Dental Braces: Once Again Texas Makes News with Braces

Dental Braces: Once Again Texas Makes News with Braces What is it with Medicaid dental care and braces in Texas?

The Texas Health and Human Services Commission, which administers Medicaid in Texas for dental braces, has filed a request to be reimbursed for $7.5 million in alleged fraudulent claims it paid to Amarillo orthodontist Dr. Michael Goodwin.

Federal authorities also moved to seize the commercial and personal bank accounts of Dr. Goodwin and his wife as part of a probe linked to a Medicaid fraud scheme, according to the Amarillo Globe-News.

In 2008, Dr. Goodwin became an individual Medicaid provider, which allowed him to bill Medicaid only for services personally provided by the orthodontist.

Soon after the change, the Amarillo orthodontist was reported as scheduling up to 400 Medicaid patients a day and allegedly billing the government for orthodontic treatment he did not perform. The Globe-News further reports that patients and former employees likened the Amarillo Medicaid fraud scheme to “herding cattle.”

In 2009 the Texas Attorney General’s Office’s Medicaid Fraud Control Unit was alerted to the fact that Goodwin was likely billing Medicaid for work done by dental assistants, who worked on dental patients that state law prohibits them from doing “at Goodwin’s direction and without his direct supervision while Goodwin was out of town, away from the office or even while present in the office,” according to an affidavit for the case.

The affidavit further states that Dr.Goodwin scheduled patients in 10-minute increments, “causing pressure for assistants to practice dentistry quickly” and eventually billed Medicaid for their work.

It goes on to outline the fact that Dr. Goodwin would fly from Texas to dental offices in Indiana almost every month, while billing Medicaid for orthodontic patient services in Amarillo on dates when flight records showed he was clearly in Indiana.

The majority of Goodwin’s patients were Medicaid recipients with some reporting that figure could be as high as 95% of his dental practice.

Unfortunately, this is not a new dental braces trend in Texas …

Last June, The Wealthy Dentist reported that in 2010, Texas spent $184 million on Medicaid orthodontics — more than the rest of the United States combined. Dentist Richard Malouf’s All Smiles Dental Centers of Texas collected $5.4 million from Medicaid orthodontics. Since that time, All Smiles’ Medicaid orthodontics billings nearly doubled to $10.2 million.

In September we further reported that WFAA-TV had uncovered that Texas taxpayers had spent $424 million on orthodontics for children under Medicaid. Taxpayers spent $100 million in 2008 and $140 million in 2009 — above the $184 million spent in 2010.

On March 1, 2012 Texas implemented a new managed care Medicaid dental program, only time will tell if this will stem the bleeding of taxpayer money on braces in Texas.

For more on this story see: Feds Link Orthodontist to Medicaid Fraud Scheme

Dental Practice Management: Dentist Embezzlement Survey

Dental Practice Management: Dentist Embezzlement SurveyA recent survey from The Wealthy Dentist reveals that 52% of dental practices who responded have been been embezzled, while 48% have not been a victim of fraud.

The reason why dental practices are at high risk is because the dentist is the central figure generating the revenue stream that moves the practice forward.

Many dentists do not have the time, the interest, or the resources to establish effective internal control systems and monitor them on a regular basis.

As a pediatric dentist expressed, “You need to have several checks and balances to help prevent embezzlement, plus do random audits to let staff know you keep on top of checking records and books.”

Of the dentists who responded, 90% of urban dentists answered yes to being embezzled, with only 43% of suburban dentists and 40% of rural dentists stating they had been embezzled.

Here’s what dentists has to say about dental practice embezzlement:

“Always double-check. Remember what Harry Truman said, ‘The buck stops here’ Do not create or allow situations to occur that would allow some one to embezzle you.” (General dentist)

Do not blindly trust even your most loyal employee! Run an audit trail every week!(Alabama dentist)

“Much easier with computer dental management software. Hard to do with a pegboard system of old. Balancing day-sheets by using old defunct accounts, etc. makes it easier to hide in a variety of ways. Small offices with key employees tied up with no cross-trained duties, one person business offices.” (General dentist)

“We need to be more educated on how they manage to do this.” (California dentist)

“Many dentists make so much money when some of our staff are not well-paid, so it is not a surprise.” (California dentist)

“You can only make it more difficult, you can’t prevent it entirely.” (Florida dentist)It happens to 95% of dental offices. The other 5% are ignorant, or have a spouse working the front desk.” (Colorado orthodontist)

It’s the person w all the passwords and been with you the longest. They know your moves and you trust them. Don’t have that person have access to your check book. Have your CPA’s bookkeeper do you checkbook reconciliation and run periodic reports for account receivable and check against bank deposits. Watch your cash.” (Michigan dentist)

“Don’t trust anyone except your wife, especially your most trusted, long-term employee. Monitor, audit, but never trust!” (General dentist)

“Thank God for computer systems that can now track corrections made!” (Texas dentist)

“I make all the deposits and look at the daily reports. You have to be hands-on to some degree otherwise you leave the door wide open for theft.” (California dentist)

Over 1,000,000 dollars!” (Texas periodontist)

Each year Marquet International, an independent investigative, litigation support and security consulting firm studies major embezzlement cases in the United States and issues a report on their findings.

The following statistics are highlights based upon The 2011 Marquet Report on Embezzlement. Here’s what they found:

  • Vermont had the highest Embezzlement Propensity Factor followed by Connecticut Pennsylvania, Montana, Virginia, Iowa and Idaho – identifying these states as having the highest risk for loss to embezzlement in 2011;
  • The financial services industry suffered the greatest losses due to major embezzlements;
  • Non-profits and religious organizations combined accounted for about one-sixth of all the major embezzlement incidents in the 2011 study;
  • The average loss for 2011 was about $750,000; the median loss was $340,000;
  • Nearly three-quarters of the incidents (72.3%) were committed by employees who held finance/bookkeeping and accounting positions;
  • The average scheme lasted nearly 5 years;
  • The most common embezzlement scheme involved the issuance of forged or unauthorized company checks;
  • Nearly 22% of the cases in which a motivating factor was known involve perpetrators who reportedly had gambling issues;
  • 5% of the cases involved perpetrators who had a prior criminal history;
  • The average embezzler in this study stole $15,189 per month from their employer;
  • Nearly two-thirds (64%) of the incidents involved female perpetrators;
  • Male perpetrators, on average, embezzled about 25 percent more than females;
  • Nearly 90 percent of the cases involved individual perpetrators;
  • The average adjusted age of perpetrators at the commencement of their embezzlement was just under 43 years;
  • 40 – 49 year-olds caused the greatest overall losses;
  • Most major embezzlers appear to have been motivated by a desire to live a relatively more lavish lifestyle, rather than driven by financial woes; and,
  • The average prison sentence was 4 1/3 years (52 months) for convicted major embezzlers.

For tips from The Wealthy Dentist on preventing embezzlement see Dental Practice Fraud Causes 200k Embezzlement Warning.

What has been your experience dealing with dental practice embezzlement?

Do you have advice for other dentists?

Dentist Accused of Faking Marathons

Dentist Accused of Faking MarathonsIn one of the more interesting dental stories to hit the news in ages, The New Yorker has published an investigative piece on a dentist who has allegedly been faking running marathons.

Dentist Kip Litton is from Davison, Michigan, and his original claim to fame came from his efforts to raise money for Cystic Fibrosis by trying to run a marathon in every state of the U.S.

The mystery surrounding the running dentist began with runner Kyle Strode, a 46-year-old from Helena, Montana, who in July of 2010 ran the Missoula, Montana marathon with Litton, or so he thought. As The New Yorker reports, Strode placed 4th out of 1,322 finishers, and won the masters division, for entrants 40 and older.

At the awards ceremony, Strode discovered Dr. Kip Litton had finished second. The story might have died here except that Strode decided to go back and review how the Missoula race had developed behind him. It was simply natural curiosity that drove Kyle Strode online to review all the race photographs.

As he clicked through the different photographs and recognized the runners he had passed during the race, he realized there were no pictures of dentist Litton. He only seemed to appear at the very end of the finish line.

Strode began to wonder if the good doctor was faking his marathon races,  so he decided to look up photographs from other races where Dr. Litton claimed to have raced. A disturbing pattern seemed to appear in which there were no images of Litton throughout the races.  He only came into view at the end of the races.

Later that July Strode received an unexpected inquiry from Jennifer Straughan, the Missoula race director, who asked him to look at a photograph from the race stating, “There is some question as to whether he (Dr. Litton) was seen along the course. He finished in a time similar to you so theoretically you would have noticed him.” reported the New Yorker.

Strode decided to investigate the dentist further by reviewing the website where Litton listed the marathons he has completed.  Strode soon discovers that at least three of the races were fake, meaning that the races never existed. Dr. Litton would later state that he often made-up races just for jokes.

Through online race forums and blogs, other racers and curious spectators began to dissect each of the races the doctor claimed to have participated in and document the ones they felt the doctor had faked.  Litton became the subject of a underground online investigation in which officials and runners alike begin to exchange information on the races Litton claimed to have participated.

Hailed as an example of crowd-sourcing detective work, the doctor’s racing story speaks more to the power of collaborative investigative work and the possibility of solving mysteries through social network connections.

Meanwhile, Dr. Litton still contends he has done nothing wrong.  It would seem the mystery of Dr. Litton, and his mighty marathon-madness has not yet been solved, but the New Yorker thought it would make a great story to tell anyway.

To read more about this story, see Marathon Man – A Michigan Dentist’s Improbable Transformation.

Dentist Loses License for Unnecessary Dental Fillings

Dentist performs unnecessary fillingsA dentist who tricked patients into getting expensive and unnecessary dental work has been banned from practice by UK’s General Dental Council.

Dr. Constantine Saridakis had previously paid a hefty amount for unneeded dental fillings performed before 2007. He was suspended from treating NHS patients in 2008, but did anyway, altering patient records to cover it up.

‘The committee considered suspension of your registration,” said the chair at Dr. Saridakis’s hearing, “but concluded that a period of suspension would not sufficiently protect the public in future.”

In multiple cases, the doctor recommended multiple fillings (as many as 10) on patients whose charts did not indicate any tooth decay. His partner provided a second opinion on some cases, often finding no evidence of decay.

When confronted by his partner, Dr. Saridakis allegedly replied, “Sometimes I’m preventative, and sometimes I’m in a money-making mood.”

Read more: Dentist conned patients into unnecessary fillings


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