The Morning Drill: August 16, 2012

Goodwin Orthodontics Website

Good Thursday morning!

On to today's dentistry and health headlines:

Dentist Indicted for Health Care Fraud in State and Federal Probe

Dr. Michael David Goodwin, 63, an orthodontist who practices in Amarillo, Texas, and Crown Point, Indiana, has been charged in a federal indictment with 11 counts of health care fraud, alleging that he defrauded the Texas Medicaid program of approximately $1.5 million, announced U.S. Attorney Sarah R. Saldaña of the Northern District of Texas.

According to the indictment that was returned by a federal grand jury today, approximately 90 to 95 percent of Goodwin’s orthodontics’ patients were Medicaid beneficiaries. The Texas Medicaid program provides orthodontic services for Medicaid beneficiaries who fit the following criteria: 1) children who are 12 years old and older with severe handicapping malocclusions; 2) children who are up to 20 years old with cleft palate; or 3) other special medically necessary circumstances, including crossbite therapy and head injury involving severe traumatic deviation.

The indictment alleges that from January 2008 through March 2011, Goodwin devised a scheme to defraud the Texas Medicaid program by billing the program more than $2 million for services he claimed he provided, when in fact, as he well knew, some of the services were not medically necessary, or dental assistants provided those services when no dentist or orthodontist was present to supervise, and even when present, did not directly supervise or provide any services. As a result of this scheme, Medicaid paid more than $1.5 million for claims filed by Goodwin.

As part of his scheme, according to the indictment, Goodwin practiced orthodontic dentistry approximately two weeks each month at Goodwin Orthodontics in Amarillo and approximately two weeks each month at his Indiana office. In order to maximize the number of Medicaid patients seen, employees regularly scheduled more than 100 patients per day and intentionally scheduled large numbers of Medicaid patients for days when Goodwin was scheduled to be out of town. To accommodate the large volume of patients, Goodwin directed dental assistants to perform impermissible acts, including comprehensive examinations, diagnoses and treatment planning for Medicaid patients when he knew that only licensed dentists were permitted to perform those acts. In many cases, dental assistants installed Medicaid patients’ braces before Goodwin had ever examined the patients, yet his instructed employees and billing staff to falsely state on Medicaid claims that he was the performing provider for all services impermissibly delegated to and performed by dental assistants.

Alumni donate $1M to Marquette dentistry school expansion

A Marquette University alumni couple have donated $1 million toward expansion efforts at Marquette’s dentistry school, according to a news release.

Dr. Jeff Moos and his wife, Beth, donated the money to the Marquette University School of Dentistry Building for the Future campaign. Jeff Moos is a 1983 graduate of the dental school and part owner and CEO of Midwest and Mountain Dental. Beth Moos graduated from Marquette in 1979 with a physical therapy degree and practices at Sacred Heart Hospital in Eau Claire. They live in Mondovi.

Their oldest son is in his third year at the dental school, and another son will start dental school this fall.

The dental school will name the faculty practice clinic in Jeff and Beth’s honor, the release said.

Woman runs dental practice without license in her trailer

According to a report from the Gwinnett County Police Department, a 37-year-old woman, who used to be a dental assistant, has been charged for practicing dentistry without a license out of her trailer. On inspecting the case, police officers found a fully equipped dental office in the woman's mobile home.

According to the incident report from Aug. 3, the police department was alerted to the illegal practice when an anonymous caller informed the department that a Norcross resident was operating a dentist's office out of her trailer. A police officer visited the location specified by the caller and confronted Martina Ramirez-Villa with the charge.

The officer put on record that although Ramirez spoke little English she seemed to understand his questions. She first denied that there was a dentist's office on the premises but she suddenly got choked up and stated, "I'm sorry I'll stop doing it." The officer asked her what she would stop doing and she replied, "working on teeth."

Further inquiry revealed that she had treated people's teeth in the bedroom of her trailer. On inspecting the room, the officer discovered dental office equipment, including a dental chair, lamp and a number of dental tools. In some small drawers next to the dental chair, the officer found several small vials of clear liquid, which was later identified as Octocaine, a lidocaine hydrochloride and epinephrine injection. In addition, several large bottles of pills labeled ibuprofen (800 mg) and amoxicillin (500 mg) were found in other drawers.

Is eating egg yolks as bad as smoking?

A new study suggests eating egg yolks can accelerate heart disease almost as much as smoking.

The study published online in the journal Atherosclerosis found eating egg yolks regularly increases plaque buildup about two-thirds as much as smoking does. Specifically, patients who ate three or more yolks a week showed significantly more plaque than those who ate two or less yolks per week.

It may seem harsh to compare smoking with eating egg yolks, but lead study author Dr. David Spence says researchers needed a way to put it into perspective since both eating cholesterol and smoking increase cardiovascular risks - but the general public believes smoking is far worse for your health.

The issue is with the yolk, not the egg, says Spence, who is also a professor of neurology at the University of Western Ontario's Schulich School of Medicine & Dentistry. "One jumbo chicken egg yolk has about 237 milligrams of cholesterol."

Keeping a diet low in cholesterol is key, says Spence. Even if you are young and healthy, eating egg yolks can increase the risk of cardiovascular diseases later.

"Just because you are 20 doesn't mean egg yolks aren't going to cause any trouble down the line," he says.

For those patients with increased coronary risk, such as diabetics, eating an egg yolk a day can increase coronary risk by two to five-fold, he adds.

Atherosclerosis, also called coronary artery disease, occurs when plaque builds up in the blood vessels leading to the heart, specifically the inner arterial wall, and limits the amount of blood that can pass through.

Doctors write a prescription for fresh produce

In the study, researchers looked at 1,231 patients of the vascular prevention clinics at London Health Sciences Centre's University Hospital, with a mean age of 61.5. Each patient had already experienced a small stroke or had high blood pressure, hypertension or a family history of cardiovascular disease. Spence says researchers chose to use patients with a higher likelihood of cardiovascular issues because it would have been harder to get visible results using the general population with a lower risk.

Patients were asked to fill out questionnaires about their diet, lifestyle and medications, including how much they smoked and the number of egg yolks they ate. An ultrasound was performed to examine their plaque buildup. Researchers took into account sex, cholesterol, blood pressure, smoking, body mass index and diabetes.

In addition to relying completely on the recollection of patients as to what they ate, the study did not account for waist circumference and it did not account for a patient's exercise program. And perhaps most notably, it only looked at patients with existing cardiovascular issues.

The study confirms what doctors already know about eating cholesterol and cardiovascular disease, says Dr, Gordon Tomaselli, chief of cardiology at John Hopkins University School of Medicine and the former president of the American Heart Association. "Cholesterol intake should be limited to 300 milligrams a day, particularly in people who have underlying heart disease," he says.

Enjoy your morning!