Interview with Gary Iocco, President, National Association of Dental Laboratories

Interview with Gary Iocco, President,
National Association of Dental Laboratories
March 2014

By: Michael W Davis, DDS

Dr. Michael W. Davis maintains a private general practice in Santa Fe, NM. He chairs the Santa Fe District Dental Society Peer-Review Committee. Dr. Davis is active in dental care for disadvantaged citizens. His publications are on ethical issues within the dental profession, as well as numbers of clinical research papers.

 

 

Gary Iocco is the current president of the National Association of Dental Laboratories (NADL). The NADL promotes the highest standards in the dental laboratory industry through education of its members, advancing technology, raising standards, and serving the public interest. Communication with dentists and the public is also an important role of the NADL.

NADL Website http://www.nadl.org/home-page.cfm
National Board of Certification in Dental Laboratory Technology http:///www.nbccert.org
The Foundation for Dental Laboratory Technology http://www.dentallabfoundation.org
NADL What’s in Your Mouth http://www.whatsinyourmouth.us

 

Questions

Dr. Davis: Many in the general public may not know the vital role of the dental technician, within the dental team. From my perspective as a restorative dentist, a dental technician can make me look like a superstar, or a nitwit. What exactly does a dental technician do, and why is that so critical in successful clinical results for patients?

Mr. Iocco: As dental laboratory technology professionals we transform the dentist’s directions from the prescription or work order and create the actual treatment option that the dentist has chosen to provide their patient. Quality dental laboratory professionals employ knowledge of modern materials and available technologies to provide our dentist clients with a restoration that is consistent with the high standard of care and esthetics that our dentists expect to provide for their patients.

This is only possible if there is sufficient communication and understanding and a mutual knowledge of and commitment to what is required for a quality outcome.

While good communication is always important, the more complex or involved a case is the earlier in the planning process a dentist should bring their dental laboratory technology professional into the conversation.

Highly skilled and experienced dentists will tell you that to provide the standard of care and esthetics that they seek for their patients restorations, they work closely with a quality dental laboratory.

Oh where, oh where did it go: CSHM’s Press Release

If anyone is looking for CSHM and Small Smiles press release after the media exposed the fact they will be excluded from Medicaid in 30 days, you won’t find it on their website any longer. No need to put out an “All Points Bulletin”, it can be found below.

President and CEO David R. Wilson, released a memo to payors on March 12, it has since disappeared from their website as well. But never fear,it’s still here.

The whole media statement, from start to finish, basically gave the finger to HHS-OIG and every person who has investigated them since 2007; in addition to making highly misleading—if not down right lying—to staff and employees.

Seems their Facebook page has disappeared as well. I imagine they don’t want any comments or questions, don’t you?

Below is the press release.

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CSHM, LLC MEDIA STATEMENT
March 11, 2014

CSHM, LLC & OIG NOTICE OF EXCLUSION

In a letter dated March 7, 2014, CSHM, LLC (“CSHM”) received a notice of exclusion from federal health care programs from the Office of Inspector General of the Department of Health and Human Services (OIG). The notice of exclusion does not apply to any individual employee or the Dental Centers and Practice Owners, but to the CSHM, LLC corporate entity only. If the exclusion should go into effect, it means that CSHM may not continue with some or all of its current responsibilities under its Management Service Agreement (MSA) and this may affect administrative services related to Center operations.

The exclusion notice is based on the OIG’s determination that CSHM has violated some terms of the Corporate Integrity Agreement (CIA) that has been in place for the management company and its predecessors since January 2010. CSHM assumed the CIA in June 2012 and it is well known that it has implemented the CIA provisions within the Centers and generally since that time. Many Center owners and employees have met the Independent Quality Monitor (IQM) and CSHM’s compliance staff over the last 18 months as the company was implementing the CIA’s provisions. Generally, the alleged violations related to certain delayed reporting of a few adverse clinical events, failure to undertake certain training in 2012 before CSHM assumed the CIA, and the omission of two adverse events on the CIA disclosure log, though over 1,200 events were successfully place on the disclosure log for processing.

CSHM believes strongly that it has substantially and in good faith implemented the CIA at a great cost in resources and with the important cooperation of the Centers and its health care professionals, particularly on the enhancing dental clinical standards. The OIG’s proposed determination to exclude CSHM for some non-compliance with its CIA is an unduly harsh and an unprecedented response to expected and common difficulties in implementing a very complex CIA that has a novel and innovative administrative, process and clinical requirements.

CSHM intends to appeal the notice of exclusion and file a request for hearing with the Department Appeals Board. During the appeals process, the exclusion will be stayed and we will continue to provide business, administrative and support services to 53 associated dental centers in 19 states and the District of Columbia, pursuant to our management services agreements. The legal process will take an indeterminate period of time. In the interim, CSHM will continue to perform normal operations and will continue to provide our internal and external constituents with up-to-date information. Should you have questions regarding this matter, please contact a member of our communications team at Lovell Communications:

• Paula Lovell: 615-297-7766 / lovell@lovell.com
• Rosemary Plorin: 615-297-7766 / rosemary@lovell.com
• Perry Hall: 615-297-7766 / perry@lovell.com

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• Link to original media release - http://smallsmiles.com/PressReleases/MediaResponseStatement_LV_20140312.pdf
• Saved copy-
  http://www.scribd.com/doc/212174183/CSHM-Small-Smiles-Dental-Media-Statement-03-11-2014

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• Link to original payor memo -
  http://smallsmiles.com/PressReleases/CSHM_Payor_Memo_20140312.pdf‎
• Saved copy of payor memo -
  http://www.scribd.com/doc/212466391/David-R-Wilson-President-CEO-of-CSHM-Small-Smiles-Dental-Payor-Letter-03-12-2014

Positive proof of no compliance at CSHM–Small Smiles

You have to check out CSHM-Small Smiles “Quality and Compliance” webpage. Past the list of the overseers, you will find a link that says“For more information, please visit: www.smallsmiles.com/compliance.

Go ahead, click it.

NBC — Firm That Manages Dental Clinics for Kids Excluded From Medicaid

 

By Talesha Reynolds

MARCH 12, 2014 - A company that manages a chain of dental clinics once accused of subjecting children to painful and unnecessary procedures and bilking the government for millions of dollars has been notified it will no longer be eligible for reimbursement from federal health care programs like Medicaid, its principal source of revenue.

The company, CSHM, manages 53 clinics nationwide, most of which operate under the name Small Smiles. The clinics treat mostly low-income children in areas where access to dental care is limited.

The Office of the Inspector General of the Department Health and Human Services sent a letter to CSHM on Friday citing multiple breaches to a compliance agreement, which mandates quality of care measures. The breaches included failing to report incidents involving patients at Small Smiles clinics in Tulsa, Okla., and Mattapan, Mass.

The OIG declined to provide further detail on the specific breaches that led to the exclusion.

Sen. Chuck Grassley, R-Iowa, who last year published a report on corporate dental management companies along with former Sen. Max Baucus, D-Mont., said Monday that the CSHM exclusion notice “will protect both taxpayers and vulnerable children receiving dental care in the Medicaid program.”

Read the entire article here

Related:

Dental chain accused of hurting kids, bilking taxpayers December 11, 2012

Dental Group Practice Association installed a new Executive Director last week. Will he work more than 8 hours a week?

Check out the uptick in legal, conference and lobbying expenses. I’m not sure how you can spend that much in a year and not work more than 8 hours a week.

Management fees have also skyrocketed.

 

 

 

 

 

 

 

 

 

 

 

 

DGPA 2007 - 2013 Tax Return Data by Dentist The Menace

CSHM comes out of hiding to issue statement regarding Medicaid Exclusion

CSHM and Small Smiles have been dodging media phone calls for days. They have finally issued a statement; begrudgingly I'm sure.

They say they will appeal. I hear they won't. Hell, they have been appealing since 2010; dang near quarterly.

They have received at least 2 earlier threats to be excluded; maybe three. The report issued last year by Senator Grassley's office basically asked, "how bad do these folks have to be before excluding them. They may appeal just to keep the revenue flowing. But I would think they should be on a Credible Allegation of Fraud pay hold.

CSHM Small Smiles Dental Media Statement 03-11-2014 by Dentist The Menace

Vice Chairman and Ranking Member of House Committee on Energy and Commerce-Oversight and Investigation subcommittee express continued concerns of dental management service companies (DMSOs).

In a letter (see below) to Inspector General Daniel R. Levinson, Rep. Michael Burgess (R-TX) and Rep. Diana DeGette (D-CO) express their continued concerns about “deceptive practices of dental management service companies (DMSOs)”.

They further call on HHS OIG to exclude any corporate dental companies from participating in the Medicaid program, saying, “Based on the report by the Senate Committees and the prior findings of HHS OIG, we concur with our Senate colleagues and recommend that HHS OIG should consider excluding any corporate entity that employs deceptive business practices that result in substandard care, from the Medicaid program.”

Burgess and DeGette are also concerned about the length of time it has taken to bring one of these companies—Small Smiles Dental Centers—to justice.

The letter recounts the history of the Small Smiles investigation, starting with the “2008 investigative news report” by WJLA in Washington. That report actually aired in November 2007; so it’s even worse, right?

The 3 page letter also states:

• “based on evidence undertaken by our offices, we are very concerned that the corporate structure and management of dental clinics often results in a failure to meet basic quality and compliance standards.”

Small Smiles exclusion- Senator Grassley is happy with the “Victory for Accountability”

Grassley: Notice from Inspector General is a Victory for Accountability

March 10, 2014
WASHINGTON – Senator Chuck Grassley, senior member and former Chairman of the Senate Committee on Finance, said the decision of the Inspector General for the Department of Health and Human Services to disqualify CSHM, LLC from the Medicaid program “will protect both taxpayers and vulnerable children receiving dental care in the Medicaid program.”
The Inspector General delivered a Notice of Exclusion (click here to read the Notice) following a year-long investigation by Grassley and then-Chairman Max Baucus of Montana into allegations of abusive treatment of children in clinics controlled by corporate investors rather than dentists.  The senators issued a report and recommendations last July and urged the administration to ban dental clinics from participating in the Medicaid program if the dental clinics circumvent state laws designed to ensure only licensed dentists own dental practices to prevent substandard care.
“Our oversight found that when states can’t hold owners accountable, then clinics are more likely to fail to meet standards that protect the children who should be helped,” Grassley said.  “The actions of some dental practices strained the Medicaid program and put low-income children in traumatic, highly questionable situations.”

 

FINALLY! Small Smiles Dental Centers are EXCLUDED from Medicaid and other Federal health programs!

OMG! OMG! OMG!

After 7 long years of persistence, it’s finally happened! Small Smiles Dental Centers are excluded from participation in Medicare, Medicaid and all Federal Health Care Programs!

Small Smiles Dental Centers - CSHM Exclusion Letter by Dentist The Menace

Let us not forget, the dental centers Quality and Compliance was overseen by:

Dr. Paul Casamassimo
Dr. Arthur Nowak
Dr. Joe Bernat
Dr. Anupama Tate
Dr. Steve Adair

Quality & Compliance - Dental Centers - CSHM by Dentist The Menace

 

I can’t woo hoo and OMG enough—I’m shaking from head to toe with glee!!!!!

Now, where can I locate a bottle of the “good stuff” Champaign!

Do you own your dental practice?

Let’s say you own your patient’s charts, do you own your dental practice?