Saturday, November 17, 2018

New Complaints About Lone Peak Management Group and Smiles 4 Kids Dental Clinics

Pediatric dental chain faces new complaints

By: Alison Grande
Updated: Nov 16, 2018

A new complaint was filed against a local pediatric dental chain, Smiles 4 Kids. The chain is managed by Dr. Justin VanBibber and owned by Lone Peak Management.

The latest complaint was filed by the Washington State Dental Association with the Department of Health and the Dental Quality Assurance Commission. The complaint alleges the dental offices in the chain, only refer patients to their other practices for oral surgery or orthodontia.

Dr. Chris Delecki is the president of the Washington State Dental Association.

"They're failing to disclose the fact the patient has other options besides their self-referrals to their own managed practices," said Dr. Chris Delecki, President of the Washington State Dental Association.

"Patients are often being asked to travel from Tumwater to Tacoma for their orthodontic care and these are Medicaid patients and for many of them transportation is one of the biggest things they face.
he complaint includes an email apparently sent by the Smiles for Kids Regional manager to office managers.

"Patients in your offices should NOT be given options as to where they would like to go for their wisdom teeth extractions -- referring patients anywhere else is sending OUR business and money away and is therefore, unacceptable."

Read the entire report here.

Thursday, November 15, 2018


Contact: Bracken Killpack
Practice at Smiles 4 Kids, Kids Dental, Family Orthodontics Put Patients at Risk
and Cost Low-Income Families
TACOMA – November 13, 2018 – The Washington State Dental Association (WSDA) has filed a new complaint with the Washington State Department of Health, alleging dental clinics operated by Lone Peak Management Group, LLC (Lone Peak) are engaging in dangerous and deceptive practices.
The WSDA complaint is just the latest complaint against Lone Peak, which operates more than a dozen clinics in Washington state, specializes in pediatric dentistry, and serves a high percentage of low-income, Medicaid-eligible patients.

The WSDA complaint was filed after research into Lone Peak practices. It alleges that the chain arranged a kickback scheme that generated nearly $170 for Lone Peak every time a patient was administered general anesthesia. Disguised as a “facility use fee” charged to the anesthesia provider, these payments far exceeded fair market value of the record-keeping Lone Peak provided the anesthesia provider, generating substantial additional profit for Lone Peak.

Dentists and staff in Lone Peak offices also were directed to engage in a system of self-referral to affiliated clinics for specialty dental services like oral surgery and orthodontia. This system ignored patient preferences and in many cases resulted in families traveling significant distances to affiliated clinics when other qualified providers were nearby.

Internal Lone Peak documents cited in the complaint clearly demonstrate the profit motive behind this policy: “Patients in your office should NOT be given options as to where they would like to go for their wisdom teeth extractions,” reads one email. “Regardless of how near/far the office … referring patients anywhere else is sending OUR business and money away and is therefore unacceptable.”

Previously, Seattle’s KIRO 7 TV reported on another whistleblower complaint against Lone Peak, filed by a former office manager who left the company after refusing to follow directives from company managers to re-use dental mouthpieces that are intended for single-use only.
Internal company emails cited in the whistleblower complaint show Lone Peak putting profits ahead of patient safety. In one email regarding the reuse of mouthpieces, a Lone Peak executive lamented the fact that “our expenses would go through the roof if we didn’t find a way around” the single-use requirement.

The emails also describe how Lone Peak ignored concerns raised by at least one clinic dentist about the reuse of single-use mouthpieces. Lone Peak agents directed dental office staff to deceive that dentist: “We should probably hide our open Isolites (mouthpieces) on the days we know she is coming in,” wrote a Lone Peak agent. “In the meantime, just make her happy when she is around, and then go back to business as usual when she leaves.”

“The concerns brought forward by the whistleblower and uncovered by our team are deeply troubling and represent a dangerous corporate intrusion in the doctor-patient relationship,” said Dr. Chris Delecki, president of the Washington State Dental Association. “This speaks to what can happen when corporations are allowed to directly or indirectly own dental practices. In this environment, corporations can direct, question and over-rule the decisions dentists make in how to best treat their patients. This is why our association has consistently advocated for state laws to prohibit this type of interference and why we have engaged in bringing these practices to light.”

Washington law prohibits corporations, including dental service organizations (DSOs), from practicing dentistry, which includes directing a dentist’s treatment plan; limiting or imposing requirements on how a dentists uses equipment or materials in the provision of treatment; or limiting or imposing requirements on the materials, supplies, instruments or equipment a dentist deems necessary to provide diagnoses or treatments consistent with the standard of care.

Lone Peak is a DSO headquartered in Colorado that manages approximately 50 dental clinics in 12 states, including Washington. Lone Peak is owned by Tailwind Capital, a private equity firm whose stated mission is to transition businesses to become “larger, more profitable enterprises.”

Documents received by WSDA indicate that certain executives of Lone Peak may also have been involved with the Small Smiles dental chain DSO, and a number of Lone Peak dental offices formerly may have been Small Smiles dental offices. Small Smiles was included in a scathing 2013 US Senate report that found the chain performed unnecessary services and that its business model deceptively gave managers rather than dentists control over the clinics. The report also recommended that Small Smiles be excluded from participating in the federal Medicaid program. 

Small Smiles and its parent company, Church Street Health Management (CHSM) have faced litigation before. In 2012, Small Smiles paid $24 million to settle allegations of Medicaid fraud brought by the U.S. Department of Justice. And in 2015, Small Smiles agreed to pay nearly $39 million in claims for alleged “unnecessary, inappropriate, unsafe, and excessive dental procedures.” Church Street Health Management has since declared bankruptcy.
The most recent complaints here in Washington also name Justin VanBibber, a Utah-based dentist who serves as the nominal head of the clinics engaged in the kickbacks and the mouthpiece reuse practice. He is listed as a practicing dentist on Lone Peak clinic websites in Washington, but the profile for his South Jordan, Utah practice lists him as a resident of Utah.
The Washington State Department of Health has opened active investigations into Lone Peak’s and VanBibber’s practices.

About the WSDA
The Washington State Dental Association’s 4,400 member dentists are committed to solutions that prevent disease and ensure quality oral health for all Washingtonians. WSDA empowers its members to advocate for and provide optimal oral health care.

Saturday, November 03, 2018

Law Offices of James R. Moriarty: $5.1 Million Settlement in Whistleblower Case Involving Samson Dental Partners, LLC and ImmediaDent of Indiana, LLC

HOUSTON, Nov. 2, 2018 /PRNewswire/ -- Samson Dental Partners, LLC and ImmediaDent of Indiana, LLC agreed to pay $5.1 million to the federal government, the State of Indiana, and a whistleblower dentist to resolve a qui tam case with fraud allegations, according to the legal team for the dentist.

A settlement agreement was entered into among the U.S. Department of Justice (on behalf of the Office of Inspector General of the U.S. Department of Health and Human Services), the Medicaid Fraud Control Unit of the Office of the Indiana Attorney General, and Jihaad Abdul-Majid, DDS.

The qui tam complaint alleged that the defendants engaged in illegal corporate practice of dentistry and various types of fraud, including fraudulent billing, excessive and unnecessary treatments of excessive patients, and a sustained pressure by non-dentists in management positions to place corporate profits over patient care by exerting undue influence on dental care decisions.

Dr. Abdul-Majid, who will receive $925,000 plus expenses, attorneys' fees and costs, is represented by Charles S. Siegel, of Waters & Kraus, LLP, of Dallas; Daniel Hargrove, of The Hargrove Law Firm, P.C., of San Antonio; James R. Moriarty, of the Law Offices of James R. Moriarty, of Houston; and Joseph D. Satterly and Paul Kelley of Satterly & Kelley, PLLC, of Louisville, Ky.

According to the settlement, the federal government and the state of Indiana contend that they have certain civil claims against Samson Dental Partners, LLC and ImmediaDent arising from the submission of false claims for payment to Medicaid during the period from Jan. 1, 2009, through Sept. 30, 2013, for the following conduct:

  • Samson Dental Partners, LLC engaged in the corporate practice of dentistry in violation of Indiana state law by exerting obtrusive influences over ImmediaDent's medical professionals and staff by rewarding production and disciplining for not meeting production objectives and directing personnel in a manner which compromised clinical judgment;
  • Samson Dental Partners, LLC and ImmediaDent upcoded simple tooth extractions and improperly billed them as surgical extractions; and
  • Samson Dental Partners, LLC and ImmediaDent improperly billed for scale and root planing (deep cleaning) when they were either not performed or not medically necessary.

ImmediaDent operates nine dental care practices in Indiana. Samson Dental Partners, LLC, headquartered in Kansas City, Mo., provides administrative and other support services to ImmediaDent.

The case is "United States ex rel. Jihaad Abdul-Majid, et al. v. ImmediaDent Specialty, P.C., et al.," Civil Action No. 3:13-cv-222-CRS in the U.S. District Court for the Western District of Kentucky. The case was originally filed on Feb. 20, 2013 by Dr. Abdul-Majid. The federal government and the state of Indiana intervened in the case in September 2018.

The lawsuit alleged violations Federal False Claims Act, 31 U.S.C. § 3730(b), and the Indiana False Claims and Whistleblower Protection Act, Indiana Code 5-11-5.5-4.

The settlement agreement is neither an admission of liability by SDP and ImmediaDent nor a concession by the federal government and the state of Indiana that their claims are not well founded.


Charles S. Siegel
Waters & Kraus, LLP
(214) 357-6244

Daniel Hargrove
The Hargrove Law Firm, P.C.
(210) 710-2867

James R. Moriarty
Law Offices of James R. Moriarty
(713) 528-0700

Joseph D. Satterly
Satterly & Kelley, PLLC
(502) 785-8758

Paul Kelley
Satterly & Kelley, PLLC
(502) 785-8758

SOURCE Law Offices of James R. Moriarty

Related Links