Response To The Shelburne-Medicaid Saga

After the posting of the Shelburne-Medicaid story, I received several private emails from dentists that were alarmed by what they read. Below is part of the correspondence between myself and dentist-and legal consultant Barry Levy. He was part of CA state’s criminal case against Drueciel Ford, DDS.

I had put many posts on www.dentaltown.com and the gist of the problem is that when the dental profession doesn’t do what is right, then others step into the void and they normally don’t have the same concerns as the profession has, and unfortunately they have the ability to make the rules that profession must then work with.

To start, the concept that Americans should stay in the US for treatment because there is no recourse should a problem arise, when they get cheaper treatment outside the country is a huge problem.  First why are dentists so quick to condemn foreign dentists, but so loathe to condemn non-acceptible treatment from American dentists, and second most dental cases are too small for lawyers to want to take, to let the harmed person be made whole.  But a profession should be the same for all, and not dependent on what area code the dentist works in, the type of practice of the number of employees.  And to go with that problem one just has to remember the Reader’s Digest article where a patient was checked out by the local dental school and then got so many different diagnosis as to make a person’s head spin.

Second I have begged dentists to realize that a problem for a colleague can have profound implications if we don’t stand up together.  Nobody stood up for Dr. Ford, despite the railroading that was being done, and now we see that nobody stood up for Dr. Shelburne.  It is hard for me to see how with the blessings that we have in our profession that we aren’t so ready to maintain so blessings. 

Third, the rules that are being established are such that the ability to run a practice is becoming more difficult and we are always being told that we should just absorb the costs, but there becomes a time when that is impossible.  I like the concept of gloves, and being told that the cost for gloves isn’t something that should be passed on to the patients, but when the post office went to gloves for their workers, and they used far less, the government wanted to pass on those costs to those using the postal system.  4 gloves a day for a postal worker is a cost that must be passed on, but boxes a day for staff is to be absorbed.

Fourth, the fraud rules are becoming such that non-acceptible treatment is being considered a fraud, and could land a dentist in criminal rather than malpractice, and fraud as also been defined as billing for treatment that you didn’t actually perform.  So if you bill for work that your associate has done, it has been called fraud in Ca., and tried but lost.  But how does that affect a dental practice where the billing costs can’t be contained.

Fifth, is the most insidious concept that making money is wrong and that tactic was used both in California and in Virginia, when looking at the life styles of the dentists involved, and how they were living.  This should be striking fear into the heart of the profession and especially so with all the dental seminars about how to increase production.

Sixth is the government’s attempt to win by threatening your staff to turn on you, and spoon feeding them what they want them to say.  It happened in Cal. and from the report the amount of time spent by the government interviewing the Dr.’s staff should be troubling to anyone.

Seventh-once you bill using mail or electronic billing a mistake can become a federal crime.  And if you look at the dollar amount for a felony, a simple mistake can turn one into a felon.  In California over a 5 year span they found something like $600 in errors and that became felony theft.  If one wants to defraud the system one would be doing it on all patients and in dentistry the fraud becomes small amounts of money charged to large number of patients.  This didn’t happen in either case according to testimony or news reports.

Eight-selective prosecution.  I find it abhorrent that the US Government will tell me that billing fraud approaching $25 Million by large groups are too small to interest them, but $8000 by a single practitioner is a huge problem.  It doesn’t make sense but the reality is that the government is a bully and would rather attack the single practitioner who doesn’t have legal counsel on retainers than deal with the large groups, doing large harm, but have legal resources.  That should trouble all dentists, and especially all dentists that are solo practitioners that don’t have legal counsel on payroll.

And the list goes on and gets worse, but dentists are a little too busy dealing with their practices, their families and their lives to deal with obscure issues that seem not to be relevant or even cross their radar screens, until it is too late.  That is why large associations should have the funds put aside to allow others to protect their interests, and when I had discussed the Cal. case the consensus wasn’t to assist, but to watch and see what happens.  Well, what happened was that a Cal. dentist was bankrupted and lost her practice to defend herself, and a Virginia dentist may be going to jail.

So I guess it depends, either I was a chicken little stating the sky was falling, or a seer telling what would happen if the profession didn’t wake up.  If you weren’t involved with either case then you might think that I am chicken little, but for the two dentists not only did the sky fall down, but their worlds were destroyed.

Barry Levy, DDS

Read the previous post on Dr. Roy Shelburne’s story

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Dentsply Reports Record Q1 Earnings

Sales were up 18% from last year. The bulk of their increased sales came from non-US markets but CEO Bret Wise noted that US sales were still respectable. Their new implant design Ankylos CX will be introduced throughout Europe and the US this year. Additionally it was noted that the merger of their endodontic and implant sales teams is now completed so that reps can now offer guidance for product use in both treatment modalities.

Read the transcript from the earnings call on SeekingAlpha

Read the Dentsply press release

Click here to read aobut the Ankylos CX

Read The Dental Implant Blog…

Dr. Roy Shelburne Tells His Side of Medicaid Conviction

Dr. Roy Shelburne was convicted last month of Medicaid fraud here in my home state of Virginia. The prosecution of Dr. Shelburne seems very aggressive and looks to be a test case but with very harsh consequences for the doctor. He’s awaiting sentencing of up to 120 years in prison and a fine of over a million dollars.

The fact that Dr. Shelburne held regular business meetings and actually turned a profit was used against him in trial. Dental office owners across the country should be concerned. When efficiency in business becomes a liability we are all in trouble.

A website was recently created in order to spread Dr. Shelburne’s side of the story. If this is indeed a test case, it will have wide implications for not only Medicaid providers but for all dentists.

Visit the site MedicaidRuinsGoodDentist.com

Visit the US Department of Justice news release

Read The Dental Implant Blog…

Adopt A Nursing Home Webcast

My friend and CareerFusion mentor Shirley Gutkowski, RDH will lead a two-part webcast starting tonight on this topic hosted by Pinktooth.net. So many nursing home residents could use the help of trained dental professionals - find out how you can make a difference.

Click here to find out more and to register for the webcasts

**First one begins tomorrow night at 8pm CST**

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The “Lead in Your Crowns” Story Hits Close To Home

My local ABC news station began the nightly news with an investigative piece on lead in dental crowns. More specifically - the crowns tested contained lead in the porcelain, not the metal. A Virginia lab owner was also interviewed. He called around to different labs to find out how cheaply he could buy a crown. $20-50 per unit. Holy cow.

So what does this mean for your practice? If your lab sends any kind of certification on materials used (separate from the lab slip) make sure your patient sees it. Even if they don’t ask about it, consider it good public relations. Imagine they return to the office and talk about their new crown. One of the coworkers mentions that she’s seen this news story. I’d like to say that our patient will respond with “my doctor showed me proof that it’s not one of those crowns” rather than “uh-oh.” Our office is going to respond proactively by beginning this conversation with our prosthetic patients.

The story is slowly gaining more speed as local news affiliates pick up on it. I mean - our infamous DC madam committed suicide but they led with this story?

Read an earlier post about lead in crowns

Read The Dental Implant Blog…

Wellpoint Buys Delta Dental’s Operating Company

The merging of the medical and dental records continue - which is a good thing. Wellpoint - the US’s largest insurer - agreed to purchase DeCare Dental. This will give them a combined membership count of about 9 million. It will be easier to cross-reference medical risk factors such as diabetes and heart condition and allow for necessary dental work to help treat overall patient health.

Read the source article

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Straumann, Nobel Report Q1 Earnings

The start of 2008 brought good news for Straumann and not so good news for Nobel Biocare. Straumann reported 12% sales growth but still missed expectations slightly. Nobel reported a 25% decline in reported profit citing a weak US dollar. Shares of Nobel have been down while Straumann has seen a rise in their share price.

The implant marketplace is much more crowded than it was five years ago. In another three, we’ll still see tremendous growth. The era of consolidation hasn’t really started in the dental implant market - there’s too much opportunity for growth. Yes - Nobel recently bought a small implant company but I believe (and others too) that it was mostly to cover their bases since AlphaBioTec’s implant design was the first generation soon-to-roll-out NobelActive. The real mixing of business is happening between CAD/CAM businesses and the implant makers.

Read the Straumann report

Read the Nobel Biocare report

Read The Dental Implant Blog…

Published in: on April 29, 2008 at 4:18 am Comments (2)

I Missed My Hydro Floss Irrigator

About a month ago, I started using the Hydro Floss Irrigator after using my Sonicare Flexcare toothbrush. It’s an irrigation unit that is meant for people like me - the ones that really don’t like to floss. The unit was pretty easy to use - fill the small tank with water and use the handle in between your teeth. The tip is meant to fit in that space between your teeth right under the gumline to force water into the pocket to flush out all that…you know, stuff.

So for the past two weekends I’ve been out of town and wasn’t able to take it with me (it’s really not meant for travel use). I really missed it. I floss because I have to but with the Hydro Floss, I’ll only have to keep floss in my travel bag. The unit is a little loud - my husband always knew when I was using it. But a little loudness is worth not having to floss.

hydro_floss_irr1The information packet had research supporting its use around implants and under fixed restorations. Judging by how well it works with natural teeth, I can see that it would be helpful to keep implant sites clean. The key is to keep the biofilms from taking hold and regular irrigation can help prevent that.

Disclaimer: Oral Care Technologies sent me the unit for evaluation but I was not paid for my review.

Read The Dental Implant Blog…

Published in: on April 28, 2008 at 4:57 am Comments (1)

Professional Dental Assisting 2008

I’m back in Norfolk, VA at Pennwell’s Professional Dental Assisting conference. I was surprised that my implant insurance lecture had more administrators than I expected, considering this is an assistant-focused meeting. Lynn Mortilla, our ADIA Executive Director, and Lisa Wadsworth are teaching a hands-on implant course tomorrow - I can’t wait to see them in action.

Christine Taxin and I will present The Assistant’s Role in Specialized Dentistry later in the afternoon. The fields of neuromuscular and implant dentistry are becoming more popular and the assistants will be the ones to help doctors implement the new technology into their offices. I’m looking forward to another day full of good questions and conversation.

This Is Not Good Public Relations

A dental office in Brooklyn has been accused of malpractice by a woman who claims she was left alone after a procedure. Ramona Mercado had her wisdom tooth extracted under general anesthesia. She claims that she woke up to a dark office - the staff and doctors had left for the day. In the end, 911 was called and Ms. Mercado eventually went home.

Incredible! How do you forget a patient?

Click here to read the news story

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Save The Date: ICOI/IPS Symposium In Chicago

Pre-symposium courses begin August 21st and the symposium runs through August 24th. The Implant Prosthodontic Section (IPS) offers incredible coursework aimed at all members of the implant team: from lab technician to surgeon to restoring dentist. And of course the auxiliaries … we all know they are the key to an office’s success! Please make plans to attend the symposium - don’t miss my seminar Friday afternoon, Insurance for Implants: Problems & Solutions.

Click here to read the meeting brochure

Read The Dental Implant Blog…

The New Patient Call

When a patient calls to make an appointment, our office uses a cheat sheet to record information. I designed this sheet years ago and had pads printed up to put by each phone station. We are computerized but have found it hard to get rid of this form mainly because it has been so helpful. In other words, it’s not broken so we haven’t fixed it.

The form is brought to the morning huddle so that we’re prepared for their concerns. From that point it goes into the patient’s chart as our first document of record.

I’m offering to send this to any office that needs it - just leave a comment or email me for the form. The patient dismissal form I blogged about (here) has been very popular - I’m happy to share that also.

Click here for the post: Dismissing A Patient

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Save The Date: Sterngold’s Implant Forum

Las Vegas is again the place to be - the Sterngold Implant Forum takes place May 9-10 at beautiful Mandalay Bay. The course will feature hands-on training as well as lecture presentations.

Click here to visit the Forum’s site

Read The Dental Implant Blog…

Florida Embezzler Rejects One Year Plea - Sentenced to 20 Years Instead

This was not the deal of a century. Cassandra Jean Lorenzi of Fort Myers rejected the initial deal of one year imprisonment because she was worried about losing her new job. HUH?? I would think that you could lose your new job when your face hit the papers for embezzling - but what do I know?

Judge Fred Hardt had given Lorenzi six months to pay money back to her former employer, Aesthetic & Implant Dentistry of Naples. But when she showed up to court on Monday with nothing yet repaid, the judge got a little perturbed. She showed up with a $6,000 check - but she took over $220,000! Not exactly the restitution the doctors had in mind, I’m sure. So the judge threw the book at her: 20 years. Wow. I’m guessing Ms. Lorenzi wishes she could get that first deal back.

Click here to read the source article that discusses the court appearance.

Click here to read an earlier post about Lorenzi

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Published in: on April 16, 2008 at 3:16 pm Comments (1)

End The Cycle of Violence: Domestic Violence Article in RDH Magazine, Part 2

The second and final part of this series is available in this month’s RDH Magazine. My co-writer and partner in crime, Anastasia Turchetta, RDH was also interviewed at the Chicago MidWinter Meeting about the topic. Please take a moment to read the articles - this subject may be relevant at some point in your professional career.

Click here to watch a video of Anastasia by the Editor of RDH Magazine, Mark Hartley.

Read Part I in RDH Magazine: Domestic Violence

Read Part II in RDH Magazine: End the Cycle of Violence

Read The Dental Implant Blog…