Medicaid Dental Center aka Smile Starters Pays $10 Million For Medicaid Fraud

by: Mark Boone

CHARLOTTE, N.C. -- The owners of a chain of dental clinics, with offices in Charlotte, will pay more than $10 million in response to a federal investigation into alleged Medicaid fraud, the U.S. Attorney’s office said Wednesday.

The owners of the company formerly known as Medicaid Dental Center did not admit to any wrongdoing as part of the settlement, said attorney James Wyatt.

As first reported in a WCNC investigation, some parents complained they took their children to the Medicaid Dental Centers on Freedom Drive and N. Tryon Street for what they believed to be routine visits.

The Charlotte offices are now operating under the name ‘Smile Starters.’

Wyatt said the clinics are under new management.

Christy Dillbeck, a west Charlotte mother, said she was asked to wait in the lobby of a Medicaid Dental Center as a dentist placed her then-four-year-old son on a papoose board, a device used to restrain children.

The dentist then drilled into 16 of her son’s baby teeth and installed steel caps, without her knowledge, she said.

“That’s a lot, a lot of work,” Dillbeck said. “And to imagine all of the children that had to go through what my son went through, it breaks my heart to even think of it.”

At least six other families contacted WCNC with similar allegations.

In a statement issued Wednesday morning, U.S. Attorney Gretchen Shappert said Medicaid Dental Center performed “baby root canals,” which were not medically necessary.

The procedures were performed between 2001 and 2003, Shappert said.

“The dentists subjected their child patients to invasive and sometimes painful procedures, often for the sake of obtaining money from the North Carolina Medicaid program,” said Jeffrey Bucholtz, an N.C. Assistant Attorney General.

Dentists Letitia Ballance and Michael DeRose are named in the government settlement as co-owners of the Medicaid Dental Center.

Wyatt, who has represented Ballance and DeRose in both federal and state inquiries, said they are no longer working as dentists in Charlotte and are in the process of selling their North Carolina dental practice.

Federal authorities said Medicaid Dental Center and its owners will reimburse the government at least $5 million for the allegedly false claims and another $5 million in fines.

A portion of the settlement amount will be distributed to the N.C. Education Fund.

None of the settlement money will go to the parents of the children who underwent the treatment, said attorney Darren Dawson, who represents five families which are considering a lawsuit against the company formerly known as Medicaid Dental Center.

Wyatt says the clinics are under "New Management".

This blogger wants to know exactly "who" or "what company" is doing all this new management?

An educated guess would say FORBA, but this blogger has not confirmed this at all. But it is clear that Dr. Michael DeRose sold (so he says) to FORBA, and it is clearly reported that Dr. William A. Mueller, Dr. DeRoses' cohort, is associated with FORBA Dental Management, more on this below.

This same type of practice by the DeRose's and Medicaid Dental Centers and the various other names that were used, was in play as far back as 2004 in Colorado. see here.

According to various reports the DeRose's sold their interest in the Colorado dental clinics to FORBA Dental Management in 2006. Either the DeRose's and Forba are in cahoots together or Dr. Micheal DeRose and his clan just moved to another state and opened the same type of Medicaid Scam dental clinics in North Carolina.

Dr. William A. Mueller, at least at one time was in with Dr. Michael DeRose and we know that Dr. William A. Mueller and FORBA are in bed together, see here.

It's clear there is a connection between all of these dental chains. As reported in this blog in a prior post, Dr. Michael DeRose owned and operated one clinic that went under the name, Smile High in Denver that was part of the entire dental clinic chained owned by Mueller and DeRose.

From documents at the Kansas Dental Board, Dr. Michael DeRose, DDS had been sanctioned in North Carolina in December 2005.

In Sept. 2006, the Kansas Dental Board took action to enforce the North Carolina Order and another hearing is set for December 2008 to see that all conditions of his probation are met. North Carolina ordered him to show and demonstrate the use of a papoose board prior to strapping any child in one.

We also know Dr. Mueller in prior years had been sanctioned by the Tennessee Dental Board, yet in the end we find him in bed with FORBA headquarted in Nashville, Tennessee.

Dr. William A. Mueller has also been sanctioned by Oklahoma's State Dental Board. See here.

This blogger also discovered that Dr. Tu Tran, is one of the founders of Kool Smiles as reported on Kool Smiles website. see here, was the lead dentist at.... are you ready..... Smile High Dental Clinic in Denver, co-owned by Dr. Michael DeRose and Dr. William A.Mueller.

By the way, Dr. William A. Mueller it is reported here that:

Dr. Mueller was charged with gross malpractice for over-using papoose boards on children in his clinic in Memphis Tennessee.


But the Tennessee Dental Board dropped those charges against him.


However, the board voted to reprimand Mueller for false and misleading advertising in his clinic there.

When googling Dr. William A. Meuller, DMD or DDS you will find several listed, but the two that stood out to me was "Chief Of Dentistry" at the Children's Hospital in Denver, and another address at St. Jude's Children's Hospital in Memphis. There is also a review of some children toothbrushes called Kindertools, where a one Dr. William A. Mueller, DDS reviewed the product and listed himself as being: Chief of Dentistry, University Of Colorado Health Science Center. see here.

There is a clear connection between all of these Dental Clinic's.


Dr. Michael DeRose, Dr. William A. Mueller, Dr. Tu Tran - Smile High Dental Clinic


Dr. Tu Tran goes to - Kool Smiles
Dr. William Mueller - FORBA - Small Smiles
Dr. Michael DeRose - Medicaid Dental Center

One would think that Drs. DeRose and Mueller would have learned their lesson about abusing children and the medicaid system since they actually were named in connection with the death of 4 year old Jonathan Barrera in Arizona at one of their co-owned dental clinics.

The Dental Clinics and Dr. Michael DeRose were being investigated as to their practices in treating children and all the vast amount of money they were raking in as far back and 2003. see here.

Here is what Medicaid Dental Center had to say in 2003.

All of this is right on the heals of FORBA Small Smiles questionable practices in Kansas.

Dr. Michael DeRose and Letitia Ballance also have clinics under the name of Carolina Dental Center.

Very Graphic Interview -Children Leave Dentist Office With Extreme Bruising

WARNING:

This video is extremely graphic and may be very disturbing!

Click Here To See Video 
Sorry, the video has been removed.

These Clinics were owned/are by Dr. Michael DeRose and Dr. William Mueller.

A child died being treated by Dr. Matthew C. Nolen, trained at clinic owned by Dr. William Mueller.

Dr. Ed DeRose owned the one clinic named "Smile High Dentistry"

According to public records, Dr. Tu Tran from "Smile High Dentistry" in Colorado moved on to become Chief Dentist for Kool Smiles.

Small Smiles Clinic Investigation Report, Methods Crticized-Wichita, KS

In Kansas, Corporate Dentistry is Illegal and that is exactly what Small Smiles, Operated by Forba Management is doing. Other dentists wants these people gone and have filed complaints of Corporate ownership against Small Smiles Clinics in Kansas.

Forba is saying someone else owns the clinic in question, and they just "manage it" but the Kansas Dental Board is looking into this as we speak.

At the Forba website they do not list the clinics locations in Wichita, Topeka or Kansas City, However, job opening for these locations are listed at Forba. Obviously, Forba Small Smiles is trying to operate under the radar of Kansas Law.

Want to take a guess as to what shined the light on these crooks, Using Papoose Boards on Children!

They better be looking into Ocean Dental, as they have clinics in Kansas as well!

Read the FULL and eye opening story below.

What have I been trying to tell everyone!

Dental Clinic's Methods Criticized
The Wichita Eagle (Wichita, Kan.)
2008-03-16

By Karen Shideler, The Wichita Eagle, Kan.
Mar. 16--A Wichita dental clinic that serves mostly low-income children is drawing criticism from some parents and other dentists, in part for using procedures that the critics say traumatize its young patients.
They say Small Smiles Dental Clinic of Wichita routinely restrains children during treatment, does not allow parents to accompany their children to treatment and does work that doesn't seem necessary.
In addition, the dentists are concerned that Small Smiles tries to give the impression it is staffed by dentists who are specialists in children's care. And, they say, it is corporate dentistry, a practice not allowed in Kansas.
Small Smiles dentist Reza Akbar, in an e-mailed statement, said, "We are proud of the high-quality, compassionate care we provide.... Last year, we served more than 11,000 children, and the feedback I have received has been overwhelmingly positive. I am unaware of any concerns raised by parents."
Akbar is the owner of the clinic, according to a Small Smiles spokesman.
Small Smiles, which opened in 2005, turned down requests for interviews or visits. An out-of-state spokesman for Small Smiles, who asked not to be named, said by e-mail, "This is a concerted effort by the company to focus on patient care in the midst of recent scrutiny."
In November, ABC News and an affiliate ran stories about Small Smiles offices in the Washington, D.C., area. The stories told of frightened children, the use of restraints and the prohibition of parents in the treatment area -- the same concerns echoed by parents and dentists in Wichita in interviews with The Eagle.
Many Medicaid clients
Small Smiles' advertising notes that it serves Medicaid and HealthWave children. The Small Smiles spokesman said 98 percent of Small Smiles' Wichita patients have Medicaid or HealthWave, programs that provide medical and dental coverage for low-income children and some others who meet income guidelines.
Many dentists do not accept Medicaid patients or accept only a few because the reimbursement for their care is less than what is paid by private insurance. But Crystal Walker, a pediatric dentist, said four of the five pediatric dental practices in Wichita do accept Medicaid patients. Some general dentists also take those patients, and dental care is offered to Medicaid patients at GraceMed and some other clinics.
In 2007, Small Smiles got more than $4.5 million in Medicaid and HealthWave dental payments from the state, according to the Kansas Health Policy Authority. The clinic declined to say how many dentists it employs.
The clinic uses what amounts to assembly-line dentistry, some say.
"They go in, they do the cleaning, they do the diagnostic, they get everything done that they can in one day," said pediatric dentist David Brown.
"It was like an assembly line," said Shelbi Meisch, whose daughter was a Small Smiles patient. "There was just nothing about the experience that felt like you were getting good care."
Restraining patients
Though parents said they were not allowed to accompany their children into the treatment area, the Small Smiles spokesman said that's not policy: "Parents decide in consultation with their dentist whether or not to be present during their child's care," his e-mail said.
Jeff Davis said he and his wife were asked to sign a consent form giving Small Smiles permission "to do everything from yell at the child to physically restrain them to tie them down."
Meisch, as well as Delicia Akbar, whose children also were Small Smiles patients, said uncooperative children -- including theirs -- are immobilized in a "papoose board." Akbar isn't related to the Small Smiles dentist.
The Small Smiles spokesman provided a copy of a consent form used at Small Smiles in Rochester, N.Y., and said the one in Wichita is similar.
It asks parents to agree to "protective stabilization," described this way: "The child is wrapped in the device and placed in a reclined dental chair." Pictures on the form show a child with what looks like a blanket and a shaped back piece.
Medical suppliers describe a "papoose board" as a rigid board with wide fabric straps that have Velcro fasteners. Separate straps hold limbs inside the wrap, providing a snug-fitting restraint that immobilizes the patient.
The Small Smiles spokesman said, "Our records indicate that protective restraint was used in fewer than 3 percent of all patient visits in Wichita last year."
Akbar took her three children to Small Smiles. She read and signed the consent form "but my understanding of the restraint was not something.. to strap them down." She said the papoose board was used on her 9-year-old.
"I didn't even think anything negative until the kids came out and told me what happened," she said.
Papoose boards have a limited place in dentistry, three Wichita pediatric dentists said, and may be appropriate for special-needs children, for example. But there are other ways to get children to cooperate, they said. They don't use papoose boards.
Walker said she uses a "tell, show, do" approach to familiarize a patient with treatment. But she said that nearly every former Small Smiles patient "will not even lay in the chair" at her office because they're so frightened. Many need sedation for routine care because of their fear, she said.
Concerns about care
Another pediatric dentist, David Brown, said his main concern is "the patients that leave there absolutely terrified." In addition, he voiced concerns about the care provided. He said he has had parents who were told at Small Smiles that their child had seven cavities, "and I personally have not been able to find seven cavities."
Meisch said Small Smiles dentists wanted to put crowns on several of her daughter's teeth, including two front baby teeth that were loose. She said she asked that those two teeth be pulled -- and the dentists pulled others as well, including a molar that has necessitated a dental spacer. "They didn't listen very well," she said.
The Small Smiles spokesman said the clinic provides care according to the guidelines of the American Academy of Pediatric Dentistry. "The appropriate treatment plan is determined by dentists and is based on the dentists' professional judgment," he said in the e-mailed statement.
Small Smiles' advertising says it provides care to "children from their 1st tooth through age 20."
Only dentists who have had extra training may call themselves pediatric dentists.
"They do seem to market to children," said Betty Wright, executive director of the Kansas Dental Board. But by noting at the bottom of its ad that its dentists are general dentists, Small Smiles complies with Kansas law, she said.
Corporate connection
Nationwide, Forba, a dental management company based in Nashville, Tenn., owns Small Smiles. Its Web site does not list the clinic in Wichita -- or the ones in Topeka or Kansas City -- among its locations. But job openings for all three sites are posted on the Web site.
The Small Smiles spokesman said Akbar owns the Wichita clinic.
"The clinic receives assistance regarding marketing, human resources, policy, information technology, collections, and other administrative functions under a management services agreement with Forba," his statement said.
Kansas law prohibits corporate dentistry, in which a practice is owned by someone who doesn't practice there.
Wichita orthodontist Kendall Dillehay said he had filed a corporate ownership complaint about Small Smiles. He was told his complaint would be investigated and that he'd be informed of the results.
Dental complaints are investigated by the Kansas Dental Board. For action to be taken, Wright said that she would need to see evidence that Small Smiles is not owned by Akbar.
Wright said no disciplinary action has been taken against Small Smiles or its dentists, nor were there any pending disciplinary orders.
Investigations are confidential, she said, so she would not say whether any were or weren't under way.
Reach Karen Shideler at 316-268-6674 or kshideler@wichitaeagle.com.

-----




Here are just a few comments from parents who have been to the Small Smiles Dental Assembly Line Clinic:

1. I worked at Small Smiles when they first opened in Wichita. It was no less than hell on earth for children. They do everything and more to the kids that is mentioned in the article. I quit within 2 weeks because it broke my heart to work there. I would never recommend anyone to take there child to this office.
2. This sounds like child abuse to me. They should be thoroughly investigated like Tiller was. Where is the justice in supporting unborn babies? Why don't they support those whom are already born? Nola Foulsten needs to look into this business. Whether parental consent was given or not. Kudos to the previous poster for quitting. When my daughter got braces she told me she had friends who had went there and that the people there were extremely mean. I'm glad I took my kids both to Dr. John Hullings he's the greatest orthodontist in town. Front office staff isn't so nice, but the ones working on your teeth can't be beat. I've never been not allowed to view any and all treatment my kids' received.
3. Reza Akbar??? It sounds like third world dentistry to me, where abuse and a lack of civil rights are a way of life. And if, as they say, "And, they say, it is corporate dentistry, a practice not allowed in Kansas", why is it being allowed. This place of torture needs to be shut down. The trauma the children are being subjected to will follow them the rest of their life. I am 65 and still don't like to go the a dentist because of bad dental experiences as a child. WAKE UP WICHITA!!!!
4. So Small Smiles takes medicaid, a govt. program. It looks like the govt. and medicine are great together. It will be wonderful when the government takes over health care via Obama or Clinton.

There are many other Small Smiles complaints at the Wichita Eagle, you can read them here.

Dr. Mohammad Akbar, Peublo, CO. in the name of Small Smiles of Wichita Health Care contributed to State Representative Candidate Bob Bethell 2006 Campaign. See Here

Think maybe Mohammad Akbar and Reza Akbar are related or one and the same person?

Ocean Dental Corporate Jet Hanger Under Construction

And so many dentists tell us the government doesn't reimburse them enough to take on children on medicaid.

These guys, like Small Smiles and Kool Smiles have made it the primary business, and business is looking pretty darn good!

Are they strapping down the children to do the work is what I want to know!!

Thanks for the "heads up" anonymous!

photo by: Gary Johnson

I knew something was going to break about these people soon. They visited this site several times a day when this blog first went up. I had never heard of Ocean Dental until I started posting about a local dentist using a papoose board. Then all these medicaid stealing dental clinic started showing up on my blog stats, which in turn got me to looking into why they were so worried I was ticked off about a papoose board!

Reg flags were flew up like a covey of quails!

FORBA - Small Smiles Closing Dentist Office

Newburgh, NY

Six months after a dental office opened in Newburgh to treat the region's most vulnerable, it will close. Small Smiles Dentistry of Newburgh had barely gotten started. The practice treated patients in a blank-faced office complex southwest of Delano-Hitch Park and specialized in treating Medicaid patients 20 years old and younger.

Employees learned the center would close when one of their corporate bosses showed up last week to deliver the news. Staffers knew too few patients had come through the doors, but they had hoped for more time.

Of the 70 Small Smiles offices across the country, Newburgh's will be the first to shut down.

Hopefully they will start to fall like Dominoes! There is always hope!

Michael A. DeRose- Health Care Reform Act Elector

New York State Department of Health

What is it?

This is what is says at the site:

Below is an alphabetical list and Excel Worksheets of organizations that have voluntarily elected to make public goods payments directly to the Department of Healths Pool Administrator. To be included on the list, an organization must have elected in conformance with HCRA provisions and Department requirements. The current list is tentative, conditional upon review and acceptance of the information submitted by the payors on their election applications. This list will be updated monthly.

Effective April 1, 2008

Here is the link to see where he is listed click

I'm not sure what this is, but using the words "conformance" and "Michael A. DeRose" in the same sentence raises my suspicions, what about yours?

The info at the link says:

Effective date (for mikie) is July 2007

Michael A DeRose, DDS, PA

Charlotte, NC

Contact Info is: Ryan Root at (704)395-6000

Congressman Dennis Kucinich Call Small Smiles a Dental Mill

Congressman Dennis Kucinich said Small Smiles?FORBA had found way to make money off poor children by creating dental mills to make a buck while blasting Medicaid for not doing more to improve dental care for children on mediciad.

"Medicaid Officials in Congress [02/14/08]"
-----------------------------------------
Small Smiles - Congress

A year after 12-year -old Deamonte Driver died of tooth decay, Medicaid officials were called before congress in February to explain what they've done to improve access to care for poor children.

Four out of five dentists refuse to treat Medicaid patients because reimbursement rates are so low. The congressman heading up the hearing blasted Medicaid for doing little to improve rates.

He pointed to the I-Team's reports on Small Smiles Dental clinics as an example of what can result.

Congressman Dennis Kucinich said "Small Smiles conceived of another away to make a profit: a
predatory mill where multiple, sometimes unnecessary procedures are imposed assembly line style on children for little regard for their welfare or proper dental practice."

Medicaid officials told congress today they are trying to make more dentists available for poor children, but conceded they have a long way to go.

FORBA hires another PR Firm

It appears FORBA, LLC Dental Management aka Forba Holding, is scrambling to do as much damage control as possible in light of the disturbing allegations with it's Small Smiles Dental Clinics.

They have hired yet another public relations firm, in Nashville, TN. McNeely, Pigott & Fox.

Wonder if they fired Rubin, Meyer or they feel they need as many public relations firms as they can hire.

After Donald Meyer was the person who sent the response to WJLA TV when the I-Team Investigation report came out exposing how Small Smiles Dental Clinics were abusing our children and our medicaid program. You can download that statement here by clicking on Froba Dental Mngt. Statement.

Kiely's Dental Abuse Update 4

Bullhead City Lawyers!

March 4, 2008

What a joke!

I called so many of them and ALL of them TURNED ME DOWN! They either didn’t do anything with kids or they wouldn’t help us because she has “No permanent physical damage.” I even had one guy tell me that “we are a busy and big law firm and since it was just restraints with no physical damage besides the petechiae then we can’t help you and no other law office is going to.” What a dick he was! ugh.

I can’t believe there isn’t ONE lawyer in this area that will help CHILDREN that have been TORTURED and ABUSED!!!!!!! It’s ridiculous! Someone needs to stand up for kids.

Small Smiles-FORBA-DeRose Update From Roberta Baskin, WJLA TV

More Damning Evidence Keep Pouring In to I-Team Investigation.

Don't forget, even though this local investigation mentions Small Smiles, they go under the Name Smile Starters Smile High, Medicaid Dental Centers, FORBA, DeRose Children's Dental Center, Small Smiles Center/Clinic of Pueblo, and others. And if you read below in my previous post, more of these Dental Offices catering to children are jumping on this same bandwagon! Beware!

February 28, 2008

Roberta Baskin, of WJLA TV, broke and continues to follow the Small Smiles Dental Abuse and Fraud Investigation. Here is the transcript of Roberta’s latest installment.

ANCHOR:

RESTRAINING CHILDREN, PERFORMING UNNECESSARY TREATMENTS, HIRING UNLICENSED XRAY TECHNICIANS... THESE ARE ALL EXAMPLES OF THE SUB-STANDARD DENTAL CARE OUR I-TEAM FOUND AT THE SMALL SMILES CLINICS IN THE WASHINGTON DC AREA, AND ACROSS THE COUNTRY. WE'VE BEEN TELLING YOU HOW THE CHAIN OF CLINICS PLACES PROFIT OVER COMPASSIONATE CARE FOR MEDICAID CHILDREN. NOW ROBERTA BASKIN AND THE I-TEAM HAVE UNCOVERED MORE.... ROBERTA?

ROBERTA BASKIN:

SOME OF YOU WHO SAW OUR EARLIER REPORTS HAVE COME FORWARD WITH NEW EVIDENCE OF THE SMALL SMILES SCHEME TO BILL THE TAXPAYER-SUPPORTED MEDICAID PROGRAM FOR WORK THAT WASN'T NEEDED - OR WASN'T EVEN DONE.

STORY: Six year old Kayla Mason brushes her teeth day and night.



She's never had any cavities. That's why her mother, LaTasha Mason, was dismayed when dentists at Small Smiles in Oxon Hills said they found THREE.

LaTasha Mason-"I was like, oh my goodness, I was surprised, I really was. And they were like, well, the lady that called me back, she was like, well that's nothing compared to what we usually see."

She then had Kayla examined by a different dentist.

Mason-" And she gets up to leave and I'm like , well, what about the cavities?"

Turns out, there weren't any.

Mason-"I was really astonished, to say the least."

Mason is upset Small Smiles planned to drill into her daughter's teeth for no other reason than to profit from it.

Mason- "It's, it's just sickening." "(that's) the only thing I can think of, why they would want to drill in these baby's mouths, is for money."

Particularly upsetting is her feeling that Small Smiles lied to her.

Mason- "One maybe, that could have been an honest mistake. But three? Absolutely not. Three is not a mistake, I'm sorry."

And when this family went to Small Smiles for a check-up, dentists saw four girls - and apparently 24 cavities.

Cheryl -" I felt like a bad mother." Cheryl assumed her children hadn't been brushing.

Roberta -"Were you in trouble?"

Rachelle -"Yes"

Cheryl -"I told them all of their teeth were going to fall out if they don't listen to me and brush their teeth. I called them "yuck mouths."

Roberta -"Yuck mouths?

Cheryl-"Yuck mouths."
Most of the work was completed, except on Rachel, who was told to come back for several more fillings. In the meantime, Rachel's mom heard about our Small Smiles investigation, and switched to Dr. Robert Camps.

Dr. Robert Camps - "I'm glad it wasn't done, because it shouldn't have been done. Roberta -"Four fillings that she would have gotten on teeth that are perfectly fine."

Dr. Camps -"Correct."

And that's not all. When Dr. Camps examined Rachel and her sister Rebecca, he realized - Small Smiles didn't DO all the work they charged for.

Rebecca's chart shows 8 cavities filled…but that's not what she remembered. "I didn't see any drill or hear any drill.

Roberta -Did they numb you?

Rebecca -"I didn't feel a numbing (or anything)."

And Dr. Robert Camps didn't see the work either. "these are not fillings." "I feel like they did more like a sealant, (where they didn't really drill into the tooth)." To be sure, Dr. Camp took x-rays.

Plea from I-Team, asking the public to keep the stories coming I, please help I-Team help the children. You are the eyes and ears! click here

ABC 7, WJLA TV is in the Washington, DC area, so all of our law makers watch this news.

Report by phone at 703-236-9559