Tuesday, December 13, 2011

The Morning Drill: December 13, 2011

Free Clinic of Simi Valley July 29 2010 019

Good Morning!

Medicaid fraud and the indictment of dentists/professional dental corporations for abusing the system have been increasing in the news lately. Today's first headline is just one example.

The Feds are taking an increasingly active role in prosecuting these cases. My advice to dentists is to tread lightly in these government programs. Should you not dot your I's and cross your T's, you could be confronted with a federal investigation into your financial affairs.

But, as far as those dentists who abuse the system and enrich themselves with our taxpayer money - hope you enjoy cuddling with your prison cell mate.

On to today's headlines:

Mass. dentist accused of $250K in Medicare fraud

SmileCenter, a dental office in Plymouth, MA, received at least $253,519 in unallowable reimbursements from MassHealth, the state's Medicaid program, according to the state auditor's office.

Most of the billing was for orthodontic services performed by a dentist who did not possess the required accreditation, State Auditor Suzanne Bump stated in a press release.

According to MassHealth regulations, dentists who practice orthodontics must complete a minimum of two years of training in a specialized program administered by the ADA.

SmileCenter's sole dentist, Christopher Freyermuth, DDS, who is also its sole proprietor, did not complete such a program, but still billed and received $201,509 from MassHealth for orthodontic services.

As a result of the investigation, MassHealth will terminate SmileCenter's specialty as an orthodontic practice, transfer its members for treatment to other dentists, and seek restitution, according to the state auditor.

The review of the $1.2 million SmileCenter received from MassHealth for dental services between 2007 and 2010 cited a pervasive pattern of excessive treatments, duplicative payments, and payments for services that were possibly never performed, officials said.

Dental X-rays predict fracture risk

A new study reveals that it is now possible to use dental X-rays to predict who is at risk of fractures.

Researchers at the University of Gothenburg's Sahlgrenska Academy reported in the journal Nature Reviews Endocrinology that it is possible to use dental X-rays to investigate the bone structure in the lower jaw, and so predict who is at greater risk of fractures in the future.

Lauren Lissner, a researcher at the Institute of Medicine at the Sahlgrenska Academy, said: 'We've seen that sparse bone structure in the lower jaw in mid-life is directly linked to the risk of fractures in other parts of the body, later in life.'

The study draws on data from the Prospective Population Study of Women in Gothenburg started in 1968.

Given that this has now been running for over 40 years, the material is 'globally unique'.

Teen dies after wisdom teeth surgery

Law enforcement is investigating after a 14-year-old boy died after having his wisdom teeth removed.

Ben Ellis underwent surgery Wednesday morning, and was found dead Thursday morning.

The Gilmer County Sheriff's Office and the Georgia Bureau of Investigation are looking into the cause of death.

Ben's family told the Sheriff's Office that he seemed fine on Wednesday after the surgery.

"He had dental surgery at approximately 10:30 Wednesday morning. Through the rest of the day he seemed to be doing fine. He went to bed. Through the day he had taken one penicillin tablet and one Oxycodone, that we're aware of. They (his parents) checked on him around 1 .a.m., and again, he was doing fine. Then at 6 a.m., when they went to get him up, they found him deceased," Lt. Frank Coleman said.

Ben was a freshman at Gilmer County High School and the youngest of four Ellis children to attend the school.

The school's bulletin board was covered with messages of condolence on Friday after students were notified of his death.

Hope for Hemophiliacs: Gene Therapy Stops the Bleeding

Hemophilia is a rare blood-clotting disease famously known for afflicting the royal families throughout Europe. One type, Hemophilia B, also called Christmas disease after Stephen Christmas, the first patient described with it, is caused by a defect in the eponymous gene on the X chromosome that leads to less than 1 percent of normal expression of Factor IX (FIX), an important blood clotting factor. Hence patients, who are usually male because they only have one X chromosome, require regular intravenous transfusions of Factor IX to prevent internal bleeding, or hemorrhage. These injections cost an individual patient about $300,000 a year, which may add up to around $20 million over a lifetime.

That may soon change due to a “landmark” study published this weekend in the New England Journal of Medicine. An international research team led by scientists at the University College London successfully used gene therapy (adeno-associated viral vectors) to replace the defective or missing copy of the FIX gene in a small cohort of patients, prompting the New York Times to write that Hemophilia B may be “the first well-known disease to appear treatable by gene therapy, a technique with a 20-year record of almost unbroken failure.” The viral vector used by the team inserted the replacement gene into the liver cells of the hemophiliac patients, carefully avoiding the chromosomes to reduce the risk of inducing cancerous mutations, and induced physiologically relevant expression of the coagulation factor up to 22 months post-therapy.

Enjoy your morning!

1 comment:

  1. Finally authorities are taking notice and beginning to prosecute Medicaid fraud in Dentisrty. I suspect headlines such as the MassHealth fraud to only increase, to my utter delight. Innocent children are being abused by the thousand in order to line the pockets of the elite. Shameful! Illegal! Dental boards r ignoring their own rules and regulations and allowing this corruption. See " casing in by cashing out".