The Smile Center–San Antonio Settlement Reached

December 10, 2015 By Patrick Danner

The last of the one-time Smile Center dentists accused in lawsuits of performing “unnecessary” or “excessive” treatments on minors that were then billed to Medicaid have settled the cases. Four dentists this week reached confidential settlements with some 100 patients who had filed medical malpractice claims in Bexar County. “Since 2011, we have filed several lawsuits on behalf of more than 250 children against the Smile Center or former dentists of the Smile Center,” San Antonio attorney Thomas Crosley said. “With this court approval of these last five lawsuits against former Smile Center dentists, we now bring to a close these tragic cases.” He added the cases were settled “to the mutual satisfaction of all parties concerned.” The Smile Center gained notoriety four years ago when WOAI-TV aired a series of stories on the chain of six dental offices. Some of the stories included parents who complained about dental procedures that allegedly left their children in pain.

Read the rest of the story here 

Read one of the Lawsuits here.

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Astroturfing by the Dental Support Organization Industry

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

“Astroturfing is the practice of masking the sponsors of a message or organization (e.g., political, advertising, religious or public relations) to make it appear as though it originates from and is supported by grassroots participant(s).”^1. -Wikipedia 
Introduction
It is imperative the so-called “dental support organization industry” (DSO industry) employ astroturfing techniques, as their entire business model is formulated on gross misrepresentations.^2-12 In order to obfuscate the rule of law relating to the unlicensed and unlawful practice of dentistry, these corporate entities must misrepresent themselves as only providing limited nonclinical support services for their chains of dental practices. This is patently false, and has been challenged by numbers of legal rulings and studies. In reality, DSOs either represent the true beneficial owners and clinical management for vast numbers of dental clinics, or they provide management for the private equity beneficial ownership. Doctors only serve in a limited role as facade nominee owners. The word “support” is intentionally designed to deceive. The lies go on.

Forms of DSO Astroturfing
There are four basic designs of astroturfing utilized by the DSO industry. At the most basic level is DSOs placing bogus positive patient reviews with online rating services or their website. The next astroturfing technique involves individual dentists who openly advocate for the DSO industry. The third method employs hired public relations and public advocacy specialists. The final level, and often most challenging to prove, is hired lobbyists who direct public policy through directly influencing government agencies and government elected officials. 

Bogus online Patient Reviews
Although this form of deceptive advertising is unlawful, violators are rarely discovered or sanctioned.¹³ The DSO utilizes existing employees or a retained service to generate positive patient reviews for dental services with online review sites, and/or their own website. Often the specific language utilized in the review is a tip-off, that the bogus reviewer is truly not a clinical dental patient, but working in the dental field. Certain DSOs have such a disturbingly high degree of employee turnover and negative staff retention rates, they now resort to posting bogus positive reviews of current or former employees on employment websites such as Glassdoor.com and Indeed.com. One will generally see multiple low rated “one-star” reviews, intermixed with over-the-top glowing “five-star” reviews. Obviously, corporate astroturfing is in play. 

Individual Dentists Espousing the DSO Agenda
On occasion, state legislatures will take up the cause of regulating and restricting the DSO industry to benefit the public interest. Bills will be presented to establish enhanced transparency in true beneficial clinic ownership. Clarification will be added to protect the doctor/patient relationship (contract), and patient rights such as the informed consent process, and always holding the patient’s interests paramount in clinical decisions. Truth in advertising and lending will be advocated. Mechanisms for bait-and-switch schemes will be discouraged.

Cleaning up DSO's is Essential to Increasing Access to Dental Care for Low-Income Children

“…For most Americans, going to the dentist isn't at the top of the list of things we want to do, but we go anyway, because dental care is necessary for our health and well-being. However, many of the poorest children in America don't have the luxury of dreading a trip to the dentist.

According to the Centers for Medicare and Medicaid Services (CMS), 43 million children in the U.S., including half of all low-income children, receive health coverage through Medicaid. This coverage includes dental services as part of the Early and Periodic Screening, Diagnostic, and Treatment benefit.”

“…While the DSO model has been successful, there remain areas of concern. A 2012 joint investigation by PBS's Frontline and the Center for Public Integrity (CPI) uncovered the questionable practices of some DSO's that raise red flags with state Medicaid officials.

The piece did, however, hold up one particular DSO as an ideal model that is "showing hope." Sarrell Dental, a nonprofit dental practice with 17 locations throughout Alabama, received a glowing review. However, some unsettling changes have occurred at Sarrell Dental since that Frontline broadcast.

In 2013, Sarrell Dental was acquired by Massachusetts-based DentaQuest. DentaQuest's President of Care delivery is Todd Cruse, who previously ran a company called FORBA Holdings LLC, a dental management company that provides business management and administrative services to 69 clinics nationwide known as "Small Smiles Centers."

Read the entire piece at Huffington Post

 

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Arizona’s Dental Dangers: Reports by ABC15 News Phoenix

“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
 
Arizona’s Dental Dangers: Reports by ABC15 News Phoenix
By Michael Davis, DDS

This year investigative reporters, Dave Biscobing and Shawn Martin presented a series of very insightful reports for ABC15 News out of Phoenix, AZ. These investigative journalists openly challenged policies of the Arizona State Board of Dental Examiners (ASBDE). They took their investigations directly to the state legislature and governor. In our modern era of diminished resources for investigative journalism in the media, these local media market reporters exemplify the highest standards for service to their profession and the public interest.
The entire series of “Dental Dangers” stories can be accessed via this link:
http://www.abc15.com/dentaldangers
Mrs. Biscobing and Martin have detailed problems as diverse as the protective “old boy’s club” for deviant dentists, within the state dental regulatory board. They exposed the dental board’s failure to disclose public record material on dentist violators. Their report on unlicensed and unregulated dental laboratories was also disturbingly informative. Patients and doctors may have no idea from what nation, and under what safeguards, their dental prosthetics may be fabricated. In fact, ABC15 uncovered that Arizona failed to provide criminal background checks for newly licensed dentists.
This reporting goes far beyond the interests of Arizona. It has significant merit nationally. Dental dangers to the public welfare can be found in most states. Our dental public regulatory agencies, which are supposed to serve the public interest, are often primarily serving a variety of other interests. This investigative reporting did in fact stimulate the process for positive changes to the operation of the ASBDE, although much more is required.
The courageous reporting of Mrs. Biscobing and Martin exposed elements within the state legislature and governor’s office, which discounted the public interest. That unfortunate fact came forth loud and clear. We witness a form of journalistic integrity, which is too infrequently seen on the national media stage, let alone a local media outlet.
We all owe a tip of the hat to Dave Biscobing, Shawn Martin, and the entire crew at ABC15 News in Phoenix. I encourage Dentist the Menace readers to click on the above link, and enjoy an inspired series of reports on dental investigative journalism.

Dental Assistant of Howard S. Schneider, LaTosha Bevel-Hillsman Arrested

Florida’s attorney general’s Medicaid Fraud Control Unit and the Jacksonville Sheriff’s Office have issued another warrant in the medicaid / abuse criminal case related to Jacksonville dentist Howard S. Schneider. Schneider was arrested yesterday. Read more about that here. They arrested and booked his assistant LaTosha Bevel-Hillsman on charges of practicing dentistry without a license, defrauding the Florida Medicaid program and child abuse. Hillsman was booked into the Duval County jail just after 5 p.m. Tuesday, November 17, 2015. What has been identified as her facebook page has very risque (and unhygienic) photos. Her license cannot be found on the State’s license verification as her name doesn’t match.

According to the JSO Inmate Information Search, Bevel-Hillsman is being held on a $30,009 bond. She is not yet scheduled for a court date. It is unknown if the practice will be providing her with a criminal defense lawyer.

Here is her booking report:

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

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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 arrest for writing bad checks

 

 

 

 

Mugshot of Howard S. Schneider Nov 2015 arrest

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.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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
By 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.

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

 

"…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

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

Everyone 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.

The story won investigative reporter Byron Harris and WFAA a 2013 Edward R. Murror Award:

WFAA 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

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.