Monday, July 19, 2010

Cardiology Now - Another Pueblo Colorado DeRose Family Scam

In case anyone was wondering if the DeRose family were also involved with Cardiology Now here is the proof.

Nick Kochenberger at LinkedIn - CEO of CNSG, LLC (Cardiology Now Services Group, LLC)

Nick Kochenberger on Twitter

Metro North Chamber of Commerce (about 2/3 down the page in the left column)

Nick Kochenberger' father (Kirk) is married to former dentist, Eddie DeRose's daughter.  He is Michael DeRose's nephew.

According to the Colorado Secretary of State website:

Trade Name - CNSG, LLC 
Formed 11-11-2008.
ID number - 20081594650
Description - Non-Medical Services

GSSW Holding, LLC
Trade Name - Cardiology Now
True Name - Cardiology Now, PLLC
Formed - 10-1-2007
ID number - 20071433935
Description - Cardiology testing and diagnostics

Cardiology Now 1, PLLC
Formed - 11-20-2008
ID number - 20081608809
Cardiology Now 1, LLC - 11-20-2008 changed name to Cardiology Now 1, PLLC

Cardiology Now 2, PLLC
Formed - 10-09-2009
ID Number - 20091536311
Nick Kochenberger - 1440 Little Raven St. # 210, Denver, Colorado,  80202
12-08-2009 changed the registered agent address and was filed by Robert L. Root, 510 W. 3rd Street, Pueblo, Colorado  81003

True Name - GSSW Holding, LLC
Formed - 09-21-2007
Changed Name 08-13-2008 to Cardiology Now, PLLC
ID Number 20071433935
In the Articles of  Amendment To Articles of Organization of Cardiology Now, PLLC it is stated the company is organized solely for the purpose of permitting individuals to conduct the practice of medicine through a corporate entity.  (this document can be found as an attachment on page 3 of the amendment filed at the SOS.

Cardiology Now Services Group, LLC
Formed - 11-11-2008
ID Number - 20081594650

Sunday, June 27, 2010

Where health care reform is really needed---Pueblo, Colorado

Pueblo, Colorado is well known as the home of the DeRose dental clinic chain that has made treating Medicaid kids into a multimillion dollar industry. This business model---one that corrupted a program designed to treat underserved poor children into a program that has made multimillionaire dentists---is one part of what is wrong with our health care system. 

The basic premise of this model is that there is money to be made by running patients through a mill. 

Do as many procedures as you can. Get the claims in quickly. Try to "convert" a patient with a relatively simple problem into a patient that needs multiple procedures. Choose a patient population that isn't well educated and that isn't going to ask too many questions. Have a slick marketing program that capitalizes on the fact that you are providing a service that no one else can nor wants to make.  Make it look like you are some altruistic and benevolent health care professional who is going out of their way to help the poor and downtrodden. 

Fortunately, many across this country (including the FBI and numerous state governments) have seen through the crap associated with the DeRose business model. It's not some theory that this model was run to defraud the government. It's a fact that fraud was perpetrated, and that is exactly why FORBA and the DeRoses had to pay back millions and millions to numerous government entities. It was easier for them to settle rather than to face potential jail time. The story isn't over yet though. Numerous class action lawsuits are in the works, and we haven't seen the final act yet.

Unfortunately, the DeRose business model is still alive and well---and it gets to the very heart of one major flaw in our medical system. This flaw is the ability of certain dentists and physicians to rape the system by capitalizing on the fact that you get paid more based on how many procedures you can do, even if they are unnecessary. 

Amazingly, the insurance companies and state and federal governments simply don't have the manpower or effort to investigate these so called professionals. There are no rules that reward ethical behavior---i.e. spending time with patients, avoiding the temptation to do one procedure after another, avoiding the urge to enrich yourself by overbilling and running patients through the office as quickly as possible. We still reward this behavior as the reimbursement for actual patient care is woefully low, and reimbursement for a procedure driven practice is still relatively high. 

So, in Pueblo, the tradition continues. Skin Care Now is set to open next week. The DeRoses and a cardiologist, Dr. James Sbarbaro, are helping to fund this new enterprise. So how does it work? 

It will be run by a non-dermatologist, Dr. Jamie Pollock. Same day and next day appointments are available, and it would appear that the goal is to move patients through as quickly as possible. By doing so you increase your reimbursement. It would also appear that there are going to be a lot of skin biopsies occurring. Why? 

Well, if you are a non-dermatologist and don't really know what you are looking at then you just biopsy the lesion. It doesn't really matter, because the reimbursement for a biopsy is pretty darn good. 

When the biopsy results come back you try to pawn the patient off on a local dermatologist because having the patient come back to Skin Care Now doesn't really fit with the business model. The model states that we need to get patients in and out as quickly as possible. Volume. That is what counts. 

Trying to get some procedure done while the patient is there (a biopsy for example). The insurance companies can't say a thing. Any physician can biopsy skin lesions. You don't have to be a dermatologist. More importantly, they have to pay! 

The target population will most likely be Medicaid and Medicare patients. Pueblo has a less educated population which is ideal for the DeRose business model as these patients are less likely to ask questions about the quality of care that they are receiving. 

A few blocks  from Skin Care Now is the office of Cardiology Now. This outfit is run by  cardiologist, Dr. James Sbarbaro. Again, the elements of the DeRose business model are apparent. Consults are limited to simple cardiac problems like leg swelling or atypical chest pain. The goal is to be seen once and to get a procedure done in the office to evaluate "functional status" or "preoperative risk assessment". Follow up visits are not encouraged. 

This approach encourages getting an echocardiogram, carotid Doppler ultrasound, ECG, or stress test on about everyone who walks through the door. Who cares if current guidelines suggest that such stress testing before surgery is not needed in most patients? Who cares if guidelines suggest no need to be doing echocardiograms and carotid Doppler tests to screen the average Joe who doesn't have any symptoms? 

The fact of the matter is that there is no one overseeing all of this. The claims get paid and life goes on. Physicians and dentists get rich out of greed. It makes a mockery out of those honest and ethical health care providers that try to do the right thing. It drives up health care costs for all of us.
So, the elements the model again are:
1) volume 
2) getting some sort of procedure done while the patient is there 
3) an unsuspecting, poorly educated patient population 
4)slick advertising, and;
5) avoiding any oversight.

So, will all the hoopla about health care reform root out these bad apples? It remains to be seen.

Saturday, June 26, 2010

Michael DeRose and Skin Care Now Open For Fraud?

Looks like Michael DeRose has found a new way to use the medical field and enhance his coffers.  

He has entered into the Dermatology business with Skin Care Now.  

Of course he's not practicing, I doubt anyone would grant him a any kind of medical licenses but he's found a "Partner".  I hope this "partner" is well informed and doesn't end up like his other partners, hanging alone in a noose.

It's much the same setup as the Small Smiles fiasco.  See patients, who will always need spots, warts, blemishes, moles, etc  biopsied, which by the way does not need 'pre-authorization."  Bill insurance, Medicare, Medicaid and line pockets with more cash to buy him status among the other crooks in town.

My opinion of course but look at the players in the game and it's easy to see who the liars and cheats are. The picture to the right is when 415 N. Grand Ave, Pueblo, Colorado was FORBA.