man Dr. Adolph Padula and others have figured out they are included in the count of 333 dentists who will lose their malpractice coverage for all their misdeeds. Yeah, I laughed pretty hard at this one.

    Creepy ole Aldoph Padula says his retroactive coverage is to last until the end of time. No wonder he's scared! 

     "The Objectors believe that some or all of the Claimants will continue pursuing claims against the Objectors which claims are covered by the insurance policies that are the
    subject of the Motion and Settlement and Release Agreement.Upon information and belief, the Supplemental Extended Reporting Period Endorsement provides for a period of “unlimited duration” during which “claims” arising from “dental incidents” that occurred after the retroactive date (i.e., February 1, 2001) and before the end of the policy period (i.e.,September 26, 2010) may be reported under the Entities Policy." 

     Be sure to hit page 6 and 7 for the long list of clinics!! And note that it says "among others"...that a boat load of clinics!! One thing is for certain, these old boys haven't been enjoying their retirement as much as I bet they thought they would.


    Continental Casualty filed an Objection as well.

    It must have been a real party at the court today, down there in Nashville. 

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    Objection filed opposing the $39M settlement for small victims of FORBA/CSHM’s Small Smiles Dental Centers


    Actually there were at least 3 Objections filed today, this is just one.

    Objection to $39M Settlement for victims of Small Smiles Dental Centers






    Monday, May 25, 2015

    Western Dental extorting $ from California Taxpayers?

    Western Dental has been in a financial bind for some time, I would guess mainly due to the poor care, many complaints and most of all the OIG audit taking place. Then last week the OIG issued it's report on California's Denti-Cal program which indicated many Western Dentists has "Questionable Billing". Two days later, Western Dental issued a statement that they would no longer accept new Medicaid patients beginning June 1. citing low reimbursement from the state program. Hmmm... Sounds like an attempt to extort more money from California taxpayers and the Denti-Cal program to me. Apparently they need more money if they are to survive without "questionable billing". And who is right there campaigning for them... the California Dental Association. Didn't hear a thing from the CDA about the Questionable Billing Issue! Knock knock!! Anyone there...!!

    Here is an article at Dr. Bicuspid

    Here is where I agree with the CDA, reimbursement rates need to be increase. But only and I mean ONLY when they get the massive amount of fraud stopped dead in it's tracks. Until then... no way!

    Maybe Western Dental is still a little pissy about the 1997 raid.

    California's largest dental HMO, already under state investigation for allegedly "shoddy" patient care, is now the focus of a federal criminal probe into insurance-fraud allegations made by former employees of Western Dental Services.

    About a dozen investigators from the Federal Bureau of Investigation and the U.S. Postal Inspector's Office raided two Western Dental clinics Friday morning in the Sacramento area and hauled out boxes of medical records sought under court order.

    Investigators were seeking evidence of what they believe to be "widespread overbilling" by Western Dental offices throughout California, according to an affidavit filed in U.S. District Court in Sacramento, a copy of which was provided to The Times. The court papers also say that federal investigators suspect the alleged insurance fraud scheme was carried out with the knowledge of Western Dental management and owners.

    Read the story here

    Will Schneider be forever used to describe unethical and abusive dentistry?

    Don't be a Schneider

     

     

     

     

    • Don’t be a Schneider
    • Schneider type dentistry
    • Schneideresque
    • Schneiderized

    Just thinking…