Friday, January 27, 2012

Dentist arrested for Medicaid fraud - Breaking News - www.observer-reporter.com

January 27, 2012

A Washington County dentist, who allegedly prescribed more than 6,600 narcotic pain killers to seven patients, was arrested today by state narcotics and Medicaid fraud agents.

Dr. Charles Kokoska, 48, 2 Mill St., Millsboro, was charged by the state attorney general's office. Koskoska has offices at his Mill Street home and at 161 Waterdam Road, McMurray.

According to the criminal complaint, between January 2009 and October 2010 Dr. Kokoska wrote more than 300 prescriptions for more than 6,600 narcotic pain killers to at least seven different patients.

The prescriptions were written for the powerful prescription pain killers Oxycodone, Hydrocodone, and Propoxyphene and filled at various pharmacies in Allegheny, Fayette, Greene and Washington counties. Kokoska also wrote prescriptions for Diazepam, a generic form of Xanax, commonly used to treat anxiety.

Dr. Kokoska is charged with seven counts of prohibited acts by medical professional and two counts of provider prohibited acts.

He was arraigned before Brownsville Magisterial District Judge Joshua Kanalis and released on $25,000 unsecured bail.

Dentist arrested for Medicaid fraud - Breaking News - www.observer-reporter.com

Centre County Dentist Facing Insurance Fraud Charge | GantDaily.com

 

January 27, 2012 at 6:46 AM

HARRISBURG, PA – Attorney General Linda Kelly announced criminal charges have been filed against a Centre County dentist accused of submitting more than $52,000 in false insurance claims following a joint investigation with the Federal Bureau of Investigations (FBI) State College office. 

Kelly identified the defendant as Dr. Jamshid Assadinia, 53, of 1764 Cambridge Drive, State College, Centre County. Dr. Assadinia owns and operates Jamshid Assadinia DDS,300 South Allen St., State College.

Kelly said Assadinia allegedly submitted insurance claims for dental procedures that he never performed and then billed the insurance companies more than $52,000 under the names of several different patients.

Wednesday, January 25, 2012

I don’t know, but I’ve been told, ReachOut America is as low as they go.

I’m hearing ReachOut Healthcare America mobile dentistry, and their Big Smiles program has a “service center” type place with hoards of telemarketers in cubicles, burning up the phone lines with a list of potential victims to contact that is as long as your arm. 

Telemarketers? Yes,telemarketers. This is where the “ReachOut” part comes into play. Each telemarketer has a list of the names of children, parents, your child’s school, and parent or guardian contact information.

For example, let’s say you are home, the phone rings, you answer and it’s a nice lady telling you the mobile dental clinic your school has approved, which is staffed with a highly qualified dentist and two assistants will be at your school on such and such date. Sounds just like picture-day doesn’t it?

ReachoutAmericaThe telemarketers have their expertly crafted scripts ready, which makes this phone call really a “high pressure” sales call. You’re probably going to be quoted statistics and such about the poor status of children’s dental health here in America, your state or even your town.

The telemarketer tell you they just your verbal permission - probably recorded- or so they might tell you. ReachOut can have their highly qualified and well trained dentist do just a little look-see, a screening so to speak, or maybe its been a while since your child’s last cleaning, they could do that for you too. They may tell you they will send home a report detailing Susie’s dental health.

They might ask, if their highly trained staff does find a problem, with Susie, do you what them to fix it, right then and there, since it is a full service mobile clinic. It will save you all kinds of time and we know as parents, time is a valuable commodity, right? Plus, how can you neglect your child by withholding dental care? Free dental care?! Free, you may ask?

The telemarketer, I mean company representative, tells you there will be no cost to you, since your child is eligible for free dental services because of your states Child Health Insurance Program (CHIP). Sounds like if you are on the “free lunch” list you get free dental care at school too, doesn’t it? 

In fact you may feel at the end of the phone call your this is all arranged by your school system as a service to all the children, included as a normal as the school nurse. Remember the fluoride rinses back in the 1980’s?

You could be lead to believe it’s nothing more than dental hygiene instruction – remember those Bell Telephone movie reels that used to make the rounds at schools?  No, well you’re not as old as me then.

If you decide you would like to be there for the event, you’re likely to be told that since they aren’t sure exactly what time Susie will be called, you could possibly be sitting there in the school all day, and you don’t want to be doing that, right? That’s just another classic separate the child and the parent ploy.

Speaking of that “free lunch” list, is that where ReachOut Healthcare got your contact information?

Tuesday, January 24, 2012

BUSINESS BRIEFS: Padula chosen citizen of year - The Pueblo Chieftain–more like snake of the century! GAG!

 

The Greater Pueblo Chamber of Commerce will honor Center for American Values founder Adolph "Rudy" Padula with its annual Citizen of the Year award, the group announced Monday.

   The award presentation will take place at the chamber's annual dinner Thursday night at the Pueblo Convention Center. Tickets remain available for the event. For reservations, call 542-1704.

   Padula, a Pueblo dentist for nearly 40 years, launched the Center for American Values several years ago. He purchased and renovated The Waterford, a large, aged building on the Historic Arkansas Riverwalk of Pueblo, into a new retail-office building that also is home to the center's meeting room and Medal of Honor portrait display.

BUSINESS BRIEFS: Padula chosen citizen of year - The Pueblo Chieftain: Local Business

UPDATED: TX Medicaid combats overuse of kids' braces -- 22 visits a year! | Trail Blazers Blog | dallasnews.com

 

UPDATE, 3:30 p.m.: The attorney general's office has 31 orthodontists under investigation for possible Medicaid fraud, David Maxwell, the office's deputy director of law enforcement, testified to the House panel. According to Rep. Lois Kolkhorst, R-Brenham, the panel's chairwoman, 24 percent of the nearly 80,000 children who last year received orthodontic services from Medicaid were under the age of 12. State social services czar Tom Suehs testified that, starting in March, the minimum age for treatment of severe misalignment of upper and lower teeth will be 13. "Some of our providers out there gamed and manipulated the system," Suehs testified. "I won't use the word fraud. ... Clearly, we didn't have some of the controls we should've had."

ORIGINAL POST: Poor youngsters in Texas who were put into braces courtesy of taxpayers saw their orthodontist an average of 22 times in fiscal 2010, state Medicaid chiefs said in testimony they were to give to a legislative panel Tuesday.

"Typically, 12 visits per year is expected," said the written testimony by Medicaid chiefs Tom Suehs (right) and Billy Millwee to the House Public Health Committee.

Read the rest – click below

UPDATED: TX Medicaid combats overuse of kids' braces -- 22 visits a year! | Trail Blazers Blog | dallasnews.com

You may have paper clips in your root canal too! -Michael Clair Guilty Plea

A Massachusetts dentist plead guilty yesterday of Medicaid fraud and assault and jury tampering. Michael Clair had been banned from providing services to Medicaid patients, yet, but in so many cases these days, that means little. He still managed to collect $130,000 in fraudulent reimbursement. He would have other dentists in the dental practice provide billing services for work he did, in order to service Medicaid patients. He also managed to get his staff to fill prescriptions and give him the pills.  Tsk Tsk  His dental license had been revoked in Maryland, West Virginia and Florida, but Mass let him in!  Yes, those dental boards are fantastic!!  NOT!

A couple of sad things, one, it took 4 years to get here!  There were anonymous reports to the dental board (yes, I'm 100000% positive on that and they weren't so anonymous!), many other letters of concern and pleas for someone to stop this man. His dental license was suspended in 2006 and he's supposedly barred form practicing dentistry, which means, he's probably already open another office.

The second, sad, and oh so scary thing is, you may have paper clips in your mouth too! Today I received the following email:

Hi there,

I saw your post regarding the dentist in Mass that "did a root canal with a paperclip. I am not defending him at all. I just wanted to let you know that the use of a paperclip as part of a provisional crown is a legitimate technique. Now, I have no knowledge of the legitimacy of billing this to Medicaid. Attached is a photograph I just took from Herb Schillenberg's "Fundamentals of Fixed Prosthodontics" 3rd edition. This is the most cited text book on the market on the subject of fixed prosthodontics.

Thank you for your time,

DrJ





Thanks Dr. J

Monday, January 23, 2012

Victim Talks About Paper Clip Root Canal - Boston News Story - WCVB Boston

Michael Clair's trial was to start today:

Michael Clair, the former owner of Harbour Dental in the New Harbour Mall, pleaded guilty to Medicaid fraud and to charges that he substituted paper clips for stainless steel dental posts in dental procedures.

Clair will be sentenced on Jan. 30 in Superior Court.

Clair, 53, now of Maryland, was scheduled to begin trial today in Superior Court on a total of 15 charges including fraud, assault, illegally prescribing drugs and coercing office staff to remain quiet about the conduct.

Instead, he offered to plead guilty to two counts of assault, three counts of larceny, five counts of Medicaid fraud, three counts of writing illegal prescriptions, one count of tampering with evidence and one count of intimidating a witness, according to a release from Attorney General Martha Coakley.

Clair remains free on bail pending his sentencing.



Victim Talks About Paper Clip Root Canal - Boston News Story - WCVB Boston

Dr. Michael Clair's license was revoked in Maryland for 5 years, but that didn't save patients in Massachusetts

Sunday, January 22, 2012

Four Winds Health, Midwest Dental, Kool Smiles Dental and Friedman Fleischer & Lowe (FFL)

logo_nwh
From FFL website:
Four Winds Health, LLC was formed to build and manage a chain of high-end urgent care centers that offer walk-in, extended-hour access for non-life-threatening acute injuries and illnesses. Through its centers, Four Winds is focused on creating a superior patient experience through the delivery of convenient, comfortable, high-quality medical care.
Four Winds is headquartered in Atlanta, GA. The company was formed by the same management team which previously founded Kool Smiles, another FFL investment. FFL provided founding capital to Four Winds in 2011

logo_midwest_dental
Midwest Dental is a leading dental practice management company with over 75 clinics in six states. Midwest Dental clinics are typically located in suburban and rural areas, and the company has demonstrated an impressive track record of growth through acquisitions of independent dental clinics. The company provides the clinics with a full range of management, administrative and financial services, allowing clinical staff to allocate more of their time to patient care.
Midwest Dental is located in Mondovi, WI. FFL acquired the company in 2011 and plans to provide additional capital to support future acquisitions.
 
ncdr
NCDR, LLC provides various non-clinical services to dental group practices, including providing dental facilities, support staff, and other business services. NCDR's principal [ONLY] client is Kool Smiles, a nationally-branded provider of dental care focused primarily on children enrolled in Medicaid and State Children's Health Insurance Programs. The limited access to care for children on Medicaid/SCHIP plans provides an attractive growth opportunity for Kool Smiles as it continues to expand offices with a mission to provide quality care to this underserved population.

The company is headquartered in Atlanta, GA. FFL invested in NCDR in 2004 to provide growth capital and liquidity to founders.

Saturday, January 21, 2012

R. Kirk Huntsman’s- The Beginning: Reachout Healthcare America-Dental One, Nexus Dental Alliance and more

Last September(2011) R. Kirk Huntsman’s was featured at a seminar entitled “Beat The Dental Practice Management Companies”  Warning attendees of the “Walmart Effect” taking over dentistry.

Yet, among many other ventures in Dental Practice Management, R. Kirk Huntsman has been Managing Partner of Montage Venture Group LLC since March 2010, according to Business Week. 

R. Kirk Huntsman Bio from Nexus Dental Alliance, his virtual Dental Management company.  Virtual, meaning you just “pretend”, “not real”? 

Mr. Huntsman has been active in the dental industry for over 23 years.

Yet, never took time to become a dentist, wonder why?  If he was so into it, you’d have thought he would want to actually be one, right?

In 1988, he became the Dallas/Ft. Worth licensee for Associated Financial Transition Consultants, Inc.(AFTCO Associates,) a dental practice brokerage company with over 65 offices nationwide.  Within two years, his was the top performing office in the nation.   In 1991, he acquired the Houston license and continued to rapidly expand. 

By 1995, he was ready to begin owning and operating practices, so he launched Dental One as a dental management services organization, or DMSO.

In 1995, as well as today, it was illegal for a non-dentist to own dental practices!  I guess Mr. Huntsman failed to read the following page of info over at the AFTCO website, but it’s easy to see how he could become confused, since it’s written in a lot of double speak BS. Plus, it used the word “Goodwill” which I’m sure is not in his vocabulary.  Had the word, “Greed” been used, it would have had his complete attention.  Here is what is on the AFTCO’s website:

Orthodontics for sale- Texas

I was over on a dental practice brokerage firm site and wondered how many orthodontic clinics might be up for sale in Texas.  Surprisingly there were only two currently listed, however I’m guessing right now you can’t give them away down there…  Anyway, I saw this one and thought it amusing.
Specialty: Orthodontics
Number of Operatories:
Active Patient Count:
One Year Gross:
Opportunity Type:
Practice for Sale
DALLAS – 5 locations - Multi-Million Dollar Investment Opportunity! One owner wishes to sell all locations to the next “Dentist – Entrepreneur”. All staff and associates are to stay. Ideal for more than one Doc willing to “partner up” with a colleague or two. If you are an Oral Surgeon, Pedodontist, Endodontist or Orthodontist you can even have all of these offices refer to your specialty practice. Each facility computerized for easy practice management. Don’t go to work today! Let others “bring home the bacon” for you! Be a contributing clinician in this large operation or just the investor owner. Too much information to list in this ad regarding each location.