May 2009 Update

Sorry I've not posted in a while. I'm sure some have missed me while others, well, not so much. I've just been busy with life and awaiting on some news out of New York on FORBA.

For anyone wondering about the lawsuit FORBA filed, well they ended up dropping it all! They asked the judge to dismiss all their complaints and the judge signed the order.

Basically, I didn't cave, I stared them in the face without fear until they backed off. I believe you can find all the legal stuff online if you want to see for yourself. Heck there might be a blog about it one day.

I guess they racked up a $60, 000 dollar legal bill with their attorney's since that was the last figure I heard and laughed hysterically at. I suggested to their attorney to get that in cash from their client ASAP.

These people are kind of like the school yard bully. Don't cower down to them.

Don't think I'm not still on the case, because I still am. You know, the quiet before the storm as they say.

Todd Cruse Involved In Shady Business While In Sundquist Administration

Todd Cruse is married to Lesa Hensley.  Lesa is daughter of lobbyist Tom Hensley "The Golden Goose" in Tennessee politics.  

NewsChannel 5 Investigates: Friends in High Places
E-Mail May Provide Valuable Clues in Contracts Investigation
(Story created: 10/31/03)

First, there were raids. More recently, there's been a parade of witnesses before a federal grand jury investigating state contracts. Now, thousands of e-mails could provide important clues about how the Sundquist administration handled those contracts.

Millions of people communicate every day by e-mail.

So when investigators began investigating contracts handed out by the administration of former Gov. Don Sundquist, they quickly issued a federal grand jury subpoena for thousands of e-mail messages. Included was a demand for messages to and from Sundquist and other top officials.

The probe was prompted by our Friends in High Places investigation

"People put things in e-mails never expecting that they are going to have to explain them," says retired FBI agent Ben Purser.

A sampling of the e-mails provided to the grand jury -- and obtained by NewsChannel 5 -- deal with a request for proposals for computer services. RFPs, as they are called, are supposed to be judged by an impartial selection panel.

"What you are holding in your hands could very well be evidence," Purser tells NewsChannel 5's chief investigative reporter Phil Williams.

For example, there's an August 2002 e-mail from Sundquist's chief administrative officer Todd Cruse.

"When do you anticipate putting together the selection panel," Cruse asks the state's head of information resources. "I have an interest in who we choose."

Cruse would later become a lobbyist for SCB Computer Technology, one of the state's big computer contractors and a bidder for the job.

"Perhaps, and I emphasize perhaps, there could be some influence there," Purser observes.

Cruse, however, tells NewsChannel 5 he was just expressing a naive curiosity about how the process worked.

But that's not how it was taken at the time.

"Honoring his request is simply out of the question," wrote Richard Rognehaugh, then the state's new head of information resources, to Finance Commissioner Warren Neel.

Neel responded, "My guide is and remains.. keep the process clean and above reproach.

That same process was used to hand out hundreds of millions of dollars in contracts. Investigators will want to know if there were efforts to stack other selection panels -- and if there were other department heads who were more willing to go along with those efforts.

Cruse's e-mails also hint at pressure from powerful Senate chairman Jerry Cooper relating to a homeland security project.

"I would like to be able to tell Senator Cooper when he calls, again, that I am getting a response out to her by the end of the day," the Sundquist administration official wrote.

The "her" was Cooper's wife, who was lobbyist for a company that wanted in on talks about the contract.

Purser says, "The e-mails that you've shown me would demonstrate the amount of political influence that is being used in a process that is supposed to be void of political influence."

Those e-mails are just a tiny fraction of what the state's computer experts are recovering from computer backups. The grand jury subpoena demands messages from the highest levels of the Sundquist administration.

The subpoena for e-mail records was issued last December. But the state's computer experts say restoring backups has been such a massive chore that they still aren't finished with the job.

"Some of the folks did not appear to be habitual e-mail senders or receivers," Rognehaugh tells Phil Williams.

He says how much evidence that's available for the federal grand jury will depend upon the e-mail habits of the Sundquist administration officials now under scrutiny.

"The federal grand jury in any public corruption investigation is following a paper trail," Purser adds.

In this case, it's not paper -- but a trail of bits and bytes that some probably never realized they were leaving.

Smile Starters Complaint #101

I have read the article on the Smile Starters investigation. I wanted to share a story about my visit with the Winston-Salem, NC Smile Starters in 2001. I went in to have my teeth cleaned and see about having my wisdom teeth cut out. When I went in the I never had a problem with my teeth, not a spot on them. They took an x-ray and told me I had 8 cavities in all my mollars. When I asked about why my teeth didn't hurt or have any spots on them, they told my I had a rare tooth decay disorder that caused my teeth to rotten from the inside out. I was 17 so my mom didn't go with me and I didn't know I could tell them no they can't prefrom the fillings. So i let them start drilling my teeth, they gave my 10 shots in my mouth and I felt EVERYTHING!!! When I told the dentist this she told me well we have already given you too much medicine you are just gonna have to be a big girl. Then I was flinching and moving while she was drilling and her exact words to me were : "You better sit still or I'm going to cut your mouth all up. I can't stop drilling fast enough to keep from cutting you." They couldn't cut my wisdom teeth out that day so hey scheduled me for 2 days later. I went in that day and they broke my jaw removing my teeth! They claim that I had roots that are 1.5 cm longer than normal and they curved backwards and attached themselve to my jaw bone. On top of that they give my 800mg IBuprofen to manage my pain.This was the worst experience of my life. Since then I have had nothing but problems out of my back teeth. I was someone that use to pride myself on my teeth. Now I have these large black fillings in my mouth that I hate. I hope these so called dentist are not allowed to put their hands on anymore children.!!!

Thanks

Heather K

Who Owns Pueblo, Colorado

Emails question who owns Pueblo, Colorado.

________________________________________________

I had emailed you a few weeks back about the DeRoses and life here in Pueblo, Colorado. When driving to work each day I can't help but notice a very large and fancy building being constructed in a new business park in Pueblo. I was wondering what type of business it might be. Yesterday I received a flier in the mail for "Park West Dental". Owners: Dr. John Millea and Dr. Juliann Padula Millea. "General Dentistry for Youth". "Most insurances accepted including MEDICAID...." This new office is about a quarter mile away from the new YMCA in Pueblo which is being heavily funded by donations from the DeRoses.

A few observations...

1. Again, I guess I'm surprised how much money there is to be made practicing pediatric dentistry.. Am also amazed that with such an expensive and elaborate building that one would be purposely trying to attract Medicaid patients. Most physicians in town cringe at the thought of a Medicaid based practice as you would go broke in a short amount of time.

2. Is reimbursement for Medicaid dental services still too high? I don't think the original intent of the program was for dentists to get rich off it.

3. How much do you want to bet the financing for this pair of young dentists (each looks to be in their early thirties) came from the DeRoses?.. I have a hard time believing that they are financing the building themselves. There are too many coincidences.

Of course, none of this is illegal. It just raises a question in my mind about the potential for ongoing fraud given the associations noted---i.e. Padula-DeRose-child's dentistry-close proximity to the "DeRose" YMCA building, etc...

_____________________________________________

So I sent out an email asking about this and here is what I was told:

Yes the dental clinic is owned by Dr. padula which is Dr. Eddie DeRose's brother in law so I am guessing it is Dr. Padula daughter and son in law. Dr. John Millea use to work at....guess what....DeRose Dentistry or now known as Small Smiles of Pueblo on Liberty lane. The YMCA is being funded and built by Dr. Eddie DeRose. The clan down there involves Dr. Eddie DeRose, Dr. Adolph Padula(bro-inlaw), Dr. John Parrish(bro-inlaw). Both Padula and Parrish were part owners of Small Smiles before FORBA bought them out and I am pretty sure the non compete clause included them so hence....they use their kids names. Probably gonna start up new clinics under their names to run FORBA out of town.

____________________________________________

DeRose Involved In Health Club?

I found this post the other day on a website and was wondering if anyone has anymore information on this?

Dan DeRose is Mike DeRose's brother, and he was the subject of Medicare fraud charge in the mid-90s when he owned a local health club. The results of the lawsuit against him were never made public.

Pay for Preformance

As ridiculous as this concept is, I hope FORBA execs are first inline.

A Look Into Kool Smiles In Kentucky

Each week I'm going to be taking a look into state filings of Kool Smiles, I'm starting with Kentucky.

Organization Number- 0669850

Name- Kool Smiles, PSC

Type-Kentucky Corporation

Status-Active

Standing-Good

File Date- 7/30/2007

Last Annual Report- 5/14/2008

Principal Office- 400 Galleria Parkway, Suite 800, Atlanta, GA, 30339

Registered Agent-CT Corporation System, 4169 Westport Road, Louisville, Kentucky, 40207

 

Corporate Officers:

President: Tu Tran

Director: Tu Tran

Incorporator: Tu Tran

Kentucky- Small Smiles and FORBA Holding

Kentucky

FORBA Holding, LLC
Small Smiles of Lexington, PSC
Small Smiles of Louisville, PSC

3-17-09 report

FORBA Holding, LLC

Organization Number-0674614
Organization Name- FORBA Holding, LLC
Type-Foreign Limited Liability Company
State Originated-Deleware
Origination Date-4-17-2006
Status-Active
Standing-Good
File Date-9-28-2007
Principal Office-618 Church Street, Suite 520 Nashville, TN
Signed by Manager-Rodney Cawood, Manager, EVP, CFO

KY 2008 Annual Report
KY 2009 Annual Report

Small Smiles Dental Center of Lexington, PSC

Organization Number-0673476
Name- Small Smiles Dental Center of Lexington, PSC

Type-Kentucky Professional Corporation
Status- Good
Standing- Active
File Date - 9/12/2007
Last Annual Report- 7/29/2008
Principal Office - 618 Church Street, Suite 520, Nashville, TN 37219

Registered Agent- National Registered Agent, 400 West Market Street, Suite 1800, Louisville, Kentucky.
Authorized Shares- 1000
Current Officers:
President- Kenneth E. Knott
Secretary-William Nash
Director-Robert F. Andrus
Director-Robert F. Andrus
Shareholder-Robert F. Andrus
Shareholder-Robert F. Andrus

Incorporator- Kenneth E. Knott
Assumed Names:
Small Smiles Dental Center
Small Smiles Dental Centers of Lexington
________________________________________

Small Smiles Of Louisville, PSC

Organization Number- 0662918
Name- Small Smiles of Louisville, PSC
Type-Kentucky Professional Corporation
Status-Active
Standing-Good
File Date-4/24/2007
Last Annual Report-7/29/2008
Principal Office: - 415 N. Grand Ave, Pueblo, Colorado 81003 (isn't that FORBA's address in Colorado...hmmm)
Registered Agent- CT Corporation System, 4169 Westport Road, Louisville, Kentucky 40207
Shares-1000
Corporate Officers:
President- Jodi Kuhn
Secretary-William Nash
Director-Jodi Kuhn
Shareholder- Kenneth E. Knott
Shareholder- Robert Andrus

Shareholder-Jodi Kuhn
Incorporator-Jodi Kuhn
Assumed Names: Small Smiles Dental Centers of Louisville, Small Smiles Dental Clinic, Small Smiles Dental Clinic of Louisville.
____________________________________________
Now it's my understanding that Kenneth Knott and Robert Andrus were fired by FORBA over some 'credentialing fraud', but I don't know that as fact.
They used to be listed as the following until FORBA updated their Corporate Contact sheet in August or September last year.
Ken Knott- SVP Central Region
Robert Andrus-SVP West Region
So doesn't this mean these two either worked solely for FORBA and lent their name and dental licenses for business filings OR they owns the clinics in Kentucky as well as work for the company that so called 'manages" those clinics.
That being the case, should it not be these three, (Ken Knott, Bob Andrus, and Jodi Kuhn suing me in Federal Court instead of the company that just 'manages' the clinics for them?
But wait, according to the trademark office, FORBA Holding owns the rights to the Small Smiles logo. Boy this sure is confusing isn't it.


update: 2-1-2010

Small Smiles of Louisville, PSC

Kentucky Organization Number: 0662918
Formed 4-24-2007 By Jodi Kuhn

Name and address of Original Shareholder:

Jodi Kuhn
5615 Sarah's Oak Drive
Cincinnati, OH 45248

Name and address of Incorporator:

Jodi Kuhn
5615 Sarah's Oak Drive
Cincinnati, OH 45248

Mailing Address of Principal Office:

415 N. Grand Ave
Pueblo, CO 81003
Status-Active
Standing-Good
File Date-4/24/2007
Last Annual Report-6/17/2009
Principal Office: - 415 N. Grand Ave, Pueblo, Colorado 81003 (isn't that FORBA's address in Colorado...hmmm)
Registered Agent- CT Corporation System, 4169 Westport Road, Louisville, Kentucky 40207
Shares-1000
Corporate Officers:
President- Jodi Kuhn
Secretary-William Nash
Director-Jodi Kuhn
Shareholder-Jodi Kuhn
Incorporator-Jodi Kuhn
Assumed Names: Small Smiles Dental Centers of Louisville, Small Smiles Dental Clinic, Small Smiles Dental Clinic of Louisville.
(Note in 2009 report Dr. Robert F. Andrus and Dr. Kenneth E. Knott are no longer 'shareholders')
KY 2008 Annual Report
KY 2009 Annual Report
On June 25,2009 they finally changed the Principal Office address to FORBA Holding, LLC's address at 618 Church Street, Suite 520, Nashville, TN.

Ky Change of Principal Office 2009

___________________________________________________________________

Small Smiles Of Lexington, PCS

Kentucky Organization Number: 0673476

Formed 9-12-2007 By Dr. Kenneth E. Knott

Name and address of Original Shareholder:

Robert Andrus

1499 Blake Street

Denver, CO 80202

&
Kenneth Knott
7530 S. Biloxi Ct.
Aurora, CO 80016

Name and address of Incorporator:

Kenneth Knott
7530 S. Biloxi Ct.
Aurora, CO 80016

Mailing Address of Principal Office:

618 Church Street, Suite 520

Nashville, TN 37219
Organization Number-0673476
Status- Good
Standing- Active
File Date - 9/12/2007
Last Annual Report- 6/17/2009
Principal Office - 618 Church Street, Suite 520, Nashville, TN 37219

Registered Agent- National Registered Agent, 400 West Market Street, Suite 1800, Louisville, Kentucky.
Authorized Shares- 1000
Current Officers:
President- Jodi Kuhn

Secretary-William Nash
Director-Jodi Kuhn

Director-William Nash

Shareholder-Jodi Kuhn

Assumed Names:
Small Smiles Dental Center
Small Smiles Dental Centers of Lexington
(Note in the 2009 report Dr. Robert F. Andrus and Dr. Kenneth E. Knott are no longer 'shareholders' or 'directors')
KY 2008 Annual Report
KY 2009 Annual Report





Looks like Dr. Jodi Kuhn has laid a hell of a lot on the line for FORBA Small Smiles House of Horrors.

Kansas TV Station Looks Into Small Smiles

Families Concerned About Small Smiles

Posted: March 17, 2009 03:40 PM

Updated: March 17, 2009 09:30 PM

Jason and Naomi Pinkston called FactFinder Investigators shortly after taking their four-year-old daughter, Aerial, to the dentist. They say they knew right away something wasn't right.

"I feel they took advantage of my daughter to make a profit," says Naomi.

Jason says the family did research shortly after their experience at the clinic.

"All you have to do is Google these guys to get page after page of horror stories. It felt like a nightmare we couldn't wake up from," says Jason.

That nightmare, as Jason describes it, is the work Small Smiles performed on Aerial. The family showed us before and after pictures of Aerial's teeth. Her baby teeth were showing signs of decay so Small Smiles ground them down and put crowns on them. But the Pinkstons say their problems began before any work was performed.

"She didn't explain anything to me about why it would be important to Aerial to have crowns-whether we didn't do it what would happen or what a crown was. Absolutely nothing," says Naomi.

We don't know if the work was necessary; it's too late to get a second opinion because her teeth are gone. We can tell you four of Aerials front teeth that were crowned by Small Smiles will have to be pulled by another dentist.

We wanted to talk to Small Smiles about Aerial's dental work, but instead were referred to a company in Washington, D.C. Spokesperson Don Meyer tells us the clinic thinks Aerial's treatment plan was appropriate, but the execution was less than ideal. He says because of what happened, dentists in the Wichita clinic will seek continuing education.

"What we're finding is that some of our dentists may require some extra training on what's called a ‘New Smile Crown'," says Meyer.

Although Small Smiles markets exclusively to children, we were told none of the dentists at the clinic have pediatric qualifications. They are trained only in general dentistry.

We talked to pediatric dentists in the Wichita area. All of them told us many of their patients come from Small Smiles. Patients like Shelbi Meisch's daughter Amaya.

"She's terrified to see the dentist, still. Every time we go she's scared to go in," says Shelbi.

Like the Pinkstons, Shelbi doesn't feel her options were explained and Small Smiles ended up pulling six of Amaya's teeth.

"No they didn't tell me they were going to be pulling all those teeth. I was under the impression they were going to crown two back teeth and pull the front teeth," says Amaya.

Another dentist had to perform corrective work Amaya's case.

Then there is Stacy Luthy and daughter Emma. Stacy contacted us after learning we were working on the story.

"They informed me that they had a harness they put the kids in that restrains them. They made it sound routine and no big deal."

Stacy wasn't allowed to be in the room with her daughter when they went to Small Smiles about two years ago.

"About 20 or 30 minutes later they came out and said she had been throwing up. They brought her to me. She had been screaming. She was horrified. She was in tears," says Stacy.

Like Aerial and Amaya, Emma has also had corrective work performed. The teeth Small Smiles crowned fell out, leaving her with nothing until her permanent teeth come in.

The parents say all three girls now have to be sedated to even visit the dentist.

"She'll never not be afraid of a dentist, which is alone is horrible because it's such an important thing to do," says Naomi Pinkston.

That's why the Pinkstons came to us. To encourage other parents to ask the questions they didn't ask.

More Company Response:

Forba, the company that manages Small Smiles, tells us many changes were made in late 2007. They include some of the following:

• Parents are now allowed back with their children during visits. Small Smiles made the change after receiving complaints from parents.
• It conducted about 12,000 surveys seeking parental feedback.
• Working to better communicate with parents.
• Dentists have been retrained on the use of protective restraint
• Created a toll-free number for parents to call with concerns or complaints (1-877-302-KIDS)
• Kansas law requires dentists' offices to be locally owned. This is the company's response to corporate ownership concerns.

It is not uncommon for doctors and dentists to hire or outsource various professional and specialized services, including advertising, computer technical support, legal advice, and even human resource specialists to assist them in managing their practices. For example, the Kansas Medical Society created a practice management firm to provide a broad range of office management services to physician practices around the state. Such services are provided under a management services agreement, include a variety of services and are done for a negotiated fee, much like our agreement with Dr. Reza.

Click here for the transcript of the live chat that took place after the segment aired.

________________________________________

This blogger's Comments:

I don't care what kind of crap they say, Dr. Mohammad Reza Akbar doesn't own this clinic. At the Kansas Secretary of State's Office it says the mailing address is:

Linda Zoller
618 Church Street, Suit 520
Nashville, TN 37219
(FORBA Holding and FORBA Services Address, Linda Zoller is just the VP of the legal department and does most of the state business filings.

I don't even think Dr. Reza Akbar lives in Kansas but I could be wrong, he didn't used to.

As you noticed no one at FORBA would speak on camera, heck they don't speak off camera. They only send their PR guy, Don Meyer to appear, or write responses or start a blog to defend and promote the company. You would think Dr. Reza would want to defend his own clinic wouldn't you?

Don Meyer says a lot of changes took place in 2007. Well, evidently not near enough since I didn't start this until early 2008 and I've heard these horror stories for well over a year now, and they still keep coming in. All of their talk is nothing but Hogwash and they think people are actually going to be gullible to believe it.

********************************************************************************

Here is just one comment from the KWCH TV Website: (go to the bottom of the page and click on 'see all comments')

Whistleblower:

Thursday, March 19, 2009

To Jason, you are welcome and yes I am employed at Small Smiles. The guest brought up some good points...why am I still there? Partly because I do know what goes on and even if I can only save a couple of kids from being traumatized by the procedures and roughness that and unnecessary work I have done a little to stop some of it.

I know I can't stop it all but anything helps. Yes I will be out of a job but there will be a lot of kids that won't be put through this there. As for the dentist in Colorado....yes it is a different state but Small Smiles is nationwide and all of the training is done in Pueblo, CO for the dentists so you see...they have one way of training and we have had a number of dentists that were just as bad, maybe not taking drugs but doing terrible work or pulling permanent teeth when it should have been the baby tooth, or numbing the right side and then working on the left side and ignoring the child's screams of pain.

I know they have the same sub standard type of dentists across the nation. Maybe not ALL of them but a good portion of them are very substandard. The good dentists that we have had didn't last long. They left because they refused to work like that and didn't want to jeopardize their licenses. Trust me...when I first started working there I couldn't believe this type of care was actually going on in America. Maybe I will loose this battle and they will continue to operate but at least I tried and I know I have saved a few kids from the horror and pain along with the parents.

********************************************************************************
UPDATE:

By Michael Schwanke (WICHITA, Kan)
investigators@kwch.com
316-831-6166

Update:

STATEMENT FROM SMALL SMILES DENTAL CLINIC OF WICHITA

Every year we see thousands of children who receive compassionate, high-quality dental care at our dental center. Through our parent surveys, comment line and direct interaction with caregivers, Wichita families regularly express high levels of satisfaction with our care.

However, based on the story aired by Channel 12, an internal review of standards, quality and compliance has been initiated at the Small Smiles Dental Clinic of Wichita.

We take seriously any parent who expresses concern with their child's care, and we are always looking for ways to improve. We strongly urge any parent who has concerns to contact our parent hotline at 1-877-302-KIDS.

Kansas Dental Board is asking that anyone with a complaint regarding Small Smiles contact their office.
You can file an offical complaint at http://www.kansas.gov/kdb/ or call 785-296-6400.

________________________________________________
This blogger's comment:

1. The key word in that statement is the word "our". If Dr. Akbar owned that clinic wouldn't the term be "my" but no, they once again FORBA admits to owning these clinics.

2. I've heard this same statement over and over for 2 years! Why do you think that hotline number was set up in the first place?

3. The Kansas Dental Board has been alerted on several occasions about Small Smiles and their tactics and haven't done a darn thing so far. But I highly suggest you give it a go anyway.

4. I like to hear from those patients who were actually treated by Dr. Mohommad Reza Akbar himself.

Man Died After Having Wisdom Teeth Pulled; New Jersey Jury Awards $11 Million for Dental Malpractice

 

March 09, 2009 10:06 PM

In the largest oral surgery malpractice verdict in New Jersey history so far, a jury awarded $10.2 million this week to the family of 21-year-old Francis Keller of Woodbridge, who died from suffocation after having his wisdom teeth removed by oral surgeon Dr. George Flugrad, of Perth Amboy.

Because Keller had a genetic immune disorder which caused severe swelling in reaction to trauma, he should not have been a candidate for dental or any other surgery. The morning after his tooth extractions, he began to have trouble breathing, and suffered from throat swelling that ultimately led to suffocation and death.

The Middlesex County jury found that Dr. Flugrad committed malpractice when he extracted the wisdom teeth in full knowledge of Keller’s genetic condition.

Colorado Springs Gazette Mentions 20/20 Probe

Colorado Springs Gazette's reveals 20/20's probe into Small Smiles.

 

Small Smiles dentistry focus of ‘20/20′ probe

March 5th, 2009, 2:02 pm by Brian Newsome

Small Smiles Dental Centers, a national chain with offices in Colorado Springs, Denver and Pueblo,  will be featured Friday in a “20/20″ report about questionable practices. Small Smiles, which serves mostly children on Medicaid, has come under fire in various media stories for restraining kids, not allowing parents to be present with them, and doing unnecessary procedures to get Medicaid reimbursements Here is a YouTube clip from an ABC News investigation in the D.C. area.

A spokeswoman for “20/20″ confirmed the report will air Friday at 8 p.m. MST. Correspondent Deborah Roberts reported from Pueblo, according to 20/20 media relations publicist Alyssa Z. Apple, but Colorado Springs is not specifically mentioned.

I found the following over at "American Thinker".

By Brian Riley:

When President Obama recently nominated Kansas governor and universal healthcare advocate Kathleen Sebelius to be to the country's Secretary of Health and Human Services (HHS), the president of America's Health Insurance Plans (AHIP) called it "a very smart choice. She has a good intellect, a big heart and tremendous expertise." AHIP and its predecessor, the Health Insurance Association of America, have a track record of financial support for Gov. Sebelius dating back to the time she served as Kansas Insurance Commissioner.

Of course, the health insurance industry also supported President Obama's first choice, Sen. Tom Daschle. Daschle's financial backers included AHIP, which paid Daschle $40,000 for two speeches, and health-insurance giant United Health Care, which paid him $5,000 for "advice."

Many people criticized Daschle for taking money from the insurance industry. Few people asked the more obvious question: What were insurance companies doing paying thousands of dollars to someone who devoted his life to policies that could put them all out of business?

Daschle's book Critical: What We Can Do About the Health Care Crisis praises universal, single-payer healthcare as a worthy goal. However, he concludes that it would be politically problematic to implement such a system in the United States due to the opposition of special interest groups like the insurance industry.

Here is how AHIP, the health insurance industry's top trade association, responded to the nomination of someone who views the very existence of insurance companies as an obstacle to reform:

"Senator Daschle is exceptionally well qualified to bring people together in support of universal coverage, cost-containment, and improved quality."

The industry's philosophy -- not to oppose policies that would harm insurance companies and their customers; not to simply acquiesce to ridiculous demands; but to enthusiastically embrace changes designed to reduce the ability of average Americans to buy health insurance -- was on display during the recent expansion of the State Children's Health Insurance Program (SCHIP, commonly pronounced S-CHIP), the federal program designed to provide healthcare to children.

In the past, SCHIP benefits typically were limited to families earning up to 200 percent of poverty level. The legislation recently passed by Congress raises the cap to 300 percent of poverty level and allows states to raise the cap even higher, subject to lower federal subsidies for those additional benefits.

To qualify for SCHIP benefits, the government requires families to first drop their individual health insurance entirely.

If families do not have an individual policy but get their coverage through their employer, they may be allowed to keep their group coverage in some cases. States may offer this option if the employer pays least 40 percent of the cost, as long as the policies do not allow families to set up a health savings account to pay for their medical expenses.

As a result of provisions like these, many kids who enroll in SCHIP in the future will not come from the ranks of the uninsured, but from families that drop their private coverage in order to receive "free" government care. According to the Congressional Budget Office, even before these changes it already was the case that for every 100 children who qualified for SCHIP, 25 to 50 dropped their private insurance.

Imagine for a moment that you are the chief lobbyist for U.S. health insurance industry, and Congress is considering a law that would give government healthcare benefits to people who can afford to pay for their own insurance. Further imagine that Congress would require people who already have health insurance to drop that coverage in order to qualify for government aid. What would your response be?

Here is the actual response if the insurance industry, provided by AHIP:

"This vital legislation provides health security for millions of children in working families and builds momentum for comprehensive health care reform. Expanding coverage for kids is a big first step toward ensuring that all Americans have affordable, quality health care."

Some foreshadowing of the insurance industry's apparent death wish came during the U.S. Presidential campaign. Sen. John McCain proposed giving families $5000 each to buy their own health insurance, while Sen. Obama proposed giving everyone the option of a "new public plan" instead of private health insurance. My review of campaign donation data indicates that employees of the nation's biggest health insurers -- Aetna, Blue Cross, Cigna, Humana, United HealthCare, and Wellpoint -- voted with their dollars, giving over twice as much to Obama as to McCain.

In Ayn Rand's book Atlas Shrugged, industrialist Hank Reardon is stabbed in the back by his "man in Washington," Wesley Mouch. In the novel, Reardon is a relatively innocent victim of the man hired to protect his interests from Washington predators.

In the real world, the insurance industry is no innocent victim. For example, to head its Washington operations, the industry chose someone whose experience came from working for the AFL-CIO and, I am not making this up, the Committee for National Health Insurance, an organization formed by labor unions to lobby for "a truly radical overhaul of the health care system" with the federal government as the nation's only health insurance carrier.

I wonder how that job interview went:

Question: "Tell us a little about your experience."

Answer: "I've been working to put you all out of business."

Reply: "Great! When can you start?"

I personally know someone who recently was sent out of her local welfare office in tears, because an overwhelmed government bureaucrat mistakenly told her there was no state coverage available for her child's leukemia.

I know of a child who was hospitalized because her parents were not given government assistance to buy insurance, but instead were forced to use the local Medicaid-funded clinic where their daughter was misdiagnosed.

I have read stories in my local newspaper about children who are strapped to "papoose boards" like tiny Hannibal Lecters in order to get their teeth examined. Why? Because instead of providing financial assistance to low-income families to make dental insurance more affordable, the government instead forces them to go to Medicaid-financed dentists.

These horror stories are what we all have to look forward to as elected officials, aided and abetted by insurance industry lobbyists, gradually replace private health insurance with government-run healthcare.

Bryan Riley was the Republican candidate for Kansas Insurance commissioner in 1998, losing to incumbent Kathleen Sebelius.

I just wish that money was allocated to increase reimbursement rates to our private dentists. This would surely shut down these dental mills. Hit them in the pocketbook, right?

I encourage each of you to contact your state Legislators and Heath and Human Services Department and voice your opinion about increasing the reimbursement rates.

I was doing my weekly searches of various 'terms', one was 'medicaid fraud'.  One the second page or two of the results I ran across something at a very unusual website called jihadwatch.org.

Here are a couple of snippets from a comment I found there:

 

"Their attitude toward governments is strictly adversarial. Every man is expected to get away with as much as he can and trust extends to one's family and clan alone. When they come to the U.S. Muslim doctors start medicaid fraud mills and even those who run small groceries frequently launder money, deal in fake cigarette tax paper, etc etc. Parasites on an 'infidel' state. These aren't the 'bad apples'. These are the 'good Muslims'."

 

 

As for the behavior of Muslims in the West, why should they not fiddle the system of the Infidels? After all, it is only just, only right, that they take whatever they can from the Infidels, and cheating the government of an Infidel nation-state is not cheating, from a Muslim point of view, at all - nor is cheating Christians, Jews, Hindus and others who, in effect, are living on borrowed time -- until that moment when Muslims become stronger, and more numerous, and can impose their will, as they have, in the Muslim view, not merely a right, but a divine right, to do so.

Not every single Muslim, obviously, feels this way. But opinion polls and information of all kinds that goes far beyond the merely anecdotal evidence (though that anecdotal evidence is not to be dismissed), and simple common sense about what Islam teaches its Believers to believe, and which a great many of them clearly do believe, tells us that many of them -- a great many -- do indeed think this way, and act, when they can get away with it, upon it.

Dr. Maziar Izadi Leaving FORBA's Albany Access Dentistry?

It's been reported to me that Dr. Maziar Izadi of Small Smiles Albany, New York fame is leaving the practice. I don't know how true this is, but it came from a pretty solid source. 

If you remember he was the 'lead' dentist when this clinic was called Small Smiles, then the bad press hit the clinic with a series of reports from Steve Flamisch.

FORBA then changed the name of the clinic to Albany Access Dentistry, then tried to sell the public and New York's Medicaid System that it was under new ownership and the new owner was Dr. Izadi and FORBA was no longer involved. We know this not the be the case now, don't we.

Wonder who will be the lead dentist now, clearing throat, I mean 'owner' of Albany Access Dentistry.

Wonder if Dr. Izadi is getting ready to skip the country?

update:
He went to work at another clinic who was notified who he was, he was fired.  He then landed at Allcare or Aspen, I forget.

Emails Say FORBA/Small Smile's Revenue Down Due Since Having To Alter The Way They Treat Patients After Investigations

Jim Scarantino updates us on his look into New Mexico's Investment into FORBA/Small Smiles at the Rio Grand Foundation Website:

Newsflash: The State Investment Council doesn’t know what it’s doing with our money.

In the Rio Grande Foundation’s last report on the State Investment Council (SIC), we asked whether the SIC was really on top of what was being done with our money. We took a close look at one of the SIC’s smallest investments, a $550,000 acquisition of equity in a low-income dental chain called Small Smiles. We chose to investigate this investment for two reasons: (1) it would not be too large to overwhelm us; and (2) if we could get a handle on Small Smiles, then one would think the SIC would also have a full grasp of the facts surrounding this modest investment.

We were able to gather a full range of information about Small Smiles. That information revealed its foreign corporate ownership as well as a raft of scandals about the way Small Smiles mistreats children and bills Medicaid for its services. All of that information came from sources other than the SIC. The SIC could not answer even the question as to how much of the state’s money was invested in Small Smiles. We ended up knowing more about this investment than the SIC itself.

Our suspicions that the SIC does not know what is being done with our money were confirmed in a review of documents recently produced under a Public Records Act inspection.

In late November 2008, we filed a request to inspect every document—every memorandum, e-mail, report and letter—containing any information about Small Smiles. We were able to inspect the documents at the SIC’s offices on Wednesday, January 7, 2009.

For an investment of over half a million dollars that has been its portfolio for nearly two years, the SIC had only 73 pages in its files. Many of those pages were duplicates of the same e-mails. Many were simply lists of companies. Many of the pages were merely cover letters containing no substantive information. Close to half of the pages produced did not mention Small Smiles at all.

Some of the pages simply mentioned the words “Small Smiles” once without providing any information about the company, its finances, or operations. For instance, a list of all the New Mexico companies in which the SIC was invested would merely name Small Smiles, but would say nothing about the company’s affairs. Numerous versions of documents of that nature were among those turned over by the SIC.

The e-mail correspondence conclusively shows that the SIC has been negligent in monitoring this investment. A little over a week after the Rio Grande Foundation began asking questions, an e-mail dated December 5, 2008, was sent from Brian Birk, the managing partner of Sun Mountain Capital, to Bruce Duty, a partner in Red River Ventures. Sun Mountain Capital is the investment firm in Santa Fe that manages the SIC’s New Mexico’s private equity investment program. Red River Ventures is the venture capital firm that made the investment in Small Smiles in 2007.

“Hi, Bruce,” Birk writes, “it’s been a while since we’ve touched base….I was over at the SIC talking to Greg K [Greg Kulka, the SIC’s Director of Private Equity and ETI Investments] and somehow the topic of Small Smiles came up. As I recall, RR [Red River Ventures] has an investment in the company. Was that in the parent company, a subsidiary, or ??? If you could provide a little color that would be appreciated. Also, Greg and I could not remember the last time we received a quarterly report from Red River. Could you e-mail us your latest, and are you current in your reporting?” [Emphasis added]

Several things stand out. First, the SIC and its venture capital manager reveal they did not know where the money for the Small Smiles investment had gone, into “the parent company, a subsidiary, or ???” Yet, in its 2007 year-end report, the SIC touted Small Smiles as one of the “New Mexico companies” in which it had proudly invested taxpayer money. From all the records reviewed, including years of meeting minutes, this is the first time the SIC ever asked where our money went.

Second, the e-mail proves that the SIC and its venture capital manager were not staying on top of this investment. They “could not remember the last time” they had received a quarterly report from Red River. The SIC’s ignorance was so bad it had to ask Red River whether it was current in its reporting, instead of being able to ascertain that information from the SIC’s own files.

Bruce Duty of Red River Ventures answered two days later, December 8, 2008, at 3:06 p.m. All of the deletions were made by the SIC before disclosing the correspondence to us.

“Brian and Greg:

Yes, it has been a while since we’ve spoken.

Unfortunately, every company in Red River’s portfolio is being impacted to some degree by ‘the storm.’ Those suffering the highest stress include Small Smiles and [deleted]. For both of these companies, the story is too much acquisition debt and too little EBITDA [earnings before interest, taxes, depreciation and amortization]. [Deleted] and [deleted] have never been profitable and will need to raise cash to avoid failure….

The situation at Small Smiles is [deleted]. The company has endured a year of adverse publicity that triggered investigations by the DOJ and 16 state AGs. Because of the intense scrutiny, the dentists across the system have significantly reduced the way they practice, resulting in the revenue per patient visit falling from over [deleted] a year ago to [deleted] currently.

This the first time in nearly two years of holding an investment in Small Smiles that the SIC was informed of the scandals entangling company’s operations. A review of the minutes of the SIC’s meetings and the meetings of the New Mexico Private Equity Investment Advisory Council show that Small Smiles was never once mentioned or discussed by the people who supervise investments of state money.

This e-mail sheds light on the problems with Small Smiles’ billing practices. The company is being investigated for overcharging and performing unnecessary procedures. It faces allegations that its dentists worked under billing quotas, and did unnecessary work to hit their numbers. Small Smiles has been suspended from some state Medicaid and private insurance programs because of its unethical billing practices. The fact that Small Smiles dentists “have significantly reduced the way they practice, resulting in revenue per patient falling” lends credence to the allegations against Small Smiles. It indicates that Small Smiles dentists were providing treatment based not on what was medically necessary, but based upon revenue targets.

This time Greg Kulka, the SIC’s Director of Private Equity and ETI Investments, sent the follow-up e-mail to Red River. About one hour after receiving Bruce Duty’s first detailed report on Small Smiles he writes:

“Bruce, My main question is about Small Smiles. I know they have offices here in New Mexico. Are they headquartered here? In other words, are they considered a New Mexico company? Please let me know. Thanks.

Remember: the SIC’s 2007 annual report boasted of its investment in Small Smiles, identified as “a New Mexico company.”

Bruce Duty of Red River wrote back within minutes:

“Greg, the corporate offices of Small Smiles are in Nashville, TN. Small Smiles has three clinics in New Mexico—two in Albuquerque, one in Santa Fe.”

In fact, as Rio Grande Foundation has reported, though Small Smiles has corporate offices in Nashville, it is owned by Arcapita Bank of Bahrain.

What Now for the State’s Small Smiles Investment?

The December 2008 report by Sun Mountain Capital lists 54 New Mexico companies in which the SIC has made investments under its private equity program. Unlike the 2007 annual report, Small Smiles is no longer on the list. But $550,000 of New Mexico taxpayers’ money was invested in Small Smiles on the premise it was a New Mexico company. What has happened to that money? Has Red River been required to return it? Or has the SIC simply written off its investment in Small Smiles?

The Rio Grande Foundation posed to these questions to the SIC. We have received no direct answer, only a retort that we “obviously don’t understand private equity.”

Our research shows it is the SIC that should be asking the questions we’ve been asking. We may not “understand private equity”, but we do understand that taxpayer dollars, unbeknownst to the SIC, were invested in an Arabian owned business that abuses children, and that has been excluded from Medicaid programs because of unethical billing practices and that is under investigation in nearly every state where it operates, We—ignorant as we are about “private equity”—were the ones who brought these facts to the SIC’s attention.

Taxpayers pay the State Investment Officer Gary Bland a salary in excess of $300,000. He has a fiduciary obligation to manage our money prudently. That requires knowing what is being done with that money. In the case of Small Smiles, he has obviously failed to meet his obligations to taxpayers.

The private equity program pushed by the Richardson Administration requires the SIC to pour hundreds of millions of dollars of investments in New Mexico private equity. This has resulted in a rush to get money out the door into the hands of venture capital risk takers. The SIC does not have the staff needed to adequately supervise those investments. Consequently, the SIC has deferred excessively to outside investment firms.

We have not seen any real, traditional investment returns from the quarter billion dollars poured into the New Mexico private equity program. We are, in fact, losing money in many of those investments. The SIC does not reveal these losses in its annual reports. Instead, it continues to paint a rosy picture about its investments. That picture, as demonstrated in the Small Smiles investigation, is misleading and false.

The Legislature needs to take a hard, detailed look at the SIC’s private equity investments. It needs to dig beyond the glossy pages on the annual report. It needs to go over each of the “New Mexico companies” listed and ask of each of them: are they profitable, have they paid us any dividends, have we made any capital gains, and, if not, why in the world are we continuing to lose money in failing companies?

The only defense offered by the SIC of these risky investments is that they “create jobs.” The Legislature should also dig into those claims, and demand a company-by-company accounting of these job-creation claims. The Small Smiles investigation conducted by the Rio Grande Foundation shows that the information in the SIC’s annual report is not reliable. If claims about a small investment are so dramatically false and misleading, it calls into question the validity of claims about larger expenditures, and whether large losses are being hidden in the SIC’s files.

Complaints Still Coming In: Little To No Improvement Since Steven Adair Joins FORBA/Small Smiles

What exactly is Dr. Steven Adair doing to stop the abusive and poor quality dental care at FORBA/Small Smiles clinics?

A few months ago FORBA announced he was Chief Dental Officer. However I've been told that he's really just a part time advisor and sends out emails now and then. I don't really know exactly what he's supposed to be doing, but so far I'm not seeing much. Maybe he needs to send his emails to me as well.

Rochester, NY, Massachusetts and Cincinnati, Ohio came in over the weekend. Actually all on Sunday. Three emails from three different states and clinics and they all sound pretty much the same. It's hard to deny the fact that this abuse is widespread, isn't it?

Below are three emails I received over the weekend. Actually I got all three of these on Sunday. Just when I thought things might have gotten a bit better I find the same complaints just keep coming in.

Of course my advice to these people were to file complaint with Federal and State authorizes as well as dental boards.

I would also like to offer this:

1. Get copies of ALL of the patient chart including x-rays and make sure the parents compare the original chart to the copied records to make sure they get them all. Our office mgr is famous for only copying the pages she wanted copied which just made me furious.

2. Get those records to another dentist for a 2nd opinion or even to the medicaid office or whatever insurance they have.

3. Check with the insurance carrier or medicaid to see what was actually billed and make sure it all adds up. If it doesn't add up file a complaint with your state Attorney General and Board of Insurance as well as the agency who oversees your medicaid program.

My name is M***** C*********** and I am the grandfather of a three year old girl (A******* *******) that has had a traumatic incident with the Small Smiles clinic here in Rochester NY. A********* had in our opinion been traumatized at the dentist. She was restrained, intimidated and tortured to the point her capillaries in her eyes broke! This so called dentist insisted on capping her baby teeth to reduce further damage to her teeth!!! Her baby teeth!

This procedure resulted with my granddaughter’s gums becoming enflamed and swollen. When my step daughter (Sarah Minor) returned her to little smiles for an emergency visit she described the resident dentist as “jamming” an inspection mirror into her mouth in an attempt to PRY it open! When she freaked he exclaimed “he was bitten earlier in the day and didn’t want it to happen again”. After a short visual exam (not even five minutes) she stated “he did not see anything and for her to brush more”!

That night the pain became so unbearable for her that she was rushed to the emergency department at Rochester General. It was here that the ER dentist told Sarah she had a bad infection and required immediate surgery before it turned into a health issue!! To date she has had one such surgery and is scheduled for another due to the depth of the infection around the capped teeth!

When I did an Internet search to see if this company had any other complaints I could not believe what I read. Everything that was written by other parents – word for word- was what happened to A********. This is how I was directed to your office and am filing an official complaint!

I am going to try and contact the other parents as well as legal counsel to see the extent of our rights but someone from your end has got to do something also .All these new parents are trying to do the best they can and are being taken advantage of.

There needs to be tighter laws and regulations regarding medical practitioners dealing with children. If they think they can tie up our children and torture them with no consequences they have another thing coming!

Sincerely,

M******** L. C*******

For S******* M******** mother of A******* *********

________________________________________

Hello,
I don't know exactly where to begin...but myself and a friend are looking into the Small Smiles practices in MA, after both of our sons had questionable experiences. Her son was put in a papoose restraint for a non-emergency visit. We are serious about doing something, but are looking for advice as to where to begin. Any thoughts?
Rachel

_________________________________________

i read somewhere to contact you about small smiles. I am a former employee of the clinic in Cincinnati, Ohio and for the rest of my life i will be ashamed of the things i was made to do. i attended a dental assisting school and right after that i was sent to work at small smiles i hardly knew anything about dentistry and the laws and regulations in the dental field. small smiles told us we had to do this we don't talk about that we work fast fast fast and do as much as we can but it was never good enough! ever morning they would have a meeting about how we have to make more money in order to keep the place open. i know now that was a lie! things got so bad i watched as a doctor place a mirror so far back into a three year olds mouth that he gagged and then the doctor leaned down by his ear and told him to shut up or he will do it again!! i reported the man to the cooperate office and they promoted the doctor to regional manager!!! i couldn't take it anymore and i wanted to make dental my career and i knew i couldn't stay with small smiles and have a good conscience. Please feel free to email me back or anything I feel an obligation to help shut them down.

New Mexico Watchdogs Looking Into Taxpayer Money Given To FORBA/Small Smiles

Looks like a 'can of worms' has been opened in New Mexico in regards to FORBA/Small Smiles. It appears more 'watchdogs' are jumping on the bandwagon questioning FORBA and it's Small Smiles Clinics, especially in New Mexico.

New Mexico is where government decided to give FORBA/Small Smiles New Mexico taxpayer dollars as a gift to help FOBA open a couple of clinics. Serious questions are being raised as to why and how FORBA/Small Smiles ending up getting that money.

1. Rio Grand Foundation Story

2. Paul Gessing Article

3. Jim Scarantino Report

4. Mario Burgos Blog

Below is Jim Scarantino's Report:

Nothing to Smile About: New Mexico’s Curious Investment in Small Smiles Dental Clinics

Does New Mexico’s State Investment Council know what is being done with the tens of millions of dollars it has invested in New Mexico venture capital? That doesn’t seem to be the case, at least in the instance of one curious investment.

In its 2007 annual report the State Investment Council (SIC) reported it had acquired ownership positions in 45 New Mexico companies. These investments amounted to $141.4 million. That sum includes the $19 million invested in Eclipse Aviation, which is now in bankruptcy. The report does not disclose how much New Mexico has invested in these companies or what percentage of their stock is owned by New Mexico state government as the result of these equity acquisitions.

The Rio Grande Foundation has been asking the SIC for that information for two months So far, the SIC has not been able to provide an answer. It does not seem to be any more readily available to the SIC than to taxpayers who want to know what is being done with their money.

Except for the Eclipse Aviation investment and the millions invested directly in Earthstone, a Santa Fe cleaning products company, the rest of the SIC’s current investments in New Mexico companies have been made in partnership with a venture capital funds that are based in New Mexico or have an office here, though their principal office may be in another state.

As Charles Wollmann, the SIC’s Public Information Officer explains it, the SIC relies on these investment firms to determine how much is invested in each company. Accordingly, that information is not readily available to the SIC…or New Mexico taxpayers. Indeed, Wollmann has cautioned that some of this information may be proprietary and not for public disclosure.

The Rio Grande Foundation has taken a closer look at Small Smiles, one of the 45 New Mexico companies identified in the SIC’s 2007 report. We have learned that Small Smiles is not truly a “New Mexico company” but is a multi-state chain of Medicaid dental clinics owned by out of state interests and managed by a company whose ownership can be traced back to the small Arabian nation of Bahrain. Our investigation also reveals that by investing in Small Smiles the SIC has bought into a company with a record of abusing child patients and engaging in unethical billing that has put it under government investigation. And, as we have learned, there are more public relations troubles brewing for Small Smiles.

Small Smiles, a New Mexico Company? Try Colorado, Tennessee or even the Middle East.

Small Smiles operates Medicaid dental clinics for low income children and infants in nineteen states and the District of Columbia. It began operations in New Mexico in 2007, opening one clinic in Santa Fe, one on Albuquerque’s west side and one in southeast Albuquerque.

Through its partnership with Red River Ventures of Plano, Texas, the SIC acquired equity in Small Smiles in 2007. Bruce Duty, a director of Red River Ventures, told the Rio Grande Foundation that his company invested a total of about $5.5 million in “Smile Smiles, LLC.” About 10%, or $550,000 of that investment came from New Mexico’s SIC. The rest came from other investors, including the United States Small Business Administration.

There is no New Mexico corporation identified in the records of the New Mexico Public Regulatory Commission as “Small Smiles, LLC.” Instead, the Public Regulatory Commission corporations archive reveals three Small Smiles professional corporations corresponding to each of the three clinics. Each of the Small Smiles dental clinics was incorporated as a separate professional corporation.

None of the directors of the New Mexico Small Smile clinics are New Mexicans.
The director of the Santa Fe clinic and the clinic on Albuquerque’s west side is Kenneth E. Knott. He is a Senior Vice President of FORBA of Nashville, Tennessee. FORBA is one of the nation’s largest dental clinic chains. (More on FORBA below). Knott is a busy man. He is also a dentist, and is licensed in Ohio, the District of Columbia, Connecticut, New Hampshire, South Carolina, Kentucky, Oklahoma, and Virginia. He also is the director of Small Smiles Clinics in Akron and Youngstown, Ohio, Ft. Wayne, Indiana, the District of Columbia, and Reno, Nevada.

The director of the Small Smiles clinic in southeast Albuquerque is Adolph R. Padula. He is a retired dentist from Pueblo, Colorado. He is related by marriage to the DeRose family of Pueblo, Colorado, the founders of the Small Smiles chain of Medicaid dental clinics.

The corporate records of all three New Mexico clinics give either mailing addresses or identify a principal out of state address in Pueblo, Colorado.

So how does this tie Small Smiles to the Middle East? Follow the thread a little bit further.

First, we have to go through Pueblo. That’s where Small Smiles began, growing out of the DeRose dental clinic. The DeRoses once owned a string of dental clinics across the country catering to Medicaid patients. They sold their interest in Small Smiles to FORBA. Dr. Michael DeRose, one of the founders of the Small Smiles chain, in 2007 agreed to pay the federal government $10 million to settle charges his clinics had charged Medicaid for unnecessary procedures, such as capping children’s teeth. As reported below, this is an allegation that continues to arise against Smile Smiles clinics even after the DeRoses sold their interest to FORBA.
All Small Smile clinics are now managed by FORBA, which also began in Pueblo. FORBA owns the trademark on “Small Smiles.” FORBA stands for “For Better Access.” It has grown into one of the nation’s largest dental care management companies. It reported revenue of $142.2 million in 2006. That year it was acquired by a Sanus, a Nashville-based holding company, and then moved its main corporate offices to Tennessee. It continues to maintain some operations in Pueblo.

Sanus, in turn, was acquired by Small Smiles Holding, LLC, a company formed for the express purpose of acquiring Sanus.

But Nashville isn’t the end of the line. The terminus is Bahrain. In January 2007, just before SIC’s investment in Small Smiles, Sanus sold FORBA for $435 million to Arcapita Bank of Bahrain.

In sum, instead of investing in a New Mexico company, the SIC’s partner has invested in a company owned by a bank on the Arabian Peninsula. The SIC’s 2007 report, claiming an investment in a New Mexico company called Small Smiles, is incorrect.

Grim Smiles
At the time that the SIC’s money was being invested, Small Smiles was the subject of a damning Emmy Award winning expose’ of its medical and business practices in Washington, D.C. area clinics. WJLA-TV of Washington, D.C. launched its investigative report with film footage of a screaming child being restrained on a “papoose board” while his mother was excluded from the room. The series of investigative reports also discovered that Small Smiles was using unlicensed x-ray technicians and billing Medicaid for hundreds of thousands of dollars in unnecessary dental work, including pulling children’s teeth without a valid medical reason.
“Drilling for Dollars,” triggered a criminal investigation by the Maryland Attorney General. Several insurance companies suspended Small Smiles and directed patients to seek dental work elsewhere. The report elicited complaints from patients and employees around the country that were collected at the television’s website.
In May 2008, New York terminated Small Smiles’ participation in its Medicaid program in response to reports by CBS-6 news of Albany that its Colonie clinic was performing unnecessary procedures such as needlessly crowning teeth. When Small Smiles challenged these claims, more than one hundred parents came forward with complaints of mistreatment backed by photographs. As in Maryland, parents were not permitted to be present with their children during examinations and dental procedures. A dozen parents also reported that their children were restrained on a “papoose board.” Some parents reported their children screaming in pain because the dentist operated before anesthesia took effect or operated without any anesthesia at all. Parents also reported the use of dirty dental instruments. Lawsuits have been filed by several parents against Small Smiles based on these allegations.
Small Smiles has drawn the ire of New York’s United States Senator Charles Schumer. After the New York Office of the Medicaid Inspector General revoked their Medicaid authorization, he issued a statement saying, “"I'm glad they're terminating Small Smiles," said U.S. Sen. Chuck Schumer (D-NY), a staunch critic of the company. "They don't deserve to be in business and certainly not get any federal money." Sen. Schumer says he has seen news reports documenting similar allegations against Small Smiles clinics in Denver, Rochester, and Washington D.C. "They ought to prosecute some of the people who did this," he told CBS-6 via satellite from Capitol Hill. "This goes beyond a mistake. This is hurting our children and ripping off the federal government...and I think there ought to be a criminal investigation of this."

Similar allegations against Small Smiles clinics in Kansas have been reported by The Wichita Eagle and in Colorado by KUSA-TV of Denver.
Debbie Hagan of Owensboro, Kentucky collects complaints from Small Smiles patients and parents at her blog, “Dentist the Menace.” (www.debbiehagan.blogspot.com). She also receives reports from dentists who have worked in Small Smiles clinics. One person identifying himself as a dentist who worked at a Small Smiles clinic wrote, “I was disgusted with the way children were treated. I wouldn’t take a dead snake to that place.” FORBA has sued Hagan for defamation and posting what it claims are copyrighted internal company documents. That has not stopped Hagan from continuing to run her blog.

The bad publicity for Small Smiles and FORBA may be getting worse. Good Morning America recently aired parents’ complaints against Small Smiles. Additionally, ABC’s nationally televised investigative news program “20/20” has completed a critical report on Small Smiles. According to its producer, Glenn Ruppel that report will air very soon.

What Did the SIC Know and When Did It Know It?
The SIC does not seem to have been aware of any problems with Small Smiles while its partner Red River Ventures was investing taxpayer dollars in that troubled company. A review of all the minutes of meetings from 2007 and 2008 of the State Investment Council and the New Mexico Private Equity Investment Advisers Council, which advises the SIC on private equity investments, did not reveal any discussion of nor any report on Small Smiles.
The SIC had no response when asked if it was aware of the history of problems of Small Smiles’ clinics. The SIC does say it is no longer categorizing Small Smiles as a New Mexico company.

Below is a Snippet from Mario Burgos Blog Entry:

How is it that the SIC has had so many questionable (I'm being kind here) and ill-fated investments? Well, you might remember that it has been standard policy under the Richardson administration to fire those advisors who did not want to issue rubber stamp endorsements of shady (okay, sugar-coating is not really my style) deals that Governor Richardson wanted to see approved.

That's right, I said, "Deals that Governor Richardson wanted approved." After all, the Governor is the chairman of the SIC. Now, in light of all of the recent scandals, you may be wondering if the Governor has ever received any campaign contributions from anyone connected to Small Smiles.

Well, I'm glad you asked. As it turns out, the Chairman and CEO of the holding company for Small Smiles is Michael Lindley of Nashville, Tennessee. Mr. Lindley did indeed donate a $1,000 to our Governor's presidential campaign. He also gave a $1,000 to Congressman Ben Ray Lujan's campaign.

Of course, my guess is that our Speaker of the House Ben Lujan solicited the funds on his son's behalf. After all, other than the imprisoned former State Senator Manny Aragon, the only other elected official to recieve funds cycle after cycle from Small Smiles in New Mexico is Speaker of the House Lujan.

New Mexico Investment Council Blasted For Small Smiles Investment

Remember a week or so ago I reported on Small Smiles in New Mexico. Plus I had reported last year that I thought it was odd the two top dogs at FORBA had made political contributions to a New Mexico lawmaker. Well, it appears others in New Mexico have taken notice to Small Smiles as well.

Click Here for the Story

State Investment Council needs a closer look

By Paul Gessing/For the Sun-News

Posted: 01/08/2009 12:00:00 AM MST

The pending loss of New Mexico's $19 million investment in Eclipse Aviation raises important questions about how wisely the State Investment Council (SIC) is handling our money. This is not the first private equity investment by the SIC to go sour. New Mexico lost a $7 million investment in TCI Medical, a start-up nuclear medicine company that was supposed to create 100 jobs in Carlsbad but employed just seven people. The SIC also lent about $2 million to Millenium Transit, a bus manufacturing company in Roswell. That company is now in bankruptcy.

The SIC does not seem to know exactly what is being done with New Mexico's money. It claims to have bought equity positions in 52 New Mexico companies, but it cannot say, despite repeated requests by the Rio Grande Foundation, how much money it has in each of these companies or what percentage of each company's stock is owned by New Mexico taxpayers.

The Legislature, at Governor Richardson's urging, has authorized the SIC to invest up to 9 percent of the Severance Tax Permanent Fund in acquiring stock in private New Mexico companies. This is a substantial amount of money. At the end of 2007, the SIC had over $141 million invested in private New Mexico companies.

So far, the SIC's New Mexico private equity program hasn't produced hard returns for New Mexico taxpayers. For years, the SIC claimed its New Mexico private equity program was in the black. But favorable (and inflated) valuations for Eclipse, the largest holding in the portfolio, accounted for those paper gains. With Eclipse in the tank, the false bloom is off the rose.

Even some of the SIC's smallest acquisitions look questionable. Take for instance, its investment in Small Smiles. The SIC's 2007 annual report showed an investment of an unstated sum in this New Mexico company. By directly contacting the venture capital firm that handled this investment, the Rio Grande Foundation learned that about $500,000 New Mexico taxpayer dollars have been invested in Small Smiles. The SIC itself had not been able to answer this question.

Contrary to the SIC's annual report, Small Smiles, is not a New Mexico company. It is a national chain of low-income dental clinics owned by a bank in Bahrain. Furthermore, at the time half a million taxpayers dollars were going to help Arab investors, Small Smiles was being blasted in an Emmy Award winning investigative television series called "Drilling for Dollars." Small Smiles clinics in the Washington, D.C. area were exposed for abusing children by strapping them to "papoose boards." Small Smiles had engaged in unethical billing practices. Parents came forward with complaints of unnecessary dental work being performed on their children without their consent.

The same complaints about Small Smiles arose in New York, Colorado and Kansas. New York Senator Charles Schumer has called for criminal prosecution and disqualification of Small Smiles from the Medicaid program. New York, in fact, did revoke Small Smiles' Medicaid credentials.

A review of SIC meeting minutes shows not one mention of Small Smiles' difficulties. In fact, Small Smiles wasn't discussed once though a half million dollars were invested in this troubled company.

The Eclipse bankruptcy proves that politicians and their appointees make very poor judges of the next big breakthrough in aviation or other technologies. The fact that even in its smallest investment the SIC seems less than completely informed should make taxpayers concerned about whether their money is being prudently managed.

There is scant oversight of the SIC's investment practices and decisions. Only when a big investment like Eclipse craters does the public learn of losses. It's time the Legislature revisit the discretion it has given the SIC, and provide for greater transparency and more informed decision making. It should also ensure inescapable accountability for those who make the wrong calls in handling the public's money.

Paul Gessing is the President of New Mexico's Rio Grande Foundation, an independent research and educational organization dedicated to principles of limited government, economic freedom and individual responsibility.

Small Smiles Investor Receives Bail Out Money

Cit Group received 2.33 Billion in Bail Out (TARP) money according to the website.

Since I have never professed to understand the complicated maneuvers FORBA/Small Smiles made in late 2006 I'm not going to even try to explain the relationship between Cit Group and FORBA/Small Smiles other than to quote an article from streetinsider.com.

November 20, 2006 3:37 PM EST

American Capital Strategies Ltd. (Nasdaq: ACAS) has invested in Small Smiles Holding Company LLC, a holding company formed to acquire Sanus Holdings Inc., a leading dental practice management company. American Capital's investment takes the form of senior subordinated debt, holding company PIK notes and common equity and supports the acquisition of Sanus by affiliates of Arcapita Inc. and the Company's senior management.
A syndicate led by CIT Group Inc. (NYSE: CIT) has arranged a revolving credit facility and a senior term loan. The Company's management team and private investors are investing in the equity of Small Smiles.

Is Kool Smiles Coming To a Place Near You?

Here is an anonymous email that stated:

I am a dentist that currently works at Kool Smiles. There are many corporate habits that just turn my stomach but I go along because they keep paying me. One thing is that we do not do is change rubber gloves between patients. Can you imagine the health risks that we are taking doing this?

It makes me sick.

Something must be done.

FFl have given Kool Smiles in Atlanta 48 million dollars to expand and DPMS (in San Ramon, CA) another 48 million to expand so they can sell the company off in 2010.

If people are visiting your site, they must be concerned about the impact that you are having with everyone reading your blog. They want to sell the whole thing to someone for hundreds of millions of dollars.

FFL (Friedman, Fleischer and Lowe) has two companies to keep an eye on in their portfolio.

DPMA

From FFL's, Website:

DPMS, Inc. provides various non-clinical services to dental group practices, including providing dental facilities, support staff, and other business services. DPMS's principal 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 was founded in 2006, and is headquartered in San Ramon, CA.

and

NCDR, LLC (Kool Smiles)

From FFL website:

NCDR, LLC provides various non-clinical services to dental group practices, including providing dental facilities, support staff, and other business services. NCDR's principal 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.

Small Smiles Seeking Dentists In Several Clinics

If you are interested in a job with Small Smiles in any of the following cities:

Aurora, Colorado

Colorado Springs, Colorado

Pueblo, Colorado

Reno, Nevada

Wichita, Kansas

Oklahoma City, Oklahoma

Tulsa, Oklahoma

Montgomery, Alabama

Dothan, Alabama

Roanoke, Virginia

Albany, New York

or

Boston, Massachusetts

and are interested in treating young underserved children they offer excellent base salary, promotion opportunities and benefits (including monthly bonus potential, then click here to apply.

Aggressive or Overtreatment

In an interview a Small Smiles lead dentist, Aldred Williams said:

"We aggressively treat these children to eliminate disease in their mouth. Small Smiles makes no apologies for that. I'm not going apologize for being aggressive," Williams said.

The word 'aggressive' really bothers me. What's worse is to think thats the 'training' the dentists get (could call in brainwashing I suppose).

I guess a person could insert "overtreat" in place of "aggressive" couldn't they an it still have the exact same meaning.

Of course I don't think Dr. Williams is there any longer after saying that publicly to the mainstream media.

I got this particular quote from the Good Morning America story on Small Smiles, but it was said in the interview with Roberta Baskin at WJLA aas well, I believe.

Here are other quotes from the Good Morning America and WJLA TV story:

1. Former Small Smiles dental assistant, Deborah McDaniel, said she was fired for objecting to the way children were being handled.

2."They wanted us to tell parents that they needed services on teeth that were healthy," McDaniel said. "They were healthy and they didn't need it."

3. "It's a competition throughout the country to see who can convert the most patients, not give the patients the most care," said Trina Crosby, another former Small Smiles employee.

4. The pressure to convert patients may come from FORBA. In fact, every morning Dr. Williams and his staff review the production goals set by the managers in Colorado.

7."They're sweating. Sometimes they urinate on themselves. They'll throw up," Crosby said.

5."It does no good for anybody but the dentist, I guess, who's looking for a bonus," said Robert Camps, a nationally recognized authority on pediatric dentistry whose Maryland practice serves mostly patients on Medicaid.

6.When Camps saw video of Miguel's dental visit, he was disturbed deeply. "It's traumatic for me to watch. I can only imagine how traumatic it is for Miguel," he said.

7.FORBA, the company that owns Small Smiles, said its dentists and staff are sent to its Colorado offices for training. (but I hear only the "lead" dentists are sent for training)

There were 158 comments on this story, you can read all of them here.

Here are just three:

1. I think ABC news should do an undercover investigation on the Small Smiles chain. I mean in every clinic. In one month's time, you would uncover mistreatment of children, insurance fraud, ADA violations, etc. As someone mentioned before - when a new doc joins a clinic and are yet to be accredited with an insurance company - other docs sign off on the chart and the insurance is billed under the signing dentists name. BTY - although it was never publicized, the chain is now within the 'portfolio' of a middle eastern bank. In other words, FORBA and Small Smiles is actually owned by a Bahrainian business group. There is so much more I could say - I can only pray that this story does not wither away. I would love to see the Federal Government step in and conduct an indepth chart by chart audit at every Small Smiles site.

2. I will join the ranks of the 'former employees'. I my year and a half at Small Smiles, I saw and heard so much abuse to children, that I actually developed an ulcer. I fought on a daily basis about the manner in which the docs, assistants, and hygienists were allowed to speak to the children. I witnessed the lead doc getting about 6 inches from the face of a crying, terrified, restrained child and yell at the top of his lungs, "That's enough. Stop being a punk." We were often directed to separate siblings. Especially older siblings that would overhear any yelling at their younger sibs. Competitions on converting....any employees remember "The Road to the Superbowl"? We were also trained to forbid parents in the back clinical area. If the parent balked (especially when there was a several thousand dollar treatment plan), the lead doc, in all his arrogance, would have me escort the parent to a consultation room, and proceed to tell the parent that dental work is just as serious and important as heart surgery and that they wouldn't be allowed in the operating room. WTF ever! The insurance fraud is OUT OF THIS WORLD!!! I was instructed to bill for prophys (cleanings) when all that was done was about a 2 minute tooth brushing with some toothpaste. No prophy angle, no scaling, nada. But I was told to bil a full prophy. I questioned that so much, I was actually told that if I asked and further questions and/or 'stirred the pot' any further, my job would be in jeopardy. I do have to add, that the original FORBA was much more caring than the 'business men' that bought FORBA at the end of 2006. The 'new' management was PURELY about the money. The 'old' FORBA cared about its employees and patients. The new FORBA - in an email that was accidentally forwarded to me had these requirements for a dentist - 'if she isn't cross-eyed and has all 10 fingers, let's make her an offer' sadly, I regret not forwarding that email to the dentist in question.

3. I am an employee at a pediatric dental office and very, very familiar with Small Smiles and their practices. Before you judge them you have to look at all angles of the situation. I live in Colorado, and here, there are so many loop holes and in dentistry and things that are not regulated in dentistry that that in itself should be a crime and the state of Colorado should be looking at that and not just be pointing the finger at Small Smalls. Each clinic is so different that you can not judge all of them as a whole. They are a corporation but they are run individually and some by a bunch of morons who don't know dentistry from gardening. Others of the clinics are run by a fabulous staff who really know their patient care, legalities, and methods. The sad part is knowing who is who. I stand up for Small Smiles because I have so many friends in the dental community who work at great clinics and others who work at ones who honestly do not know how to treat their staff or their patients. Like I said above, you can not only point your finger at the clinics. You have to look at the laws and you have to look at the parents who bring their children in. Until I became a CDA - EFDA I did not even know that baby crowns and root canals existed for two year olds, and I did not think that a 14 year old mom with three other kids was going to be handing me this child to do the work on... so you tell me when this 2 year old is screaming and crying after riding on the bus an hour from home with his mom and other 3 brothers and sisters in the cold of you are going to have mom come back to the room with all the other kids???? or tell me that you tell me that you are going to have a meth addicted parent come back and try to calm their child when THE PARENT keeps saying shut up and sit in the chair. Please do not get me wrong either, I am not saying that anyone is a bad person if they are on Medicaid at all, never would i say that.