Four clinics in California were raided on October 20, 2020 according to a recent report by dentistry Today. The investigation was being conducted by the Federal Bureau of Investigations in cooperation with California’s department of Justice.
The dental clinics that were being investigated are part of a non-profit organization 501(c)3 under the federally qualified health care (FQHC) provider, Borrego Community Health Foundation (BCHF). During the investigation, computers were seized, employees were interviewed, and dental medical records were confiscated.
The El Cajon based organization also has offices in Kearney Mesa, the Borrego health and the headquarters of Premier Healthcare management. Warrants were served at all of these locations in connection with the investigation.
The Investigation
Borrego Heath said in a press conference that they intend to continue with the full cooperation of all government inquiries. They added that it was their belief that the billing practices of one of its organizations is what may be in question. This was stated by Nick Priest who is the CEO of Premier Healthcare Management.
One of San Diego’s prominent real estate developer and the father of Nick Priest is Daryl R. Priest, who founded Premier Healthcare Management. During business dealings with former Borrego Health CEO Bruce Hebets, agreements were established for millions of dollars in property rentals as well as medical billing services. Some of these included Premier Healthcare Management’s $25 per billing invoice for service rendered to Borrego Health. These fees amounted to up to $20 million per year.
One of the issues that stand is that these earnings and agreements were never disclosed during tax filings, which under the IRS requirements, they should be reported and especially as an approved Federally Qualified Health Care provider.
It was also disclosed that not only were there inconsistencies with billing but that as a non-profit, the top executives of the organization were making similar salaries as the salaries of Fortune 500 executives. One of the lower income scales in their team of operating officers is $325,336 for one of their (COO).
Borrego Sun
For the past 6 years, Borrego Sun has held the fire over Borrego Health and held them to stiff scrutiny. As stated by Patrick Meehan, they have been investigating Borrego Health over the past 6 years, since 2014 and it is because of their hard work that we are in the place we are today.
Borrego Sun also reported on clinics that were fundamentally lacking on proper medical and PPE supplies, while at the same time letting go of much needed physicians during the COVID-19 pandemic. It is important to note that this is only 4 dental clinics out of the many that this organization coordinates with. However, the allegations that stems from the top of the organizations is another matter altogether.
As a contributor of this online research, I want to make sure we are aware that this is a vast organization with many branches and associates that do provide health services in many areas.
It seems that under CEO Mika Wallis, the Foundation had a focus on getting as much taxpayer dollars as possible with the least amount of work. And while the rest of the work force focused on helping and treating the community that needs them there, the executive branch was less than forthcoming as to their dealings. In the end and thanks to the Borrego Sun, the truth came out and now the FBI can confirm some of these allegations.
Impressive Growth
The dental billing caseload for Borrego Health has increased exponentially over the past 3 years. In 2017, it is reported that Borrego Community health Foundation generated up to 106,000 dental patient visits. However, those numbers were easily towered by 2019 when their peak hit at about 190,000 dental patient visits.
These numbers bring to questions the validity of those numbers and if they were part of a patient churning operation. These types of ops are normally used by dishonest dental FQHC’s in order to generate the type of fraud they can quickly get away with. However, over time, these numbers become more obvious and can trigger investigations such as these. They can also become evidence for an investigation initially exposed by a whistleblower.
If you’re interested in learning more about the financial details of this investigation, you can read the full article in Dentistry Today.
