Boston Herald Monday September 26, 2011
The cheating done by food stamp recipients is peanuts compared to vendor fraud (“Life’s a beach on EBT street,” Sept. 22).
Most fraud is done by pharmacies, doctors, dentists, nursing homes, hospitals and sellers of medical equipment. The government recovered $2.5 billion in overpayments for Medicare in 2009 as the Obama administration focused attention on fraud enforcement efforts in the health industry.
Click here to read the full story
The Real Cheaters
Monday, September 26, 2011
Saturday, September 24, 2011
Inside the mind of a corporate dentist who is paid based on production.
Here is what happens to a dentist working at a dental mill when they don’t produce. Names and dates have been changed.
I believe this is a letter from a “lead” dentist at a dental mill clinic sent to their “regional manager". It’s apparent production is the only goal and is precisely why getting a bonus and/or a piece of the pie for compensation is more than wrong! It’s criminal! This is exactly why under Quality of Care Corporate Integrity Agreements, employee compensation or bonuses are NOT to be based on “production” goals.
I believe this is a letter from a “lead” dentist at a dental mill clinic sent to their “regional manager". It’s apparent production is the only goal and is precisely why getting a bonus and/or a piece of the pie for compensation is more than wrong! It’s criminal! This is exactly why under Quality of Care Corporate Integrity Agreements, employee compensation or bonuses are NOT to be based on “production” goals.
Dear Regional Manager,
This letter is in regards to the production levels of Dr. F. As you know the clinic was approximately $500 away in production from the $300/3000 Bonus for the month. This is one of MANY examples of Dr. F not completing the majority of the treatment on the patients she sees on a daily basis. The patient, RH, was seen on 12-1-2010 by Dr. F and the only treatment done was a facial composite on the #C and the rest of the treatment to be performed was dismissed because the patient was nervous and he wanted the dental visit to be easy.As you can see, Dr. X Ray Fraud would have done all the extractions had mom not spoken up and refused.
The clinic missed out on the possible $425.96 of production because he wanted to make the visit EASY? I find this very upsetting because I strive to work at my full potential and lead by example to my fellow doctors and employees to work hard regardless if I want to make a dental appointment easy.
If I wanted to make the appointment easy for every nervous patient, I believe a strong majority of our parents would be upset that they would have to continuously keep coming back because the patient was nervous. RH was my patient today and I completed the majority of the treatment except the extractions (per mom) and yes the patient was initially nervous, but did great for the injections and treatment. In conclusion, my question is how many more patients are to be dismissed or partial work completed because they were nervous and how many production goals must be compromised because of Dr. F’s lack of effort?
Sincerely,
Dr. X Ray Fraud
Jim Moriarty “Only a human can practice dentistry” “No corporation is allowed to practice dentistry.”
by BYRON HARRIS
Bio | Email
WFAA
Posted on September 23, 2011 at 11:15 PM
WFAA's Byron Harris has investigated dental organizations that have charged the government millions for children's braces. Here is the latest from the on-going News 8 investigation which includes a statement from Texas attorney, Jim Moriarty.
E-mail bharris@wfaa.com
Related:
Thursday, September 22, 2011
Don’t become part of the crime and cover-up–Report it!
This goes out to any Small Smiles or Church Street Health Management employees.
The Office of Inspector General and Health and Human Services take Corporate Integrity Agreements seriously, especially Quality of Care CIA’s and even more important the agreements that have to do with the treatment of children.
I know many of you are afraid to speak up about the violations and breaches of the Corporate Integrity Agreement. I know many of you are concerned about other misdeeds happening at the dental centers as well as at corporate headquarters.
I encourage each of you to report any and all violations. If you don’t feel comfortable using the Hotline that is set up, and I understand that completely, then at least report directly to the OIG/HHS.
You may direct complaints of suspected Medicaid fraud to
State Medicaid
OIG's Hotline1-800-HHS-TIPS (1-800-447-8477) or directly to a
Fraud Control Units
If the monitor is visiting your center, please talk to the monitor. I’m sure all reports and allegations are taken seriously. If you can’t talk freely right then, surely you can find a way to get the monitor’s attention to slip them a phone number or a note or something. Get the name of the monitor and contact them later….do something.
Heck do all of the above if you don’t feel comfortable talking to the monitor and your concerns swept under the rug. Even though I doubt that is the case. But I understand just about every one of you are terrified.
You guys are the first line of defense against children being mistreated and Medicaid fraud prevention. Please do the right thing. For example, if you see procedure being coded and billed improperly, please report it, please. Don’t become part of the crime and cover-up.
Wednesday, September 21, 2011
Dr. James Crow sentenced to prison for Medicaid Fraud - using wrong billing codes
Medicaid Fraud and Perjury by Brownwood, Texas Dentist. Perjury(emphasis added).
Who at these Medicaid mills are willing to leave your family, newborns, sick parents and head off to prison? Better be thinking about it.
_____________
September 21, 2011
SAN ANGELO, Texas — A Brownwood dentist convicted in federal court in San Angelo of defrauding Medicaid has been sentenced to 70 months in prison and ordered to pay more than $1.6 million in restitution.
James Crow, 67, was ordered by U.S. District Judge Sam Cummings to surrender to the Bureau of Prisons on or before Oct. 26. He also was ordered to pay $1,653,474 to Texas Medicaid and forfeit that amount in cash, a truck, several Harley Davidson motorcycles, a residence in Brownwood and additional real estate elsewhere in Brown County, a camper, a boat and a trailer.
Cummings also issued a finding that Crow had committed perjury during the two-week, May 2011 trial in San Angelo.
Crow was convicted on evidence that he filed claims to Medicaid for services he didn't perform and for services billed under improper billing codes. Crow billed Medicaid for resin-based fillings when the service weren't performed or services were performed that were not reimbursable under Medicaid.
The case was prosecuted by the U.S. Attorney's office in Lubbock using investigations conducted by the Texas Medicaid Fraud Control Unit and the FBI.
Who at these Medicaid mills are willing to leave your family, newborns, sick parents and head off to prison? Better be thinking about it.
_____________
September 21, 2011
SAN ANGELO, Texas — A Brownwood dentist convicted in federal court in San Angelo of defrauding Medicaid has been sentenced to 70 months in prison and ordered to pay more than $1.6 million in restitution.
James Crow, 67, was ordered by U.S. District Judge Sam Cummings to surrender to the Bureau of Prisons on or before Oct. 26. He also was ordered to pay $1,653,474 to Texas Medicaid and forfeit that amount in cash, a truck, several Harley Davidson motorcycles, a residence in Brownwood and additional real estate elsewhere in Brown County, a camper, a boat and a trailer.
Cummings also issued a finding that Crow had committed perjury during the two-week, May 2011 trial in San Angelo.
Crow was convicted on evidence that he filed claims to Medicaid for services he didn't perform and for services billed under improper billing codes. Crow billed Medicaid for resin-based fillings when the service weren't performed or services were performed that were not reimbursable under Medicaid.
The case was prosecuted by the U.S. Attorney's office in Lubbock using investigations conducted by the Texas Medicaid Fraud Control Unit and the FBI.
Tuesday, September 20, 2011
Obit sheds light on DeRose family tree
Grove, Jean P.
Jean P. Grove - Pueblo Chieftain - March 12, 2001 - Longtime Pueblo resident, passed away March 9, 2001. Preceded in death by husbands, Frank G. Palladino and Arthur E. Grove; sister-in-law, Veronica DeRose; and brother-in-law, Bruno DeRose. Survived by nieces and nephews, Dr. Edward J. and Neta DeRose, Sel and Vivian Elizondo, Dr. Rudy and Berni Padula, Alfred J. and Rose Schiavoni, Mary Lou Keating; and sister in-law, Jada Willard. Mrs. Grove resided in Pueblo for 50 years and was a loyal member of Sacred Heart Cathedral and St. Pius X churches. Service will be held at Sacred Heart Cathedral on March 13 at 10 a.m. The family respectfully requests the omission of food and flowers. Contributions may be made to the Fellowship of Christian Athletes, 7 Glen Eagle Court, Pueblo, CO 81001, in memory of Mrs. A.E. Grove. Interment, Roselawn Cemetery.
How to slow the child abuse, tortuous dental overtreatment and fraud
If states want to stop the influx of these substandard dental mills; if states want to end the continued overtreatment and child torture perpetrated on the poorest and most vulnerable of our citizens; if states want to cut the Medicaid fraud by same dental mills by billions; the solution may be as simple as slowing down the reimbursements.
Many think they gravitate to states with the highest reimbursement rates or those states that pay for more procedures, but that’s not always true. If you were to ask an exec at one of the mills, you may well be told it’s actually how fast the money flows into their coffers.
Look at the states who are slow to pay; you won’t find many dental mills there. Take Illinois for example, they are considered to be slow to pay; no Small Smiles or Kool Smiles there.
Of course that’s just one of the factors considered, but it’s a huge one! Other factors could be:
How quickly dentists can be credentialed
How quickly dentists can be licensed with the state dental board
Who they know and can control at the state dental associations
Tuesday, September 13, 2011
Just Saying….
Being lectured about wasting taxpayer dollars by a Medicaid Fraudster is off the chart ridiculous. Just saying….
Sunday, September 11, 2011
Attorney Tom Crosley Taking The Smile Center Cases–Was your child injured?
SAN ANTONIO - More than 70 parents are preparing to sue a local company of dental clinics called The Smile Center. A News 4 WOAI Trouble Shooters investigation unleashed a flood of complaints by parents who say their children got poor dental treatment at the San Antonio clinics. The San Antonio clinics have made millions on work paid for by Medicaid
.
Tom Crosley runs the firm that is preparing to file suit. “In the last few weeks we've been approached by the families of 60 or 70 children to investigate whether their kids were victims of unnecessary dental work, shoddy dental work, excess dental treatment," said Crosley.
The Smile Center handed out letters to potential new patients that state the allegations are gross misrepresentation of the facts. The Smile Center also claims they are saddened and shocked that we would report this story without telling their side of the story.
See video and further story information here
Tom Crosley, Attorney At Law
2632 Broadway St
Suite 101 South
San Antonio, TX 78215
210-354-4500, 877-535-4529
Fax: 210-244-2744
info@crosleylaw.com
.
Tom Crosley runs the firm that is preparing to file suit. “In the last few weeks we've been approached by the families of 60 or 70 children to investigate whether their kids were victims of unnecessary dental work, shoddy dental work, excess dental treatment," said Crosley.
The Smile Center handed out letters to potential new patients that state the allegations are gross misrepresentation of the facts. The Smile Center also claims they are saddened and shocked that we would report this story without telling their side of the story.
See video and further story information here
Tom Crosley, Attorney At Law
2632 Broadway St
Suite 101 South
San Antonio, TX 78215
210-354-4500, 877-535-4529
Fax: 210-244-2744
info@crosleylaw.com
The Smile Center in San Antonio, Texas Under Investigation
WOAI TV
Updated: 9/08 10:04 am
The Smile Center Investigation
Posted on 09/08/2011 by bcollister
A criminal investigation is underway into a chain of dental clinics here in San Antonio that targets children on Medicaid. This comes after I uncovered complaints of poor treatment at The Smile Center.
The Texas Attorney General now confirms it has launched criminal and civil investigations into The Smile Center.
The Attorney General’s office wants to know if the clinics defrauded Medicaid by billing for dental work that did not need to be done. I’ve been reporting since February about complaints from parents who say the clinics did unnecessary and shoddy work on their children.
These parents were unhappy with dental work done on their children and paid with millions of your tax dollars through Medicaid.
A representative from the Attorney General’s office confirms it’s Medicaid fraud control unit has 180 bankers boxes of records taken from The Smile Center locations here in San Antonio. The agency’s civil Medicaid department has also filed a complaint in civil court against the business. But we don’t know what’s in that complaint because it’s sealed.
Updated: 9/08 10:04 am
The Smile Center Investigation
Posted on 09/08/2011 by bcollister
A criminal investigation is underway into a chain of dental clinics here in San Antonio that targets children on Medicaid. This comes after I uncovered complaints of poor treatment at The Smile Center.
The Texas Attorney General now confirms it has launched criminal and civil investigations into The Smile Center.
The Attorney General’s office wants to know if the clinics defrauded Medicaid by billing for dental work that did not need to be done. I’ve been reporting since February about complaints from parents who say the clinics did unnecessary and shoddy work on their children.
These parents were unhappy with dental work done on their children and paid with millions of your tax dollars through Medicaid.
A representative from the Attorney General’s office confirms it’s Medicaid fraud control unit has 180 bankers boxes of records taken from The Smile Center locations here in San Antonio. The agency’s civil Medicaid department has also filed a complaint in civil court against the business. But we don’t know what’s in that complaint because it’s sealed.