Showing posts with label Abusive Dentistry and Medicaid Fraud. Show all posts
Showing posts with label Abusive Dentistry and Medicaid Fraud. Show all posts

Sunday, January 31, 2016

Attorney James R. Moriarty Responds to CRIME WATCH DAILEY: Pediatric dentist accused of mistreating young patients

For 6 years I have attempted to stop what I consider to be highly abusive dental mistreatment of our youngest and most vulnerable children, mostly without significant success. 

Dental abuse ranging from lying to the moms, pulling teeth without pain relief, grossly excessive use of stainless steel caps, unnecessary baby root canals and widespread use of physical restraint devices on infants as young as 18 months. 

For reasons I cannot comprehend, many of the honest and legitimate dentists sit silently, the dental boards responsible for policing dentist do nothing and most of the criminal and civil state authorities charged with protecting the public, and the taxpayers do little or nothing.  

I can identify hundreds of dental offices secretly and illegally owned by private equity firms ranging from the money behind the propane gas we use to cook on in the back yard, billionaires from the middle east and even the husband and wife who started one of the largest computer companies in the world.  

I've complained at every level of county and state government and produced evidence to show this illegal and abusive conduct.  All almost for naught.

One 27 year old Medicaid mom, severely pissed off by the visible and obvious abusive treatment of her daughter single handedly brought this guy down.  Turned down by the police, ignored by the dental board and refused by lawyers who she sought to hire to stop this behavior, she turned to Facebook and the court of public opinion and then the stuff hit the fan. 

My hat is off to this mom.  She has done more to protect the public than legions of trial lawyers, endless numbers of state and local authorities and every sit-on-their hands dental board in the country.

My hat is also off to John Phillips, a brilliant, aggressive young lawyer who does not tremble at the thought of fighting  mano on mano in the court of public opinion. 
 


​Please watch this 15 minute video (3 segments):​


 


http://crimewatchdaily.com/2016/01/25/pediatric-dentist-accused-of-mistreating-hundreds-of-his-young-patients/


 
Law offices of James R. Moriarty
4119 Montrose, Suite 250
Houston, TX 77006

(713) 528-0700 office
(713) 528-1390 FAX
(713) 857-1212 cell
jim@moriarty.com
moriarty.com

Sunday, May 31, 2015

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

Jacksonville, Florida

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


Monday, May 25, 2015

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

Don't be a Schneider

 

 

 

 

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

Just thinking…

Sunday, May 24, 2015

What are the “Powers That Be” saying when it comes to Medicaid dental fraud and overtreatment?

Below are select excerpts from the transcript and powerpoint slides of a January 2015 CMS Learning Lab Weninar entitled “Advancing Program Integrity for Medicaid Dental Programs: Federal, State and Stakeholder Efforts”.  The Webinar was held by Medicaid-Chip State Dental Association’s (a must check out website) Lynn Douglas Mouden, DDS, MPH, Chief Dental Officer with the Centers for Medicare and Medicaid Services (CMS), (also associated with a host of other organizations). Speakers included:

First, John Hagg, Director of Medicaid Audits, Office of Inspector General, US Department of Health and Human Services, John.Hagg@oig.hhs.gov. His presentation begins on page 3.

Second, Meridith Seife, MPA, Deputy Regional Inspector General, Office of Evaluations and Inspections, Meridith.Seife@oig.hhs.gov, 212-264-2000. Her presentation beings on page 5, about 2/3 the way down the page, and; 

Third, Linda Altenhoff, DDS Chief Dental Officer with the Office of Inspector General, Texas Health and Human Services Commission (THHS). Linda.Altenhoff@hhsc.state.tx.us. Her part of the presentation at the bottom of page 7.

(Bios of each speaker can be found on page 2 of the transcript)

I found a few things troubling, that I’ll discuss later.

Below are the excerpts from Ms. Seife  portion where she speaks about the latest (at the time) OIG Questionable Billing Dental Medicaid Reports:

Who we are:
•The Office of Evaluation and Inspections (OEI) conducts national evaluations of HHS programs from a broad, issue-based perspective.
•We are working on a series of studies evaluating Medicaid pediatric dental services in selected States.

So why are we looking at Medicaid dental services? Well, as I'm sure many of you know, in recent years, there have been a number of high-profile cases where certain dentists and dental chains were found to have engaged in some extremely abusive dental practices. Although such cases represent an extremely small number of bad actors, they can have truly devastating effects on children. Dentists have been found guilty of routinely extracting healthy teeth, performing unnecessary pulpotomies, or putting stainless steel crowns on teeth that didn't need them. Obviously our primary concern is that no kid should ever have to endure unnecessary treatment, or that treatment that doesn't meet basic standards of care. But this can also have a significant impact on taxpayers as well.

The primary goal of our evaluations was to use Medicaid claims data in a way that could accurately identify dental providers who exhibited patterns of questionable billing. We're doing this currently in four states. In 2014 we issued reports on providers in New York, Louisiana, and Indiana. And our California report will be issued early this year. Although we were somewhat limited in doing these studies in only a few selected states, we hope that these reports will serve as a model for how other states can use their Medicaid data to identify potentially problematic providers in their Medicaid programs, and, hopefully, to target their resources more effectively in looking at those providers.

So I've already referenced, a few times, this idea of questionable billing, but I haven't really defined what it means. It's based on a type of analysis that the OID has done in other parts of Medicare and Medicaid, but this is the first time we've applied such an analysis to dental services. What is it? It's really just a method of determining certain billing patterns that are significantly different from one's peers.

We base these analyses on certain key measures that we developed in consultation with numerous experts. We spoke with law enforcement officials who specialized in working dental fraud cases. We also spoke with dental experts in state Medicaid agencies and CMS. We also received a tremendous amount of help from experts within the AAPD and that ADA.

Once we developed these measures, we then analyzed Medicaid's claim data in each state to identify extreme outliers or questionable billers, as we referred to them in our report. Specifically, we use these measures to identify providers who received extremely high payments per child, provided an extremely large number of services per day, provided an extremely large number of services per child per visit, and/or provided certain selected services, such as pulpotomies and extractions, to an extremely high proportion of children.

Once we developed these measures, we then analyzed Medicaid's claim data in each state to identify extreme outliers or questionable billers, as we referred to them in our report. Specifically, we use these measures to identify providers who received extremely high payments per child, provided an extremely large number of services per day, provided an extremely large number of services per child per visit, and/or provided certain selected services, such as pulpotomies and extractions, to an extremely high proportion of children.

Just to give you a sense of what those outliers look like, here is an example of a questionable billing analysis on average Medicaid payments per child by individual dentists. As you see, the vast majority of dentists are clustered around the median and mean amount, with an average payment of about $200 per visit. But, of course, way out towards the left, you start seeing outliers that are very different from that amount. For example, you can see that one outlier was paid over $1,100 per visit on average.

Process for Conducting Audits
•Audit Notification Letter / Entrance Conference
•Define: Audit Objectives, Scope, and Methodology
•Data Collection and Analysis
•Exit Conference
•Draft Report
•Auditee Comments
•Final Report

So, before I get into what we found, I do want to make just a few brief points about our methodology. One of the biggest challenges in conducting this type of an analysis is to be sure that you're comparing similar peer groups. Obviously you don't want to compare a general dentist in private practice with an oral surgeon working in a hospital setting. So, first, we separated out general dentists from other selected specialties. And once we grouped each peer group appropriately, we then established key thresholds for each of the measures.

These thresholds were established using a statistical method that's known as the "Tukey method." For the more statistically inclined among you, it basically calculates values that are greater than the 75th percentile plus three time its interquartile range. For those of you that are not statistically inclined, it's simply a way of identifying really, really extreme outliers. It also does this in a way that takes in the overall distribution into account. It means that you will not just be taking the top ten billers on a particular measure, it has to be significantly different from the norm. As a result, in a number of case, we found no outliers at all for a specific measure.

I should emphasize that this analysis does not confirm that a particular provider is engaging in fraudulent or abusive practices. Some providers may be billing extremely large amounts for perfectly legitimate reasons. Our position is simply that these providers are significantly different enough from the norm that it warrants further scrutiny.

So, using those measures, we identified a number of dental providers with questionable billing in each of the states we looked at. In total, we identified 151 providers with questionable billing, and Medicaid paid these providers over $56 million for pediatric dental services in 2012.

Questionable Billing Examples:
New York :
•Dentist averaged 16 procedures per child, compared with a statewide average of five.
•Dentist extracted the teeth of 76 percent of children he treated, compared with a statewide average of 10 percent.
Louisiana:
•Three dentists each provided an average of 146 or more services per day, compared to an average of 27 services for other dentists in the state.
16.

We also found that a significant proportion of these questionable billers were concentrated in certain dental chains. As many of you know, systemic problems within specific chains is a concern to many policymakers. In the three states we've reviewed so far, between one-third to more than half of the questionable billers worked for certain dental chains. Many of these chains had been previous investigated for providing services that were medically unnecessary or that failed to meet professionally recognized standards of care.

Thursday, May 21, 2015

Nearly 500 Dentists in 4 States bill Medicaid for almost $175 Million

The Daily Caller

 

 

Dentists Charged Taxpayers $175M For Unneeded Work On Kids

Ethan Barton
May 18, 2015

Nearly 500 dentists in four states billed Medicaid almost $175 million for potentially fake, unneeded or shoddy work on kids in 2012, a government watchdog reported Monday.

Investigators most recently caught 335 California dentists who sent $117.5 million of questionable bills to Medicaid, the Department of Health and Human Services inspector general reported. The watchdog caught another 151 dentists in New York, Louisiana and Indiana over the last year, who billed Medicaid $56.1 million in 2012.

“In recent years, a number of dental providers and chains have been prosecuted for providing unnecessary dental procedures to children with Medicaid and causing harm in the process,” the report said. “A concentration of providers with questionable billing in chains raises concerns that these chains may be encouraging their providers to perform unnecessary procedures to increase profits.

The 335 providers, which make up 8 percent of all California dentists, served more than one-third of all the Medicaid children investigators reviewed.

Wednesday, May 20, 2015

Crooked unethical dentists and crooked corporations who own them… you are on notice

Stop Dental Abuse - Anderson Cooper Discusses the Jacksonville Case of Dr. Howard Schneider

Friday, May 15, 2015

I think Nancy Grace needs to hear from more victims

It was clear Nancy Grace was outraged at the stories of abuse by Florida dentist Howard S. Schneider. Her program aired Wednesday May 13, 2015.  

Here is hoping insiders and victims of dentists and chain dental clinics across the county contact her show and let her know this is an epidemic and needs her attention in the worst way.

Link to the show that aired:

Disturbing video: Dentist torturing young patient?

Contact Information:

Nancy Grace Facebook Page

Nancy Grace on Twitter 

@NancyGraceHLN

The Nancy Grace Show
CNN
1 Time Warner Center
New York, NY 10019
1-212-973-2800
nancy.grace@turner.com

Thursday, May 14, 2015

Next…

150514 parents close down schneider officeParents protesting Howard S. Schneider, DDS office in Jacksonville, Florida have shut him down.

Wednesday, May 13, 2015

Dr. Howard Schneider of Jacksonville, Florida outrageous treatment of children has landed the spotlight of Nancy Grace upon abusive dentistry.

 

A Florida pediatric dentist is the subject of a recently filed lawsuit that claims he is a “psychopathic sadist” who routinely “tortured” many of his young patients.

See the clip of the report to air tonight on HLH’s Nancy Grace program.

All you abusing torturing dentists, and the insurance companies who cover them… you are on notice!

Thursday, May 17, 2012

It’s not just Texas taxpayers, it’s ALL taxpayers

Texas taxpayers soaked for unneeded dental work

Speaking of Texas teeth, combine devious dentists with dubious private equity firms and what do you get?  

Soaked taxpayers it seems, Bloomberg reports.  

Some private equity firms have figured ways to overcharge Medicaid for dental work, and Texas seems to be a hotbed. The Texas State Board of Dental Examiners is investigating dozens of cases where dentists billed Medicaid for unneeded work or for services they didn't do. A Dallas orthodontist who reviewed Medicaid dental claims for the state told Congress that fraud in Texas is flagrant and that some dental clinics engaged in the illegal practice of dentistry.

Don't credit the state for uncovering the scandal. A series of exposes by Byron Harris of WFAA revealed little oversight of the state Medicaid program. He reported that more than 20,000 Texas children under age 12 received braces in a year's time. One clinic billed Texas Medicaid more than the whole state of Illinois spent on Medicaid dental care.

Chew on that a while if you wonder whether Texas state government is keeping a close watch on spending your tax dollars. 

Read more here: http://blogs.star-telegram.com/investigations/2012/05/speaking-of-texas-teeth-combine-devious-dentists-with-dubious-private-equity-firms-and-what-do-you-get-soaked-taxpayers-ac.html#storylink=cpy