Florida dentist accused of unnecessarily pulling kids’ teeth in scam: ‘Medicaid paid him per tooth’

[Judi Lynn]

Source: Raw Story

Florida dentist accused of unnecessarily pulling kids’ teeth in scam: ‘Medicaid paid him per tooth’
Travis Gettys
31 Aug 2015 at 11:01 ET

Florida dentist is accused of unnecessarily pulling children’s teeth and ripping off Medicaid for millions of dollars.

Protests have raged for three weeks outside the Jacksonville offices of Dr. Howard Schneider after he was served with 58 notices of intent to sue — which the dentist threw to the ground and fled in his vehicle after trying to grab a journalist’s camera.

Former patients have accused the 78-year-old Schneider of performing unwanted and unneeded dental procedures — and the Florida Attorney General’s Office has opened a Medicaid fraud investigation of claims that date back decades, reported WTVR-TV.

The lawsuits and investigations were launched after Brandi Motley posted a photo of her 6-year-old daughter on Facebook in May accusing the dentist of pulling seven teeth from the girl’s mouth after ordering her from the examination room.


Read more: http://www.rawstory.com/2015/08/florida-dentist-accused-of-unnecessarily-pulling-kids-teeth-in-scam-medicaid-paid-him-per-tooth/

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Dr. Howard Schneider, Jacksonville



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[Xipe Totec]

1. He wanted to buy a bigger boat.

I have never trusted dentists. Period.

[onehandle]

9. I've had terrible luck with dentists.

I look for a good dental hygienist and bond with them, so I don't need the dentist as much.

[Xipe Totec]

11. I have to actively and vociferously refuse cavity fills

Every time I go in they spot a cavity they want to fill.

I refuse.

Next time I go in they spot another cavity. Somewhere else, but never the one they spotted previously.

Apparently, my cavities self-heal with time.

[bucolic_frolic]

14. Maybe some online research

No need to drill some say, just treat with colloidal silver,
repeated topical calcium and MSM methylsufonylmethane

[Elmer S. E. Dump]

18. That sounds completely harmless.

[Xipe Totec]

22. Coloidal Silver? I don't want to turn into a Smurf!

At 60 I still have all my teeth intact, including my wisdom teeth.

The only cavity fills I have are four I got before I wised up.

[randys1]

27. LOL

[Hassin Bin Sober]

35. Yep. I just had three new cavities filled.

Wtf?

The dentist didn't even tell me what was going on and why all of the sudden I'm getting cavities. My buddy who is in the business told me about the new toy my guy has. It finds "micro cavities". Come to find out some (most?) of these "cavities" will go away.

Meanwhile, I have an old filling that had a piece fall out but he won't touch it up because he says it needs a crown. Well he already sucked my insurance dry, and then some, in February.

I forgot I had recommended this guy to a friend. He came over a couple weeks ago and tells me he saw my guy. "I just left your dentist and he filled three cavities for me. I can't understand why I all of the sudden have all these cavities" wtf?

He bought a $350,000 dollar crown machine. Now all my teeth need crowns.

I should have known when he changed his name to "dental spa" and started pushing Botox.

[shanti]

40. yes!

i love my dental hygienist, susan. she is the best! sadly, she will be retiring in a few short years. we discuss kids, gardening, etc. during my appts. she pretty much checks out my teeth, and knows what's good or bad, before my dentist (whom i love too) gives me the exam.

[secondwind]

2. omg.. just when you think you've heard it all... n/t

[Liberal_in_LA]

25. i know!

[msongs]

3. without a 2nd opinion one never knows if the dentist is telling the truth or not. imagine this...

you sit in the chair with your mouth open and the dentist tells you everything that supposedly needs fixing. he/she could be making it all up and you would never know. total trust at a price

[HassleCat]

4. He will die in jail

Prosecutors cannot ignore the criminal aspects of this case. If the feds don't get him, Florida will. His malpractice amounts to torture.

[Statistical]

5. What does this have to do with Medicare?

My private insurance "pays per tooth" however the expectation is that the Dentist won't be pulling teeth that don't need to be pulled. I hate the link to Medicare in the article because people will latch on to that "see Medicare it is horrible and Obama wants everyone to have it".

[Judi Lynn]

6. The article refers to "Medicaid." Different. n/t

[Statistical]

17. Ok sorry. What does this have to do with Medicaid?

It makes it seem like this kind of fraud of Medicaid specific. Any Dentist working for any insurance could lie say a tooth needs extraction, pull it, and get paid. Some level of professional ethics is expected.

[Elmer S. E. Dump]

19. The RWers don't care if doctors are ripping people off - only if patients are.

[csziggy]

31. Some of the children were covered by Medicaid

Which pushes this to federal level fraud and not just malpractice.

Edited to add from the link in the OP: "State records show Schneider has received nearly $4 million in Medicaid reimbursements in the past five years, and an attorney for the families said the dentist preyed on poor families to defraud the government."

[Freddie Stubbs]

39. Because regular dental insurance has fairly high copays for things other than routine cleaning, but

medicaid usually has no or nominal copays.

[Quackers]

42. I think because poor families are less likely to complain.

If a rich family says you messed up their kids teeth, you get sued. If a poor family says you messed up their kids teeth, you can call them ungrateful and say they have poor hygiene practices.

[dieter]

7. I think that's worse than killing a lion.

These families put their trust into a doctor and he seems to have betrayed them.

[Judi Lynn]

8. Why would anyone attempt to compare the two situations?

I would give the Texas dentist a tooth if he could take back the 40 hours of agony he forced upon that poor creature in Africa before he finished him off and ripped his skin off and stole his head.

Otherwise, I can see no connection.

[dieter]

12. They are both dentists /nt

[Helen Borg]

10. At least he did not kill a lion!

[bucolic_frolic]

13. Plenty of victims

of Drill 'n Fill too

Unnecessary procedures

Referral fees to specialists

----------------------------

Alt dentistry has popped up now

No need to drill some say, just treat with colloidal silver,
repeated topical calcium and MSM methylsufonylmethane

Please don't blame me for the fast and loose details,
read them on the fly somewhere

[bucolic_frolic]

15. Toothcams

I've had more than one dentist use a mini camera and monitor to
display the problems

and archive the video

There was always x-rays

One said it's evidence when insurance doesn't want to pay

I think it's probably a good idea

[olddots]

16. he actually gave dentists a worse image

which is hard to do .

[Auggie]

24. Not a good summer for them

[Raymondo22]

20. This is the result of our two-tier dental care system.

Most dentists, like most doctors, where I live, will not accept Medicaid because it doesn't pay enough. Result: Medicaid patients tend to get bottom feeders.

[Spitfire of ATJ]

21. "Is it safe?"

[Judi Lynn]

23. Just when we had forgotten seeing it! n/t

[marble falls]

26. How big of a contributor to Gov Rick Scott's various funds is he?????

Think of all the lawsuits!!!! His insurance company will go broke or deny coverage. He'll be knee deep in lawsuits.

[C Moon]

28. The last dentist I went to was honest and did good work, but she had the WORST dental assitants.

Twice, one of them dropped my crown on the floor.
Another one was so interested in what the dentist was doing (probably a student), that she wasn't paying attention and I almost choked on a chunk of filling that was heading down my throat.
The same assistant was concentrating on the dentist's work instead of her own job, and I was starting to gag on my saliva. The air hose had disconnected from the suction tube.
That was the last time I went there: a dentist is only as good as his/her assistant.

[tymorial]

29. This doesn't surprise me.

Wisdom teeth do not always need to be removed and yet a lot of dentists will advise their patients to yank them as soon as the tooth emerges above the gum line. It is considered stable revenue even if it is unnecessary. The insurance companies will always pay without question.

There is also another behavior that I have seen far too often and this is advice for DUers. If you have a dental appointment and your dentist doesn't show up after the cleaning.... make sure you review what was charged to your insurance. I have seen some dentists bill an examination fee even though you weren't seen. That is fraud. It has happened to me personally... coincidentally after going to see an orthodontist concerning a wisdom tooth removal. They told me that I would have to pay for the examination because I had already had one within the last 6 months despite the fact that the dentist never saw me.

[LynneSin]

30. But I am so glad my Wisdoms were removed and quickly

I was getting serious TMJ from my wisdom. My mouth was built very small and I actually have had a slew of teeth pulled from my mouth to make my teeth fit. If I did not have this done I would have had serious pain from overcrowding.

I feel bad for what happened to these children but sometimes teeth being pulled is a good thing. I know today I have an amazing set of perfectly straight teeth that all fit into my mouth. This would have never happened if I kept all my teeth. And I probably would have suffered from some serious TMJ and other jaw pain leaving extra teeth in my mouth.

[tymorial]

33. Then you needed them pulled.

I wrote that it isn't always necessary. In your case it was. Dentists who encourage wisdom teeth extraction when it is unnecessary are lacking in ethics.

[burfman]

32. Remember he could be innocent...if in doubt get some friends to help you out....

burfman...

[JI7]

34. i have a dentist and i wonder about some of the things

They do and charge me for

[Dont call me Shirley]

36. Dental care needs to be a part of a nationalized health care system! And eyecare!

[Thunderbeast]

37. Sadly, this stuff is pretty common

A niece who was once in foster care had horrible dental hygiene. Her medicaid dentist, rather than repairing her baby teeth, put metal caps on all of them. I am wondering if the fee per hour was much better than restorations, and if that motivated the treatment decision. I have never seen that practice for kids who did not happen to be poor. 60 Minutes did a story on this a few years ago.

Fortunately, her adoptive family was very good about diet and habits. Her permanent teeth are beautiful.

[progree]

38. PBS's Frontline too

http://www.pbs.org/wgbh/pages/frontline/dollars-and-dentists/

Dental care can be a matter of life and death. Yet millions of Americans can't afford a visit to the dentist. An investigation by FRONTLINE and the Center for Public Integrity reveals the shocking consequences of a broken safety net. Poor children, entitled by law to dental care, often cannot find a dentist willing to see them. Other kids receive excessive care billed to Medicaid or major surgery for preventable tooth infections. For adults with dental disease, the situation can be as dire -- and bankrupting. While millions of Americans use emergency rooms for dental care, at a cost of more than half a billion dollars, corporate dental chains are filling the gaps in care, in some cases allegedly overcharging patients or loading them with high priced credit card debt.

[Karma13612]

41. The way procedures are reimbursed is very specific

using a coding system for procedures.

There is a code system specific for dental procedures, and also a code system for procedures on the rest of the body. The code system for the body is : CPT codes. This stands for "Current Procedural Terminology".

It clearly defines each possible procedure that a provider can perform.

The reimbursement entities like Medicaid, Medicare, BC, Aetna, etc expect providers (doctors, dentists, hospitals, etc) to report any procedures they provide to a patient by using these CPT codes or CDT codes for dental procedures.

They will pay based on their reimbursement rates.

The CPT codes are the agreed upon terminology that makes it easy to translate the treatment the provider gave to the patient. It is reported to the insurance company. And the insurance company reimburses.

Removal of a tooth would be one of the procedures, using the CDT (Current Dental Terminology) code system by the ADA. If the code is based on the removal of one tooth, and the dentist removed 3 teeth, then he would report that he performed the procedure X3. Medicaid would reimburse based on their agreed policy of reimbursement rates. They might reimburse @ the rate of 100% for the first tooth, but might only reimburse at 50 or 75% for the remaining 2. Again, it isn't just the provider involved in this. As we know, the insurance company dictates a lot of this.

As an FYI, the CPT codes that hospitals and doctors use in their offices are written and copyrighted by the American Medical Association. Yea, the doctors AMA created the codes and copyrighted them. They are updated every year to include ones that fall out of favor, ones that are reflective of emerging medical treatment, etc.

The dentist wasn't necessarily being underhanded. He gets reimbursed based on the dental procedure codes, the insurer, and contracts he makes with them. Same with hospitals and doctors. Its all about contracts with the insurers. That's why it's so important to know what the insurance company will reimburse and what you are left paying the doctor based on YOUR insurance policy.