Kazi kibuoishi amuuleet is a Swahili phrase that translates to "hard work pays off" in English. This phrase emphasizes the importance of diligent efforts in achieving success. It conveys the idea that when one puts in a significant amount of hard work and dedication towards a goal, they are more likely to achieve positive outcomes. The concept of kazi kibuoishi amuuleet promotes the belief that success is not purely based on luck or circumstances, but instead on the efforts and determination of an individual. It encourages individuals to persevere through challenges and obstacles, understanding that the rewards of their hard work will eventually manifest. This phrase is widely used in various contexts, including education, career development, and personal growth.

Pay Up or Go Bankrupt: The Smile Magic Settlement

The news that Smile Magic Dental clinics recently settled with the Texas Health and Human Services Commission Office of Inspector General over allegations of Medicaid fraud confirms what TDMR has been saying for a long time – that the purpose of the large volume of orthodontic and dental fraud allegations against Medicaid dentists has been to either force them into bankruptcy or extort large settlements without having to prove a single allegation.

Settles for $4.5 million to avoid bankruptcy

Smile Magic, with four clinics in Texas, will shell out $4.5 million without admitting any wrongdoing because it no longer could afford the litigation that has been ongoing for over two years and hasn’t yet seen the inside of a court room. The settlement made financial sense to the clinics because it is a “cost of doing business” that will be amortized over a long period of time, more than a decade, whereas the alternative would be almost immediate bankruptcy. Any hearing was still months down the road.

Smile Magic’s Dr. Chad Evans provided TDMR the following statement:

“I think TDMR, Houston Chronicle, Austin American Statesman, Texas Tribune, and The Texas Sunset Commission Investigation and Report (Sunset Commission Report sections 10 and 11) have posted enough for anyone to see there are problems in the current due process for Medicaid providers and I am hopeful that Texas will follow through on their recent Sunset committee’s suggestions. I think seeing legislators letting go of most of the leadership [former Inspector General Doug Wilson and his deputy Jack Stick] involved in these cases says something about the process needing fixing.

“Ultimately, this case had to be settled to end an exhaustive financial and time consuming process that sadly eclipsed two years without our Texas small business’ day in court. Now we are excited to just get back to serving patients throughout Texas.

“Personally, I want and completely plan to continue delivering our amazing patient care experience and would encourage people to check out our fun experience for families and kids at mysmilemagic.com.”

Reasons why OIG doesn’t want to go to court

In TDMR’s opinion, this settlement and such settlements are a shame. They are unsatisfactory because although no wrong-doing is admitted to, the public perception is that there must have been something there. This affects not only the practice in question but also those under the hammer of similar allegations.

That is why due process needs to be provided so providers can get their day in court and get cleared of such allegations without going bankrupt.

Should the public doubt unsubstantiated allegations of wrongdoing? There is plenty of reason. Look at the following facts:

There are no criminal cases against dentists for Medicaid fraud of which we are aware. None. So the evidence of any fraud must be pretty thin if not non-existent.
When dentists have gone before the State Office of Administrative Hearings on such allegations, they have been exonerated.
SOAH judges severely criticized the state and their cases against the dentists. State expert witnesses were deemed not credible (see above links).
The blisteringly critical report of the Sunset Advisory Commission on the activities of OIG and the resignation of its Inspector General at the request of the Governor.
A criminal investigation is ongoing into OIG and the apparent criminal conduct of OIG actuary Brad Nelson in “cooking the books” on extrapolation against a dental Medicaid provider. The revelation of this conduct caused a $16 million overpayment demand against a dentist to be settled for $39,000. OIG and the Office of Attorney General have been reluctant to make public the names of any other providers that Nelson worked on.
OIG vowed never to return payment hold monies inappropriately taken from Medicaid providers. They lost that case before Travis County and on appeal.

That’s a 100% losing streak before the courts and evidence of internal malfeasance. In fact, it looks more like a shakedown than ferreting out waste, fraud and abuse.

Is it any wonder that only two dental practices have ever gotten before SOAH and only on payment holds since 2011? No one has ever made it to an overpayment hearing.

Will this change?

State needs to reduce amount owed to feds for orthodontic Medicaid program

So why the heavy hand?

The prosecution is mindful that Texas is liable to pay back to the federal government 60% of the monies it identifies as Medicaid fraud.

Looking at the almost $800 million spent on the Texas Medicaid orthodontic program from 2007 to 2011, the Department of Health and Human Services Office of Inspector General has already stated that Texas is responsible for any non-medically necessary Medicaid orthodontic treatment approved by its former claims administrator Xerox. HHSC and HHSC-OIG knew in 2008 that Xerox was not following state regulations regarding orthodontic prior authorizations but let that sham continue until the press, WFAA, found out about it in 2011.

Dentists in good faith submitted orthodontic prior authorizations. In fact even if they felt someone did not qualify, they had to submit the application to Xerox. Basically, almost all such applications were approved by the state’s then-Medicaid claim administrator.

Dentists are some of the most dedicated and highly educated health care professionals in the country. Xerox hired high school graduates working from home to review their orthodontic applications and HHSC knew about it . But when the jig was up, state bureaucrats needed to point the blame at someone, not themselves or their contractor.

HHS-OIG is supposed to come out with a second report on medical necessity of the orthodontic program this spring. Then the fur will really fly.

“Punitive prosecution” must drive providers to settle or go bankrupt

So the apparent truth of the matter is that OIG,and now the Office of Attorney General which is going before Travis County District Court on some cases and was in the Antoine Dental case, don’t have real cases.

Therefore, the prosecution strategy to reduce the amount Texas owes back to the feds is simple – if you don’t have a case you can win in court, drag it out and make it expensive to force either a settlement or bankruptcy – punitive prosecution.

Jack Stick told the legislature in 2013 (bottom of page 8 transcript) that bankrupting providers was a way for the state to avoid paying monies back to the federal government.

So even today, after the Sunset Commission hearings last December that exposed the horrendous incompetence of OIG, its legal team (now includes the OAG) has been demanding of dentists under investigation already now for several years, hundreds of new cases to review plus lots of extra depositions to make their legal cases financially punishing.

This is punitive prosecution at work.

Just look at the way SB 1803, a bill that was supposed to guarantee due process rights for Medicaid providers, was twisted into demanding providers advance large dollar amounts that they couldn’t afford for court fees to even schedule a hearing.

Due process still a sham, more of a protection racket

Thus, the Smile Magic settlement. It is unfortunate that Dr. Evans and his Smile Magic Dental are now casualties of this strategy of punitive prosecution.

Dr. Evans has been a very active and vocal advocate for due process for Medicaid providers. He has testified numerous times before legislative committees about the over-reaching nature of allegations made by OIG and was a primary force behind SB 1803 and its passing. He plans to continue this activity.

It is troubling that this Smile Magic settlement will be looked upon by some as a vindication of the tactics of OIG.

Actually it is a vitriolic condemnation of those tactics and has made the enforcement arm of Texas Medicaid look like a bunch of Al Capone-type hoods.

Let’s call it what it really is. Up to now, it has been nothing more than a protection racket, making providers “pay up” by making it impossible for them to do otherwise. It is an unfortunate “cost of doing business” with Texas Medicaid.

We sincerely hope this will change at the bureaucratic level, not just at the executive level. Due process currently is a sham and every Medicaid provider is at risk.

Smile Magic Dental of San Antonio

I took my baby there and he loved it. dr Allen was great him with and the place is such a great atmosphere for kids for being a dental place. I go here as well and I love it.

Sandra Gomez
Recommended 3 years ago

Excelente servicio trato y rapidez

Elizabeth Martinez
Recommended 3 years ago

Staff is absolutely outstanding! Everyone is organized and very friendly. Got my son in and out of his appointment quickly all while following safety protocols and procedures during this time.

We are glad to know you had a great experience, Elizabeth! Thank you for your awesome recommendation and for choosing Smile Magic of San Antonio!

Kayla Mönserrat Chavarria
Recommended 3 years ago

My experience at Smile Magic is always great. I recommend absolutely everything about it.

We are so glad we have met and exceeded your expectations, Kayla! Thank you so much for choosing Smile Magic of San Antonio!

Tasha Daniel Cisneros
Recommended 3 years ago

My kids & I love it here , staff is very friendly even the manager is very nice they make it seem like family ! I recommend to all my friends & family to come here. great job !

Tasha, thank you for your recommendation! We appreciate you sharing your experience. We are thrilled to have you be a part of our family! Thank you for choosing Smile Magic of San Antonio! Guardado Rosalinda
Recommended 3 years ago

Very please with the employees. Great work ethics!!

We are so proud you had a great experience, Rosalinda! Our main priority is to provide the best patient experience possible, and we are glad we met the mark for you. Thank you for choosing Smile Magic! Victoria Noemi Morales
Recommended 3 years ago

Muy buen personal y trabajo mis hijos salieron contentos

¡Estamos orgullosos que haya tenido una gran visita, Victoria! Nuestra primera prioridad es la experiencia de nuestros pacientes y nos encanta que pasemos esa meta para usted. ¡Muchas gracias por elegir a Smile Magic de San Antonio! KarinaMamas Rodriguez
Recommended 3 years ago

They are nice and friendly staff I would recommend others to bring there kids here ..

Thank you for your recommendation! We appreciate you sharing your experience. We are thrilled to have you be a part of our family! Thank you for choosing Smile Magic of San Antonio! Laura Delon Ruiz
Recommended 3 years ago

It was our first time but they make you feel well welcome?The workers are very nice people

This phrase is widely used in various contexts, including education, career development, and personal growth. In the realm of education, it reminds students that consistent studying and hard work will lead to better academic performance and ultimately future success. In the professional world, it serves as a reminder that career advancement and accomplishments are often the result of dedication and effort.

Frequently asked questions about Smile Magic Dental of San Antonio

How is Smile Magic Dental of San Antonio rated?

Smile Magic Dental of San Antonio has a 4.8 star rating with 1,220 reviews.

When is Smile Magic Dental of San Antonio open?

Smile Magic Dental of San Antonio is closed now. It will open on Wednesday at 10:00 a.m.

Kazi kibuoishi amuuleet also highlights the importance of having a strong work ethic and a positive mindset. It encourages individuals to actively seek opportunities for growth and improvement and to continuously challenge themselves. By emphasizing the idea that hard work pays off, it motivates individuals to work towards their goals with passion and tenacity. In summary, kazi kibuoishi amuuleet carries a powerful message that hard work and determination are key factors in achieving success. It serves as a reminder that success is not achieved overnight but is the result of consistent effort and perseverance. By internalizing this concept, individuals are encouraged to strive for excellence and to always give their best in all aspects of life..

Reviews for "The Cultural Significance of Kazi Kibuoihi Amuuleet in Modern Society"

1. John - 2/5 stars - I was really disappointed with "Kazi kibuoihi amuuleet". The storyline was weak and the characters were not well-developed. It felt like the whole movie was just thrown together without much thought. The acting was also subpar, and I found it hard to connect with any of the characters. Overall, I would not recommend this movie to others.

2. Sarah - 1/5 stars - I couldn't stand "Kazi kibuoihi amuuleet". The dialogue was poorly written and the jokes fell flat. The pacing was all over the place, and I found myself getting bored and checking my phone multiple times. The cinematography was also lackluster, with no creative shots or interesting visuals. I was hoping for a fun and entertaining movie, but unfortunately, it fell short in every aspect.

3. Michael - 2/5 stars - "Kazi kibuoihi amuuleet" was a major letdown for me. The plot was predictable and cliché, and I felt like I had seen the same story a hundred times before. The acting was mediocre, and the characters lacked depth. I was hoping for something fresh and original, but it ended up being just another forgettable film. I would not recommend wasting your time on this one.

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