Sunday, September 30, 2012

Senator calls for dental inspections Peeler says he'll introduce legislation if need be

Written by
Tim Smith, greenvilleonlineStaff writer

COLUMBIA — Routine state inspections now protect people more from bad food at restaurants than from possible unsafe conditions in dental offices, says the chairman of the Senate Medical Affairs Committee, who said he wants the state to begin routine dental inspections.

And the chairman of the Senate Judiciary Committee told that he thinks the Legislature should look at the idea of routine inspections and broaden them to medical offices.

Sen. Harvey Peeler of Gaffney, who heads the Medical Affairs Committee and is the Senate’s majority leader, said he previously wasn’t aware that dental inspections weren’t conducted by the state.

The Greenville News and revealed this month there were no inspections — unlike at least 15 other states — though the state does regularly inspect barber shops and hair salons and looks into complaints about dentists or dental offices.

“If need be, I’ll sponsor the legislation,” he said. “If you inspect a restaurant that you are putting food in your mouth, it seems like you would inspect a dentist office where you put a hand and instruments in your mouth.”

Sen. Larry Martin of Pickens, chairman of the Senate Judiciary Committee, said lawmakers should at least study the idea of routine inspections.

“I think that’s something we ought to look at since that issue has been raised,” he said.

Martin said one reason the state may not have developed a system for inspecting dental offices is that three agencies have some part in regulating them — the Department of Health and Environmental Control, the Department of Labor, Licensing and Regulation, which houses the state dental board, and the state Occupational Safety and Health Administration.

“That may be why there’s no systematic inspection, no more so than there would be of a doctor’s office,” he said.

Martin said other than responding to certain complaints, state agencies might not regularly look at dental and doctors’ offices, even though the labor agency does systematic inspections of manufacturers or other businesses under OSHA responsibility.

“Maybe there should be,” he said. “I don’t know why they wouldn’t ensure that those various requirements are being met on a spot-check basis.”

Asked how Gov. Nikki Haley felt about requiring routine inspections, Rob Godfrey, her spokesman, said the idea has been discussed by the state Dental Board.

“LLR licenses the professional, not the facility, as is authorized by statute, and LLR does undertake inspections when it receives complaints about licensees — the Dental Board by comparison to other boards receives a relatively low volume of complaints,” he said. “The Dental Board has discussed legislation to mandate inspections but thus far none has been introduced.”

“It doesn’t matter a whole lot to me one way or the other,” said Sen. Ray Cleary, the only dentist on Peeler’s committee. “If they think they need more of them (inspections), my feeling is we need to give government the tools they need to govern. So I don’t have a problem increasing the budget for that.”

Cleary, who said he has been in practice since 1975, says he has a “fairly upscale practice.”

“So my patients expect that,” he said. “I haven’t been in some offices that are not upscale, so it’s hard for me to relate to it.”

At least 15 states, according to the American Association of Dental Boards, conduct routine inspections. Nine more — including South Carolina — conduct inspections only if a consumer complaint is lodged.

Other states’ inspections have found violations.

Already this month, six dentists in Ohio, plus a radiographer and a registered dental hygienist have been cited by the Ohio State Dental Board for infractions and violations of that state’s laws and safety precautions, according to public records. Those citations were due to routine inspections conducted by that state’s Dental Board.

The routine inspections in Ohio, said Lili Reitz, executive director of that state’s dental board, are to prevent slips or lapses — or even outdated methods — from occurring. She prefers not to think dentists would deliberately break safety guidelines, even though she knows that happens.

“We’ve had everything from dentists bringing pets into the office to them sterilizing instruments in toaster ovens,” she said. “We have a checklist for them to follow. A dentist can’t say they’re caught off-guard.

“But in 90 percent of the cases, we’ll find a violation or two. When we do, we’ll be back.”

Recently, her inspectors visited a Veterans Administration hospital after a consumer complaint. VA facilities don’t usually fall under the board’s jurisdiction, but they conducted an emergency inspection regardless.

“We discovered a dentist had potentially infected 600 patients with Hepatitis C because he wasn’t sterilizing properly,” she said. “He wasn’t using gloves, he wasn’t meeting standards. He was 81 years old and that’s how he’d always done it.

“How would you ever know this if you’re not going out there to inspect?”

The South Carolina Board of Dentistry conducts licensing exams and annual registration of dentists, dental hygienists, dental laboratory technicians and ortho-technicians.

It also investigates complaints and conducts disciplinary hearings. But it doesn’t conduct routine inspections. Nor does the state Department of Health and Environmental Control, which treats dental offices differently than some other medical providers, such as hospitals or nursing homes.

Under the South Carolina Occupational Safety and Health Administration, dentist offices are subject to federal safety standards like the “Bloodborne Pathogens Standard” and guidelines for X-ray machines. Employees must safeguard themselves with gloves, face and eye protection and gowns, but no routine inspections are conducted for compliance.

This leaves the state’s dentists solely responsible for infection control in their own facilities, responsible for patient safety, for their own safety and for the safety of their staff.

An examination of the latest LLR annual report, from 2010-11, shows the state has 2,700 dentists, 3,300 hygienists and 3,600 dental assistants. Those individuals were subject to 86 complaints during the fiscal year. Those complaints prompted 71 investigations. From those, two licensees — not necessarily dentists — were ordered to cease and desist; one entered into a consent agreement; and nine received letters of caution.

Saturday, September 29, 2012

Employee complaint about dental office sanitation

Judge stops case where dentist sues patient for Yelp review

Thursday, September 27, 2012

Whistleblowers, we should all be one!

Whistleblowers Help Texas In Medicaid Fraud Cases

ttWith the help of private whistleblowers, Texas has reaped more in Medicaid fraud settlements with pharmaceutical companies than any other state, according to a report released Thursday by Public Citizen, a nonpartisan consumer advocacy organization. 

“When I’ve spoken with a couple of other states, they definitely recognize Texas as a leader in enforcing pharmaceutical fraud,” said Dr. Sammy Almashat, one of the report's authors.

Texas has recovered at least $354 million in Medicaid fraud settlements from pharmaceutical companies since 1991 with the help of private whistleblowers, according to the report. Almashat said that’s because under Texas law, whistleblowers can receive between 15 to 25 percent of the financial penalties of a Medicaid fraud settlement for bringing the case forward.

Although 13 states have similar laws, “Texas is a unique case, because other states haven’t been nearly as active as Texas in taking advantage of whistleblower revelations in prosecuting,” civil Medicaid fraud, said Almashat.

“A whistleblower brings unique underlying knowledge about the fraud that was perpetrated by the defendant in the case,” said Daniel Hodge, first assistant attorney general. In all civil Medicaid fraud cases — including those against pharmaceutical companies and many others — in the last 10 years, Texas has recovered $880 million, said Hodge, and $373 million of that went to the state treasury. 

The whistleblower cases are entirely responsible for that $880 million, Hodge said, explaining that although the Inspector General at the Texas Health and Human Services Commission referred 12,000 criminal Medicaid fraud cases to the AG's office since 2002, during that same time, that agency only referred three civil Medicaid fraud cases.

Currently, a top priority at the AG’s Office is to pursue orthodontic and dental fraud in the Medicaid Program, said Hodge. The office has assembled the Orthodontic and Dental Fraud Task Force to combine resources at various agencies, including the Office of Inspector General at the HHSC. At least one case being pursued by the task force was referred by a whistleblower. 

Given the significant portion of the state budget that goes to Medicaid, “it’s more critical than ever for the taxpayers that we aggressively pursue any actors that defraud the taxpayers and recover those dollars,” Hodge said. “We’re thrilled that Texas has been recognized for [Attorney] General Abbott’s efforts to prioritize uncovering and recovering waste, fraud and abuse in the Medicaid program.”

Wednesday, September 26, 2012

Sun Orthodontix raided by FBI–Life in dental fraud is not as rosy as it used to be, is it?

We’re getting there… 


Bio | Email


Posted on September 26, 2012 at 5:58 PM

Updated today at 6:18 PM

Story TimelineClick to open timeline



In the largest action to date, the FBI, state investigators and the attorney general have raided the offices of Sun Orthodontix.

Sun doesn't have locations in North Texas, but it was the second largest biller for braces under Medicaid in 2010.

Part of its huge growth in Texas is linked to Medicaid dental bills. News 8 found Texas dentists were charging taxpayers for putting braces on kids who didn't qualify for them under Medicaid.

Sun collected more than $9.6 million in 2010, according to state records.

FBI agents were part of Monday's raids at Sun offices, which stretch from El Paso to Corpus Christi.

"The FBI doesn't show up when they think you've committed a crime... they know you've committed a crime long before they show up," said Houston attorney Jim Moriarty, who is part of a whistle-blower case against Dallas-based All Smiles Dental Centers.

The joint raid is the largest action so far against a dental firm in Texas.

"I think you may see tens or hundreds of dentists who end up with civil or criminal charges against them," Moriarty said. "I think there is a tsunami of criminal action against crooked orthodontists in Texas."

No criminal charges have been filed against Sun or its dentists. But the company has been in a dispute with Medicaid. The state quit paying Sun Orthodontix earlier this year, questioning its practices.

Sun has taken the state to court for money it says it is owed.


Ohio State Dental Board Compliance Manual

Remember the stories last week about state not inspecting dental offices for sanitation.

Ohio State Dental Board Compliance Manual

Mohamed El Deeb continues to have Minnesota dental license suspended.

Mohamed El Deeb, license number D9508, is no stranger to the Minnesota Dental Board:

November 6, 2008  - Stipulation and Order for Conditional License after a complaint that was serious enough to be referred to the Attorney General. (I guess the Minnesota dental board knows the right person to contact at the AG’s office there, unlike Texas, where they haven’t a clue)

The incident occurred in January 2004. They found “record keeping violations” – a great catchall, like “improper equipment for us motorists” – substandard care and “incorrect billing” – aka “fraud” as it related to three patients. Evidently it related to conscious sedation, as the board called in an expert for a report.

In 2005 there was another complaint. It too was referred to the AG. Somewhere along they reviewed 5 years of his records and found several items worthy of sanctions.

September 24, 2010 Dr. Deeb petition the dental board to have his license reinstated.  They did so, with no conditions attached.

September 7, 2012 – The board issued an order of a Temporary Suspension during a closed session.

September 17, 2012 – The board continued its Temporary Suspension

Don’t’ miss WFAA–TV–Byron Harris Report

I hear there was a raid by the FBI at a Texas Orthodontic clinic. Watch for Byron’s report. 

Think “Sun”shine!

Tuesday, September 25, 2012

Here’s a challenge -

Here is the Laffer Associates Study that says DSO’s (Kool Smiles, Small Smiles, etc)  perform less procedures per patient than private dentists. It also says they steal less than money per patient than private dentists. Ok, it doesn’t use the word steal…  but still…. 

You can find a link to the raw data at the bottom of page 5 of Laffer’s study. Or at their dropbox here.  Or this dropbox here.

WARNING – if you have a copy saved as an .xls file instead of a .xlxs your speadsheet does NOT contain all the data! 

Here is the challenge – Debunk it!

According to the study they found 35 Texas Providers Identifiers for Kool Smiles in Texas. Considering Small Smiles used at a minimum 25 provider numbers for 4 of their dental centers in 2010, I betting there were a whole lot more than 35  numbers used for Kool Smiles and their many clinics in 2011.  Hell, there are at least 55 “providers” in the Indiana Kool Smiles centers.  It might have been 35 that could be identified, for Texas in 2011, but that’s the point, isn’t it?

Laffer says this about the data:

Data and Methodology
We were provided Medicaid claims paid data for the fiscal year 2011 by Kool Smiles, who had received these data from the Texas Medicaid Program via a Freedom of Information Act request. We did nothing to verify the authenticity or accuracy of these data.
Before going into the results of our analysis, let me provide a few definitions. In Texas, Medicaid covers children in families from no income up to 185% of the federal poverty level for children up to 1 year old, up to 133% of the federal poverty level for children from 1 year old to 5 years old, and up to 100% of the federal poverty level from children 6 years old to 19 years old.

Thus, the data contain all Medicaid claims arising from children aged zero through 19 years, 11 months in families with income up to the applicable multiple of the federal poverty level (the federal poverty level is an annual income of
$18,530 or less for a family of three as of 1/1/12), regardless of what type of dental provider treated the child.

We counted as a procedure every separate dental activity that was charged to Medicaid with a Medicaid billing code.
Unfortunately, the data did not contain a separate total count of patients accessing dental services. Instead, unique patient counts were provided for each Medicaid billing code. To derive an estimate of the total number of patients, we added the number of patients treated via each code for a prophylaxis cleaning and used that count as our number of unique patients.

We used this procedure for all DSOs and all non-DSOs as well.
Prophylaxis cleanings, or “prophies”, are the standard dental cleanings that every patient receives as part of a routine dental visit.24 These dental cleanings, which are typically billed under the same code each visit, provide a more reliable method for this patient count than other routine services, such as exams, which might be billed under different codes and lead to double counting. There are three codes for prophylaxis cleaning, each based on age: D1110 for patients 13 to 20 years old, D1120 for patients 6 months to 12 years old, and D0145, 25 a code specific to the Texas Health Steps program, for children under 3 years old.

The Medicaid data we received contained a count of clients who received the procedure associated with each Medicaid billing code, broken out by location of dental service (see below). Summing the number of clients receiving each prophylaxis procedure thus provides a proxy for the total number of unique patients treated under Medicaid in Texas in 2011.

Accordingly, we use “prophies,” a routine procedure administered with regularity, as the count for unique patients, or “patients,” as we’ll refer to them in this analysis.

Additionally, the data quite naturally did not explicitly identify which dentists were associated with DSOs. The amount of reimbursement doesn’t differ for DSO dentists and non-DSO dentists. In order to receive reimbursements for treatment
performed on Medicaid patients, however, a dentist must apply for and be assigned a Medicaid Texas Provider Identifier (TPI) number. We made a list of all of the DSOs we could identify that do business in Texas, and any TPI that filed a claim using an identified DSO address was counted as being a DSO dentist (see Appendix A for a full listing of all DSOs included in our calculations). All other TPIs were counted as non-DSO dentists. In the process, we dropped the claims data for any TPI that filed with Texas Medicaid but was associated with an address that was not within or immediately bordering Texas.

An important caveat is that the total population of DSOs within the data represents office locations, and not individual dentists. In going through the data, we were unable to find multiple dentists working at the same DSO office billing
separately. With few exceptions for non-DSOs, it seems a rule that most group practitioners bill under a single base (7-digit) TPI instead of their unique and individual 9-digit TPI.

Basically, I read this to say “GIGO” – Garbage In – Garbage Out. So someone spent a hell of a lot of money for a report that means nothing and I mean nothing. Goes to show you though, tell a company what you need it to say, and they can get the data to make it so.

As well, these DSO’s work very hard to hide the fact they are operating as a DSO, since it’s illegal, so the number of non-DSO dentists numbers have to be distorted, right?  Like I said, GIGO!

Monday, September 24, 2012

Civil trial begins for Dr. Brain Seastrunk - accused in child death. Dr. Seastrunk is blaming nurse, Cynthia Jones.

Civil trial begins for doc accused in child death

By Craig Kapitan
Updated 10:57 p.m., Thursday, September 20, 2012

Read more:

When 22-month-old Maddoux Cordova woke up from a routine outpatient dental procedure three years ago crying, thrashing and trying to remove his intravenous line, Dr. Brian Seastrunk approved two doses of morphine instead of Advil.

The anesthesiologist's decision, along with his failure to closely monitor the boy after the narcotic was administered, led to the child's death, attorneys for Cordova's parents told a civil court jury Thursday as testimony began in a malpractice trial.

Seastrunk's attorneys have countered that the nurse who requested and administered the drug — and therefore the hospital that hired her — instead is to blame. The hospital also has been sued but is not a party in the trial.

“As a doctor, the rule is you don't expose your patient to needless risk,” plaintiff's attorney Beth Janicek said during an opening statement in 37th state District Court. “That's what they live by. It was needless to order such a powerful drug.”

Cordova was found not breathing by his grandmother the afternoon of Dec. 11, 2009, about five hours after he was discharged from Village Specialty Surgical Center, according to court documents. He was revived by emergency responders but was brain dead, and on the day after Christmas the decision was made to take him off life support.

Gun toting dentist, Dr. Conrad Jim Kusel Jr. uses lethal weapon to keep staff under control during meeting. Lawsuit filed.

All the illegal dentistry happening in Florida, used to stay in Florida. Seldom did news come out about dentists arrests, going mad, or illegal corporate practice of dentistry. But boy, oh, boy, has that changed in the last two weeks!
LAWSUIT: Port St. Lucie dentist terrified worker with staff meeting gunplay
CBS12PORT ST. LUCIE, Fla. -- A lawsuit filed by a former employee claims a Port St. Lucie dentist waved a gun around at a staff meeting, telling staff to "sit down and stay in line."

Everyone agrees the dentist had a gun at work that day.Police reports show six detailed accounts of the same meeting. But the State Attorney's office here never pursued charges against the dentist -- Dr. Conrad Jim Kusel Jr. of the Kusel Dentistry practice in Port St. Lucie.

Lawyers for former receptionist Sunday Sack, a 13-year employee there, say she suffered post-traumatic stress disorder from the February incident in which she and others allege Kusel pulled the gun in an angry tone and said "everyone is going to sit down now and and I'm sure everyone is going to stay in line during the meeting, right?"

Sunday Sack: "That morning that gun was pointed and cocked it, and started to talk, I saw that vein, I saw that vein popping..I literally froze and basically fell down into my chair..I was like paralyzed."

Kusel's brother Brian Kusel is also a dentist there. The suit also names him for not intervening in the situation.

The lawsuit does not specify damages, but Sack says she planned to work there for the rest of her life and is seeking money for lost wages and distress. She's been attending counseling since the incident in February and says she was so affected, she spent months hiding in her own closet fearing for her life.

Sack is now on Social Security disability for her diagnosed trauma. In police reports, Kusel defended his actions by saying the gun was bought with money the staff had given him for the holidays, and he was showing off what he'd purchased. Since the gun-waving incident, three other employees have left the practice.
Imagine if Dr. Thomas Floyd had a gun in his office !!!  He would have shot children instead of jabbing them in the mouth with pliers and beating them in the stomach.

Dr. Tuan Vu – sentenced to 4 years in prison for fraud

Dentist Sentenced for Health Care Fraud

A dentist who lives in Arlington but practices in Alexandria has been sentenced to nearly four years in prison for health care fraud.

According to the U.S. Attorney’s Office, 43-year-old Tuan Vu, who owns Cosmetic & Family Dentistry, PLLC, pled guilty in January to committing health care fraud. Court documents show that Vu admitted the scheme took place at least from January 2007 to September 2011, when he billed dental insurance providers for services he never performed on his patients.

Because of the scheme, more than 50 private insurance providers lost more than $2 million. The federal government and the Commonwealth of Virginia also suffered losses, including more than $300,000 to the Federal Employee Health Benefits Program and the Virginia Medicaid program.

Vu was sentenced to 46 months in prison, to be followed by two years of supervised release. Additionally, he was ordered to pay a $250,000 fine and more than $2 million in restitution.

Saturday, September 22, 2012

More on the brutality of Dr. Thomas P. Floyd

This report on Dr. Thomas P. Floyd - West Palm Beach dentist- holds true to the first hand reports I've received. In addition, it was reported to me, that the police received complaints "a couple times a week" about abuse taking place in Dr. Floyd's office. His ex-wife is an orthodontist in the area. Some reports about this brutal dungeon master go back years. To think this man is walking free is infuriating! HE BEAT CHILDREN on a regular basis!!!!!
Thomas P. Floyd, West Palm Beach, Florida Pediatric Dentist, Arrested for Child Abuse
September 20, 2012 , by Elaina Robbins
Thomas P. Floyd, a West Palm Beach, Florida pediatric dentist, was arrested Friday after he was accused of handling one of his 4-year-old patients roughly, reports say. Floyd, 61, was booked into the Palm Beach County Jail on a single charge of child abuse. Officials also suspended his dentistry license following his arrest. It is unclear whether a bail bond was set for the defendant. It is also unknown whether Floyd has retained a private criminal defense lawyer.
Reports say that Floyd operated a pediatric dental office out of the 400 Executive Center in West Palm Beach prior to his arrest. His office specialized in dental care for children, teens, and young adults. However, earlier allegations about malpractice against certain patients reportedly surfaced in 2010. During one of those occasions, a 7-year-old female patient accused Floyd of placing her apron in her mouth during a procedure. The doctor reportedly did this to quiet the patient down. The girl apparently removed the apron, citing that she experienced difficulty breathing with it in her mouth. Reports indicate that Floyd did not face charges regarding this allegation.
In this more recent incident, a 4-year-old patient accused Floyd of striking him in the face several times during his appointment. The patient was not publicly identified by police because he is a juvenile. The case opened after a witness phoned police from Floyd's office, stating that a toddler in one of the office's examination rooms was making distressful noises. When detectives arrived, they located the frazzled boy, who reportedly explained to officers that "the doctor went pow pow on my face, and it hurt."
Investigators found that the child's lip was injured (Floyd purported was a result of the child nipping himself during the exam) and that the child's gums were inflamed. The mother took the child to St. Mary's Medical Center, where doctors located a small laceration under the boy's tongue. He also sustained several cuts to his lips and another cut to his gums. Investigators from the police department and Child Protection services cross examined the child and found the details to his story to be congruent.
A while after the incident, an employee at Floyd's office decided to speak to authorities regarding the boy's treatment. The witness, who remains anonymous, purportedly claimed that Floyd placed the boy on a medical stabilization board, which limited the child's mobility during his examination. He then attempted to perform a dental procedure, but the boy allegedly refused to open his mouth. Floyd then made several alleged attempts to open the mouth with what was described as an irritated mood.
During those purported attempts to open the child mouth, Floyd allegedly pried at the child's jaw with a pair of dental clamps.
However, the child reportedly spit the clamp out and the doctor attempted to force them back in, sources say. When that failed, the assistant alleged that Floyd "jammed" the child's mouth with a dental bit. At one point during the procedure, the assistant claimed that child's mouth began to bleed. The assistant then reportedly asked the patient in the waiting room to call police.

Friday, September 21, 2012

Shawn Zukosk Claims Dental Clinics did Unnecessary Dental Work

Shawn Zukosk Claims Dental Clinics did Unnecessary Dental Work

Submitted by Courthouse News on Sep 21, 2012

SCHENECTADY, N.Y. (CN) - A man claims in court that he was one of many children who received poor dental care at the 22-state "Small Smiles" chain, which federal and state governments accused of doing unnecessary dental work while taking "hundreds of millions of taxpayer dollars."     

Shawn Zukoski seeks punitive damages from Smalls Smiles Dentistry of Albany, five other LLCs or corporations, seven dentists and others.     

The complaint states: "In 2010, top law enforcement officials from the Department of Justice and representatives of numerous state governments (including New York), announced that they had uncovered a nationwide scheme directed at infant dental patients and the Medicaid system.

A dental clinic chain known as 'Small Smiles', operating in twenty-two states including New York - performed unnecessary, inappropriate, unsafe and excessive dental procedures on young children. It received hundreds of millions of taxpayer dollars."     

Zukoski says he was treated at the clinic in suburban Albany from 2005 to 2007, when he was 13 to 15.     

During that time, he says, he got 12 fillings, a pulpotomy and crown, two extractions, four temporary crowns and two root canals.     

Sometimes X-rays were taken and sometimes not, but "treatments that were needed, including steps to prevent decay or its spread, were ignored," he says in the complaint.     Zukoski claims he "received treatment ... that was below the applicable standard of care and caused him to suffer injuries" at the hands of defendants Small Smiles Dentistry of Albany, Albany Access Dentistry, and dentists Maziar Izadi, Evan Goldstein and Judith Mori.     

He also sued an umbrella defendant called Old FORBA and a handful of dentists and others who organized and served as officers of the entities that comprised it.  

Medicaid Dental Fraud–Possible Scammers include Rotten Dentists, Gov. Perry, His Contractors and the Revolving Door.


Possible Scammers Include Rotten Dentists,
Gov. Perry, His Contractor & the Revolving Door

Governor Rick Perry denounced Obamacare’s insurance exchanges and Medicaid expansions this summer. Calling Medicaid “a failed program,” he compared expanding it to “adding a thousand people to the Titanic.”1 Now it seems as though Perry may have known more about Medicaid failure—and steering that particular Titantic—than he revealed at the time.


Thursday, September 20, 2012

Besides state Dental Boards not policing their dentists as they should, the Department of Health and OSHA are failing as well.

Dr. Thomas Floyd, the brute dentist in Florida, arrested two weeks ago for beating up a 4 year-old child, was also found to operate a dental clinic in extremely unsanitary conditions.  One parent I spoke with said Dr. Floyd would not sanitize the stainless steel crowns when he was trying to find the right fit – in one child’s mouth, then another’s. He didn’t change gloves from patient to patient, nor did he sanitize his instruments. When the state finally got off their butts and went to check on these allegation – allegation that had gone on for 5 years – they discovered his facility to be a hazard. (I hope all the children who have seen this dentist are receiving blood tests!)
It appears Florida is not the only state NOT checking on dental offices. South Carolina, another state that allows dental mills to run amok doesn’t check either. I bet they check tattoo parlors!

Written by 
Mike Foley
Staff writer
The South Carolina Department of Labor, Licensing and Regulation last year conducted 4,626 routine inspections of cosmetologists and barbers.
During that same time, the agency conducted zero routine inspections of the state’s dentists. The South Carolina Board of Dentistry — which falls under the agency’s jurisdiction — also conducted no routine inspections. The hands-off situation extended to two other state agencies: The Department of Health and Environmental Control and the Occupational Safety and Health Administration.
Yet right now, while each of those regulatory boards handles some regulatory aspect over dentists or dental practices, routine inspections are not included.
The Board of Dentistry conducts licensing exams and annual registration of dentists, dental hygienists, dental laboratory technicians and ortho-technicians. It also, investigates complaints and conducts disciplinary hearings.
Under the South Carolina OSHA, dentist offices are subject to the federal safety standards such as the “Bloodborne Pathogens Standard” and guidelines for X-ray machines. Employees must safeguard themselves with gloves, face and eye protection and gowns, but no routine inspections are conducted for compliance.
This leaves the state’s dentists solely responsible for infection control in their own facilities, responsible for patient safety, for their own safety and for the safety of their staff. Yet, while some local dentists interviewed said precautions and regulations in place protect patients, they wouldn’t be averse to routine inspections.

Wednesday, September 19, 2012

Can someone be paid to be a jumping up and down idiot? Yes! Here’s proof.

If Pigs Could Fly And Dental Professionals Could Be Turned Bad By Private Equity Investment
Thomas A. Climo

On May 30, 2012, provided an article written by Donna Domino, features editor. It was titled “Private equity firms eye big profits in dentistry.” Ms. Domino was the second journalist to reach out to me that month. The first was Sydney Freedberg of Bloomsberg, whose piece was “Dental abuse seen driven by private equity investments” on May 16.

Both journalists were nice, courteous, and consummate professionals. I want to make clear that although I believe I was very helpful in providing them with data and insight from my consulting of both group and solo dental practices, I did not say one negative word about private equity investment into dentistry.

A third journalist, Josh Kosman of the New York Post, will confirm this, even though he also wrote an article with the provocative title that replaced an “S” with a “$” entitled “Private equity firms $ink teeth into dentistry,” published August 27, 2010.

The exaggerations contained in all three articles tying private equity investment to bad dentistry are only anecdotal, and not supported by serious statistical numbers.

But…but…but “Equivalent PhD, Climo, you said, and I’ll quote:

“…private-equity firms are likely to work dentists longer once they take over practices to boost profits and that could lead to worse service.”


Tuesday, September 18, 2012

The Great Dental Surgery Fraud of 2012


The Great Dental Surgery Fraud of 2012
September 6, 2012

So, remember a while ago when I told you that Little Man had 13 cavities and would need oral surgery?  Well, that has turned into something resembling a three ring circus.  I will just say right off the bat that I don't really care for the dental office but we didn't have many choices for dentists who accept Medicaid.  They didn't do anything overtly wrong, per se, it was more of a mother's intuition.

After the appointment where they told me he practically needed a whole new set of teeth, a woman in scrubs (I have no idea who she was or what her job function is) whisked me into a conference room, had me sign a bunch of papers, called the surgery center and had an appointment for Little Man's surgery within a matter of 10 minutes.  Seriously.  I felt like I was at a used car lot!  Once I had finished signing the papers, scrub woman asked me who would be signing the consent for him to go under anesthesia.  I said that it would be his DHS worker since DHS is his legal guardian.  Fine, no problem.  They'd call her and get her to sign the papers, which they did.  His surgery was supposed to be yesterday.
The day before the surgery, as I am walking out the door with five children in tow to take two to their first day of school, my cell phone rings.  When I check the voicemail later, there is a message from Little Man's DHS worker but, because it was cutting in and out, all I got was something about her not being able to make it to the surgery the next day.  Um, okay.  I didn't think she would.  Then I received a call from the surgery center telling me that we would have to reschedule because the DHS worker was "unwilling" to sign over legal guardianship to me for the day so he could get surgery.  Um, okay.  What the WHAT?!  A judge is in charge of assigning guardianship...what is this woman talking about?!

Read this mom’s entire story on her blog “It’s a Vertical Life

Friday, September 14, 2012

10 year old Marcos Tirado’s dad says no one tried to save his son


Heartland Dental–Rick Workman paid $3 mil to settle fraud charged in 2008; May 2012 they got their $3 million back

On May 23, 2012, Rick Workman breaks ground on a HUGE expansion for their corporate headquarters in Effing-no-where, IL. Part of the new facility will be for “training” purposes and I’m sure the psychiatric department will have new offices. Psychiatric department you ask? Yes, that’s what I’m told. If you can’t maintain your production numbers, they actually have psychologists come for a little chit chat. A little couch time, so to speak.

Now,less than 4 months later, Workman has put Heartland up for sale, asking price… a mere $1.4 BILLION dollars.

To here him tell it, he just leases the use of some appointment scheduling software, that he doesn’t even own, and does some payroll services for independent dental clinics. (liar, liar, pants on fire…) 

I’m sure the folks of Illinois are tickled pink to give Workman his $3 million dollars back for his “expansion”.  ( $3 mil is the EXACT amount Heartland had to pay to settle fraud allegations in 2008.) Did anyone hear the “Kennedy” tone in the voice?


In Effingham, IL Richard Eugene and Angie Workman’s home is located at 16130 Hildene Drive, Effingham, IL 62401

16130 N. Hildene Drive Effingham IL - Workman Home

4-Year-Old Given Double Root Canal by School Dentist Without Parents' Permission

Posted by Jeanne Sager on September 13, 2012 at 9:57 AM

thestirThere's such a huge pile of forms to fill out when our kids go back to school that you kind of lose track: am I signing up to be a school trip chaperone here or am I signing my life away? You might be tempted to rush right through them all. But the story of a little boy was given two unnecessary root canals by a dentist in his school's art room -- without his parents being consulted -- should be enough to kill that temptation.

Stacey Gagnon did agree to let her son Isaac get a basic examination from a dentist at school. Who can blame her? It seems like smart parenting to me. Which is why what happened to this little guy is so scary.

Stacey and husband Darren say Isaac didn't "just" get a basic examination. They say a dentist who they'd never met took their 4-year-old into the school art room and performed not one but two root canals and put in two steel crowns. The Gagnons say no anesthesia was used to numb the little man's pain. Instead they allege that three adults held him down as he kicked, screamed, and gagged. Not surprisingly they say their son now has night terrors and a desperate fear of "the dentist man."

That right there makes me furious. There is no excuse for terrifying and torturing a child. Even if this were something the parents had said "OK" to, even if this were in a professional dentist's office, that's out of line. Kids deserve to be treated with the same care as adults.

But hold your fury. It's about to get worse: the Gagnons say they never received a call asking for the go-ahead to do these procedures, and a pediatric dentist hired by the Gagnons says he doesn't see why these procedures were performed in the first place.

So a child was tortured (because, yes, that's what a root canal without anesthesia is) for nothing? NOTHING? AND his parents weren't told?

I can't say for sure, but it sounds like some greedy dentist was hoping to make more money off of the school district. And picking a 4-year-old makes sense: they are so young they don't know to say no or ask someone to call their Mom.

But as the Gagnons wage a lawsuit against the dentist for malpractice, I keep going back to what Stacey agreed to for Isaac. It sounds like she was doing what we all do: saying, hey, sure, free medical care for the kid!

I know I sign my daughter up for a free in-school cleaning every year because it's added protection for her little mouth. Because we live in such a poor district, we can even get free fluoride treatments for our kids.

But the more I think about it, the more I realize the forms we get for these kinds of things from our school districts are pretty vague. Do we really know what we're getting our kids into when they're away from us for long hours and we can't step in to care for them?

I hope the Gagnons have a good lawyer who can sort this out and get some justice for little Isaac, but it's a good lesson to the rest of us to double and triple check those forms.

Do you allow your child's school to perform dental work on your kids? Does this story impact your decisions?

Head on over to 'The Stir” and read all the comments by moms.  Mom’s are outraged.

Wednesday, September 12, 2012

Inside Edition airs the Isaac Gagnon story and the dangers of mobile dental clinics.


msMorgan Stanley, the true backers of ReachOut Healthcare America and their nasty mobile dental dungeons have been on this site several times the last few days. So has their PR people. Are they worried?

Shocked is more like it. I’m told their attorney’s about flipped, when they saw their RHAemployee, Dr. Alvin Coon, DDS attempt to hit the reporter with his car. I guess someone failed to mention that to them. Wonder what other surprises are in store.

Features the parents of little Isaac and the nightmares which haunt him; the mean dentist who “got” Isaac - Dr. Alvin Coon attempting to run over the reporter: and an Interview with the Gagnon family’s attorney, James Moriarty.

If you have inside information, are an ex-employee - like the one in this story- who wants to stop this child abuse or a parent whose child has suffered at the hands of these Mobile Dental vans, please email me. Surely we can stop this child abuse together.

Here is Inside Edition’s report:

INSIDE EDITION Investigates Mobile Dentistry
Aired September 11, 2012

Inside EditionIt sounds like a good idea - mobile dentists sent to schools to provide dental care for needy children in classrooms and school parking lots. But some families are now crying foul, saying their kids were harmed by dentists drilling for dollars.

Darren and Stacey Gagnon say their four-year-old son Isaac was given two baby root canals and two steel crowns by a dentist bigsmilesscheduled to visit Isaac’s school after the school contracted with a company called ReachOut Healthcare America.

What’s worse, say the Gagnon’s, is that the dentist, Dr. Alvin Coon (who they never met) performed the operations without their consent in of all places - the school’ art room in Camp Verde, AZ.

“I couldn’t believe that they were doing these procedures in a classroom,” said Stacy Gagnon.

She also says Isaac was never given any anesthetic or medication to numb the pain.


Fake dentist, Humberto Perez, arrested, along with his wife and daughter.

Appears the Miami police are in the dentist arresting business this week. They have nabbed themselves another one today, adding Humberto Perez to the list along with Dr. Thomas Floyd. Arrested today were, Humberto Perez, 81, Maria Perez, 69 and their daughter, Odalis Hernadez Perez, 41.

Miami CBS 4 news

Humberto Perez arrest affidavit.dental_dungeon_suspects_244x183

Crimesider Staff
Daily Blotter
(CBS) MIAMI, Fla.- Three people are being charged with child abuse after a dentist operating out of a home permanently disfigured a 14-year-old girl's teeth, CBS Miami reports.
On Wednesday, Miami police busted a couple and their daughter at their 'dental office' in Little Havana. 
Humberto Perez, 81, Maria Perez, 69, and Odalis Hernandez-Perez, 41, were all charged with performing dental services without a license along with two charges of child abuse, a statement from Miami police spokeswoman Officer Kenia Reyes read.
The child abuse charges came after a 14-year-old's mother reported her daughter's teeth were permanently disfigured following her appointment at the clinic.
While the girl's mother and grandmother say that they saw a fully operational dentist office, Major David Magnusson of the Miami Police described the room as, "everything a dentist's office should not be."
The 14-year-old described the room to police as small, and full of pots, medical instruments and teeth.
As Humberto Perez conducted dental work on the girl, she reported feeling weak and sick. According to Perez's affidavit, he injected a syringe of prescription medication into her mouth and then started filing down her teeth.
The affidavit alleges that's when the girl told Perez she felt uncontrollable pain. Perez continued with the dental procedure anyway.
The arrest affidavit for Perez's daughter claims the 41-year-old told her dad, "Dad, I hate when you work on children. They always put on a show with the crying."
The girl lost several teeth during her two visits to the office and suffered from an infection that caused her teeth to separate from her gums. She is now being treated by a qualified doctor.
"The licensed dentist said that in his 30 years of experience, he has never seen anything as horrible as what they have done to this girl," Maj. Magnusson said.

Tuesday, September 11, 2012

Dr. Thomas Floyd–more parents stepping forward with horror stories

As what usually happens, when a local news station airs the stories on children being abused by evil child abusing dentists, more parents come forward. So goes the case in Florida of Dr. Thomas Floyd.
Last evening, more parents have come forward, one parent whose child suffered being gut punched by Dr. Thomas Floyd 11 years ago, when her child was 3 years old.
Apparently Dr. Thomas Floyd has been a very very bad man for many years. Sucker punching innocent children, beating them black and blue. Busting their lips wide open. Parents have filed complaint, up to 25 in the last five years alone. What has the police in West Palm Beach, Florida done about this over the years, not one damn thing!
Apparently, the authorities in Florida think it’s perfectly reasonable for a man to beat children if he has some initials after his name, and someone refers to his as “doctor”.  What have the employees of Dr. Thomas Floyd done over the years? They have assisted in the child abuse as far as I’m concerned and are just as guilty as he is! Shame on each and every one of you – from Dr. Thomas Floyd all the way down to the county/district attorney who has done NOTHING!

Rest assured there are thousand of children this man has beaten, punched, smacked, slapped and no telling what else over the years.  Has he waterboarded children like, Megann Scott in Oklahoma? Yes, he probably has.
[Update, September 11, 2012 2:42PM
Just confirmed that this Dr. Thomas Floyd was in fact the dentist I was contacted about. I will also have to nibble on my words, and I don't mind doing that. It was people working at the clinic who took pictures and have evidence to nail this bastard.

For those who did, Big Round of Applause!!! For those who didn't, shame on them. Now, for the slow ass response from authorities, every child who was beaten since they were alerts, well, they have some responsibility in that! ]

More patients of dentist accused of abuse coming forward

WEST PALM BEACH -- More allegations have come to light involving a West Palm Beach children's dentist.

Dr. Thomas Floyd was arrested last week for child abuse, for allegedly punching a 4-year-old boy in the mouth back in May of 2010. Now another parent says her child was punched too.

Crystal Rolle of West Palm Beach says in February of 2001, Dr. Floyd punched her daughter in the stomach when she was only 3-years-old to make her stop crying.

The girl, who's now 14, remembers what happened. Aaliyah Rolle, Dr. Floyd's former patient says, “He punched me and then he punched me again and I think I was crying more and screaming.”

Crystal Rolle, Aaliyah's mother says, “I don't think he should have anything to do with children or anyone for that matter.”

Crystal says Dr. Floyd was not charged in that incident 11 years ago, because police told her they didn't have enough evidence.  There were no eyewitnesses and police couldn't take the word of a 3-year-old. Dr. Floyd is free on $3000 bond.
He denies abusing any children and says he's innocent.

The Department of Health suspended Floyd’s license to practice dentistry after his arrest Friday.

Monday, September 10, 2012

Inside Edition–Dentist on Wheels–Shows Dr. Alvin Coon of ReachOut Healthcare America, run over the reporter!

WATCH – September 11, 2012

Dr. Thomas Floyd, arrest for beating up a 4 year old in his dental office.

A mom contacted me last fall about this guy. At least I think this was the dentist.  She was working hard to get him arrested.



STATE, POLICE: West Palm Beach pediatric dentist Thomas Floyd beat up 4-year-old patient, abused others

By Scott T. Smith /
WEST PALM BEACH, Fla. -- A West Palm Beach pediatric dentist has been arrested on a child abuse charge, accused of beating up a 4-year-old boy during a dental procedure in 2010.

Thomas P. Floyd, 61, of 258 Golden River Drive in Tequesta, was booked into the Palm Beach County Jail Friday afternoon, and state officials issued an emergency order to suspend his license to practice dentistry, with multiple allegations of further abusive incidents involving other children (details below).
The state also alleges he used unhygienic practices, including failing to change gloves or instruments between patients.

About 25 complaints have been filed against Floyd with West Palm Beach Police since 2006, the state noted.

According to a probable cause affidavit for Floyd's arrest, West Palm Beach Police responded to a 9-1-1 call on May 5, 2010, from Floyd's office at 400 Executive Center. Witnesses reported hearing a child screaming and crying in one of the exam rooms and the boy later told police that "the doctor went pow pow on my face" ... "and it hurt."

At the time, no employees said they witnessed the incident, but several advised "this was an ongoing problem with Floyd being physically abusive to patients."

The responding officer noted the child had an injured lip, but Floyd said the child bit it during a procedure to cap several teeth.

The child's mother took photos of the injuries and took him to the pediatric unit at St. Mary's Medical Center, where records noted the boy had a tear under his tongue, multiple cuts on his lips and a laceration on his gums. His lips were swollen and had dried blood on them.

An investigator met with the mother and child on April 5, and a Child Protection Team interviewed him a week later and his stories were consistent that the dentist had hit him in the face several times.


Inside Edition

I believe Inside Edition will be airing a program tomorrow, September 11, 2012 about mobile dental clinics, specifically ReachOut Healthcare America.

Friday, September 07, 2012

Deaths and dental care, could this be one of the problems?

Dennis Yamashita DDS, Chairman and Director of Oral and Maxillofacial Surgery at Los Angeles County/USC, Ostrow School of Dentistry at USC, and Children's Hospital Los Angeles, is charged with incompetence, gross negligence, and multiple counts of negligence for his treatment of a 44 year old who died under general anesthesia that he administered while performing a biopsy in his office in 2009. Dr Yamashita has been involved in the training of dental oral surgery residents for many years in Los Angeles and currently remains at this position as the Program Chairman and Residency Director at USC and affiliated hospitals.

The California State Dental Board, according to an online public record released a few months ago on its website ( is moving to revoke his license to practice and general anesthesia privileges for incompetence -- presumably for treating this patient without prior consultation or consideration of her extremely high blood pressure and other medical problems that resulted in her having suffering a stroke under his care, failing to do a proper medical examination prior to anesthesia, failure to control the patient's high blood pressure on two occasions (she had had a prior surgery at his office a year before), failure to keep proper records during the surgery and anesthesia, and failure to call emergency services until 7 hours after the surgery and anesthesia were completed.

Is this the role model of the standard of care representing our current crop of dental trainees?

Thursday, September 06, 2012

Child dies while being sedated at the office of Dr. Juan D. Villareal, Harlingen, Texas

Dr. Juan Villarreal

While being sedated at this man’s office -  Dr. Juan D. Villarreal…





Marcos Tirado

…this 10 year old boy, Marcos Tirado…died…basically euthanized.





harlington dental

…at this place, Harlingen Family Dentistry, Harlingen, Texas




Read more: Local, News, Boy in Coma, Boy Dies, Tooth Filling, Dental Procedure, Marcos Tirado, Anesthesia, Trinity Baptist Hospital, Loss of a Child, Harlingen, Cameron County, Harlingen Family Dentistry, Treacher Collins Syndrome, Valley Baptist Medical Center, Death of Marcos Tirado, 10 Year Old Dies, Federal Patient Privacy Laws, Lamar Elementary School Third Grader, Lamar Elementary School, Dixieland Road

Just minutes after 10-year-old Marcos Tirado received anesthesia at a local dental office, he was rushed to the hospital.

The Lamar Elementary School fifth-grader died two days later. 

It’s a pain no parent wants to endure. 

The loss of a child, that’s too young to be gone.  It’s a hard reality for the Tirado family in Harlingen. 

He was undergoing a  tooth filling at Harlingen Family Dentistry off Dixieland Road.

"Every time there was a procedure there was a lot of precautions that had to be done, the time we took him to the dentist, the doctor said it was a simple procedure, but obviously is wasn't." said Marcos Tirado, Sr.

Marcos had a medical condition called Treacher-Collins syndrome; and certain precautions need to be followed. 

The family said they made doctors and nurses aware before the procedure. 

When they were told Marcos would need to use a gas to keep him calm. 

His father showed concern but says the staff assured him it was perfectly safe and routine. 

But 10 minutes into the procedure, something went terribly wrong.

"I thought he was in just a little pain, but obviously he was unable to breathe, he just stopped," the grieving father said.

Marcos was rushed to the Valley Baptist Medical Center in Harlingen where doctors were able to revive him.

He stayed in a coma as his parents prayed for a miracle. 

But by Wednesday evening, Marcos passed away leaving his family heartbroken.

"He was with us for 10 years and even though he went thru a lot medically he was a happy boy,” the boy’s father recalled. “He surprised us many times but when it’s time to go God gives the call..that's what it is, we'll respect that."

Action 4 News contacted the Harlingen Family Dentistry for comment.

They said they were deeply saddened to learn of the death of Marcos Tirado, Jr. but due to federal patient privacy laws, they said limited information could be given. 

“Our thoughts and prayers are with the parents and their family at this difficult time,” they said in a statement.

Is Rick Workman trying to dump his baby - Heartland Dental - before its value is zero?

Many in the industry don’t see it.  Even more are in denial about it. But it’s happening, non-the-less. Corporate Dentistry is under attack. Federal, state and local governing boards as well as law enforcement agencies are making bold moves to clean up what has been left to run amok for years. This “clean up” may be fatal. Which is fantastic for every person in America, because everyone sees the dentist at some point.

Though it may be slow and painful. Has Rick Workman finally come to gripes with that reality? I think this is a HUGE signal to all “corporate dental chains” out there. When one of the first, largest and most influential entities in the industry is ready to tuck it’s tail and run, you know it’s bad.


prhubHeartland Dental Care, Inc. Sale
September 6, 2012
Heartland Dental Care Inc., one of the largest dental practice management companies in the United States, is exploring a sale that could fetch as much as $1.4 billion, according to two people familiar with the matter, Reuters wrote Thursday. The company, in which Chicago-based private equity firm CHS Capital Partners has a stake, has hired investment banks Jefferies and Moelis to find a buyer and has drawn interest mostly from other buyout firms, the people said.
(Reuters) – Heartland Dental Care Inc, one of the largest dental practice management companies in the United States, is exploring a sale that could fetch as much as $1.4 billion, according to two people familiar with the matter.

The company, in which Chicago-based private equity firm CHS Capital Partners has a stake, has hired investment banks Jefferies and Moelis to find a buyer and has drawn interest mostly from other buyout firms, the people said.

The sources asked not to be identified because the process is not public.
Heartland Dental has about $120 million in annual earnings before interest, tax, depreciation and amortization (EBITDA) and could be sold for 10 to 12 times EBITDA, they added.

The auction is early in the second round and final bids are expected about a month from now, according to the people. Jefferies has offered to provide financing for potential buyers, they added.

Representatives for Heartland Dental, CHS Capital, Jefferies and Moelis did not immediately respond to requests for comment.


Tuesday, September 04, 2012

Monday, September 03, 2012

WSJ- Texas has eye on Xerox in Texas Dental Medicaid Fraud



Texas authorities are investigating whether Xerox Corp. played a role in allowing dentists to allegedly overbill the state's Medicaid system by millions of dollars.

Like many states, Texas contracts with Xerox to process forms submitted by dentists, who seek a determination about whether procedures they intend to perform are covered by Medicaid, a federal-state program that insures lower-income people. The company evaluates whether the planned procedures are medically necessary.

The Texas Health and Human Services Commission says it is concerned that Affiliated Computer Services Inc., which Xerox acquired in 2010, didn't dedicate enough trained staff to vet dentists' Medicaid requests, allowing dentists to receive payments for procedures not covered by the program.

Xerox declined to comment on the Texas investigation but said it doesn't face similar scrutiny in other states. The company said it helps administer Medicaid programs in 36 states and the District of Columbia, processing $54 billion in annual Medicaid spending.

"Xerox has more than 40 years of experience working with government health agencies to enhance the efficiency of health programs," company spokeswoman Jennifer Wasmer said.

A 2008 audit by the Texas health agency's inspector general found that ACS had one dentist on staff to review thousands of Medicaid requests, and that the dentist examined only about 10% of them. ACS responded that its contract with Texas didn't require all requests to be reviewed by a licensed dental professional.

The current scrutiny of Xerox in Texas, covering a period from 2008 to 2011, is part of a broader state investigation into Medicaid abuse that has so far largely targeted dentists and orthodontists, who have been accused by state officials of improperly billing the state for procedures including putting braces on youngsters for purely cosmetic reasons and performing unnecessary root canals on small children.

The Texas Medicaid program paid out $1.4 billion to dentists and orthodontists last year—a roughly fourfold increase since 2006. In 2010, the Texas Medicaid program spent more on braces than all other state Medicaid programs combined, according to a report from the U.S. House Committee on Oversight and Government Reform.

Texas dentists and orthodontists note that they are required to obtain the state's approval before billing Medicaid.

The Texas Health and Human Services Commission, in turn, has tried to pin some of the blame on Xerox for allegedly signing off on questionable procedures.

The agency's inspector general is auditing Xerox and will fine the company if it concludes Xerox didn't live up to the terms of its contract with the state, said Stephanie Goodman, a spokeswoman for the agency.

The Texas Attorney General's Office in June also issued a civil investigative demand, akin to a subpoena, against Xerox in connection with the agency's investigation into Medicaid fraud.

At the behest of Texas officials, Xerox hired a new dental director to review Medicaid requests last year, Ms. Goodman said, noting that the current audit of Xerox should be completed later this year.

Xerox's role has been diminished, she added, because in March the state shifted much of the responsibility for approving Medicaid requests to managed-care organizations.

Write to Nathan Koppel at

Kool Smiles Complaint # 153359


  • Date Occurred:08/14/2012
  • Reported Damages:$1,300.00

Over a 3 week period of time i had gone into cool smiles for fillings. I was told they couldn't do it all at once and said it was going to take 6 visits. I told them every week for 6 weeks is unacceptable seeing as i have 3 small kids and am new in town and don't have a babysitter! we got it down to 3 weeks by doing top right and bottom left. next visit was top left bottom right, and last trip was the top and bottom front. I knew that we had some bad cavities but the dentist assured me they would do every thing they could to avoid a root canal! well the first dentist who worked on me wasn't the dentist i originally met and talked with. Threw the 3 weeks i was never told how or what they were going to do to my teeth. Never was told a name of my dentist or nurse ( which were different every time). The work was done shoddy so every time i went back i told them of my still growing pain and discomfort. They just kept filing down the fillings. after the 3rd weeks visits i told them i was still in bad pain. they then said without x-rays that m 2 back molars must have gotten fractured and all my insurance would cover was to extract them! No way! They would ultimately end up pulling 3 to 4 teeth if i let them do that. Then after the last visit when i got home i noticed when brushing my teeth something crunchy. It the "filling" they did. they just covered 2 teeth together so i couldn't brush or floss in between and that had fallen out after the 1st day of it being filled. It left a gap big enough to see a cavity that was not cleaned or filled properly at all. I have tried to call the locations manage but the nurse/receptionist that answered the phone kept changing the subject and wouldn't listen to me or help. I then called the call center (which hung up on me 3 times before actually taking my call) and made a formal complaint to the highest up section i could who then forwarded a copy of my complaint to headquarters and the store manager. Going on 8 days past now and still no call backs from any one!!!! I am in excruciating pain and cant eat even with antibiotics for the abscess this drama has causes and pain pills which barely help and make me sick to my stomach! I asked for my x-rays to go to another dentist and was refused them even though i paid for them. The nurse said "what do you need them for" and never would release them! I hate that we chose this place and i hate all the crap and suffering I'm having to go through and they cant even be human enough to call back or see if they can fix it or do any thing to help! We will NEVER go back there ever again!$1,300.00

(as taken from website, with typos corrected)

Sunday, September 02, 2012

Dental care in America: A study in austerity, neglect and profiteering


Dental care in America: A study in austerity, neglect and profiteering

By Gary Joad
1 September 2012

A Frontline production on the Public Broadcasting System (PBS) aired in June documented the painful and ill experiences of millions of working class families and their children, the disabled and poor, and retired persons as they seek dental care in the United States.

In the opening scene of “Dollars and Dentists,” hundreds of people with jaw and tooth pain form long lines in the early morning freezing rain of southern Virginia, seeking relief from a volunteer dental clinic. Most patients declare on camera that they are often too sick and sore to eat, and that they are compelled to live with pain every hour of their lives.

As the clinic’s Dr. Terry Dickenson states at the program’s beginning, “Gas, food, and rent compete with dental care for the dollars these persons have.”

Washington, D.C. resident Vanessa Nations, 31, reported that she had been significantly ill with dental and gum infections for many years, until her problems became so severe that she needed all her teeth extracted. She commented, “I feel like little bits of poison are killing me.”

She could not eat sufficiently, and therefore could not maintain a normal weight. Virtually all her teeth were chipped, broken off, and discolored. Poignantly, she brought a smiling teenage photo of herself to show the dentists how she wanted to look again, as they planned the removal of her ruined teeth and the manufacture of her dentures.

Saturday, September 01, 2012

Dr. Li Lu Skelton, DDS–San Antonio, Texas

Dr.LiLogoDr. Li Lu Skelton – Li Dental Implant & Smile Center – appears to be an habitual offender. It seems landing in front the the Texas State Dental Board of Examiner’s is nothing more than the normal course of doing business. 

Dr. Li Skelton’s record at the Texas State Board of Dental Examiners reflects she serves up some substandard dental care pretty regularly. In one case alone, she had to pay an $8,000 fine and $11,000 fine. In at least one other case, she delivered too much anesthesia to a patient, causing that patient seizures and hospitalization, according to the KSAT report.

When KSAT-TV featured one of her mangled patients – Darryl Davis- in a May 2012 report, Dr. Skelton sent this lovely letter to the station when asked for comment.

Li Dental Care, PC
In San Antonio, Texas
18th of May 2012

(The patient) has made several accusations relating to his treatment. He had accepted and signed three agreements which include confidentiality as to the content of these agreements.

[ Note, the very first paragraph in her comment, was to point out she felt as though she had convinced – I call it duped- her patient into signing three agreements to keep quiet about her gross negligence, malpractice and battery.

If threats standard procedure for Dr. Li Lu Skelton, wonder how many patients are out there, that have been mangled, feel intimidated by her and feel they have no place to turn for help.]

Dr. Li and the Dental Practice have made every reasonable effort to satisfy (the patient's) concerns and his continued attempts at demanding money and challenging the professional reputation of this Dental Practice are unfortunate.

[Clearly, Dr. Li Lu Skelton, has NOT made every effort to “satisfy” this patient’s concerns, instead she took him to court to try and shut him up.]

By making this a public issue, (the patient) may be considering our release of this patient information to the public. We will not do so. Patient confidentiality is not something we take lightly and will not ever violate patient confidentiality. Therefore, we cannot respond directly to (the patient).

[Huh? First, considering Dr. Li Lu Skelton’s many complaints from patients, this is a public issue, she could well be a danger to public health.]

Li Dental Care, PC is a professional Dental Practice operating in San Antonio for over 15 years, providing professional dental service to thousands of patients. Additionally, Dr. Li has placed over 6,000 implants and had produced thousands of wonderful smiles for Texans.

As in most matters of human endeavor sometimes things do not work out as planned. Even in manufacturing there is a failure rate. In the matter of implants a small percentage are going to fail. It does happen and sometimes there is no identifiable reason as to why implants fail. The good news is that this is ordinarily fixable.

[So, the “good news” is that this is ordinarily fixable? Really?  With all “good news” statements like that, there is always the “bad news” to follow. For this patient, the bad news is:

I will need to lose all of my back molars a total of 6 teeth, and that's not the best news. I have front teeth that were crowned over teeth with soft tissue and will need them removed as well. So, at a young age I will need to wear an upper denture for at least 6 months so the infections in my sinuses both left and right side can heal. And imagine there is no help for dental patients that have been treated this way. I am left without words! – Darryl Davis

Li Dental Care, P.C. stands on its very high quality reputation for professional services and patient care. Dr. Li’s goals include helping her patients achieve the new smile they so much desire and deserve.

[High quality reputation, hmmm, just how is that measured and where can I find that reputation? Not on file at the dental board, that’s for sure, not looking good in Bexar country district court records either, see below.]

Darryl was getting “No Satisfaction” from Dr. Li Lu Skelton, so he took it to the public. Like me, he started a blog!


Dr. Li SkeltonThe original name of the blog about Davis’s gruesome experience was Dr. Li Skelton Dental Nightmare, it’s since changed to Dr. Li Skelton – My Dental Experience.

Dr. Li Lu Skelton filed a lawsuit against her former patient, Darryl Davis, on June DarrylXray11, 2012 - 13 days after KTSA ran the story of his dental nightmare, with Skelton. I’ve not seen the suit, but I suspect it’s a SLAPP suit of sorts. Texas enacted anti-SLAPP suit legislation in 2011.

For Dr. Li Lu Skelton to be taking some “Holier Than Thou” attitude toward her patient is absurd! Look at Davis’ radiograhphs!

If you have had a bad experience with Dr. Li Lu Skelton, click here, this one needs to be stopped, ASAP. Don’t depend on the TSBDE to do the stopping, they recently renewed her license to practice dentistry for another year. Only plus there, is for the malpractice attorney.


Dr. Li Lu Skelton, DDS is no virgin to Bexar County District court either. She has had 6 cases in 4 years filed against her. Imagine her Malpractice Insurance costs!! Hope she has some, what if she’s been canceled?

Dr. Li Lu Skelton DDS Bexar County Lawsuits

Search Texas Cases

According to the lawsuits, it looks like Dr. Li Lu Skelton used to work for Carillon Hills Dental Associates, with John A. Moore, DDS. Dr. Moore doesn’t seem to rate very high either, he has one star and a comment says they didn’t even think he was a real dentist…  lol !


Darryl Davis’ attorney is:

Adam T. Froeschl
9045 Grissom Road. Suite B.
San Antonio, TX  78251

Fugitive on the run–Elizabeth(Dr. Liz) Hinojosa and Monica Salazar Orozco

Mother, daughter accused of posing as dentists in Oklahoma City sought by authorities

Elizabeth Hinojosa and Monica Salazar Orozco, of Oklahoma City, worked in offices where alleged crimes took place after hours, investigators said

By Tim Willert | Published: August 31, 2012

A mother and daughter accused of posing as dentists pulled teeth, performed root canals, injected anesthesia and forged prescriptions, court papers show.


Elizabeth Hinojosa, 47, and Monica Salazar Orozco, 28, both of Oklahoma City, were charged Friday in Oklahoma County District Court with practicing dentistry without a license, a felony. Hinojosa also was charged with one count each of forgery, medical battery and embezzlement.

Warrants were issued for their arrest Thursday, authorities said.

Hinojosa was a dental assistant and her daughter was a receptionist where the alleged crimes took place between September 2010 and May 2011, according to a probable cause affidavit filed with the charges.

Both worked for Dr. Salam Ramadan, who owns and operates Dental Spa locations at 1211 SW 44 and 3315 NW 63 in Oklahoma City.

Ramadan said Friday she didn't find out about the alleged crimes until she was contacted by the Oklahoma Board of Dentistry. The board started investigating after receiving a complaint.

“I was blindsided by it,” she said. “I had no idea it was going on.”