Charles’ US dental licence under threat

Dental surgeon Dr Michelle Charles is rejecting allegations in a complaint brought against her by the Florida Department of Health in the United States in November last year.

The Office of the Attorney General for Florida has also said that Charles was investigated by its Medicaid Fraud Control Unit on three occasions between 2000 and 2013.

Charles is registered to practise in Jamaica and currently operates out of an office in St Andrew; however, her name does not appear on the latest list of compliant practitioners because she has outstanding continuing education requirements, says the Dental Council of Jamaica, the local regulator.

The Dental Council said it was not aware of the complaint nor previous disciplinary actions taken against Charles in Florida until The Sunday Gleaner raised the matter.

Under Florida laws, she has 21 days from the day she received the complaint to request a hearing. If she fails to request a hearing within the 21 days, she waives the right to request a hearing on the facts alleged in the complaint.

Charles has not responded to the November 12, 2021 complaint, said the Florida Department of Health in confirming its latest action to our news team last Tuesday.

On Thursday, Charles told this newspaper that she was not aware of the administrative complaint, after which this newspaper supplied her with the documents.

The complaint contains two allegations; was signed by the State Surgeon General Dr Joseph Ladapo and Mohamad Cheikhali, assistant general counsel at the department; and filed on November 12, 2021 with the Board of Dentistry, the state regulator.

In the first allegation, the department said on or about July 11, 2017, Patient SB was seen by Charles in relation to the delivery of a fixed bridge, a device used to fill a space where teeth are missing.

The department claims that Charles failed to document the visit and her examination, evaluation, diagnosis and treatment of the patient.

It said this violated state laws that stipulate that the failure to keep dental records and medical history about a patient’s treatment is grounds for disciplinary action.

In the second allegation, the department contended that Charles closed her Orlando-based practice in March 2020 without fulfilling legal obligations as she did not publish a notice in a newspaper of greatest circulation in Broward County advising her patients of the termination of her practice or relocation and providing a name, address and telephone number of persons from whom patients may obtain their dental records.

It also said that Charles failed to notify the Board of Dentistry in writing within 10 days of a change of address.

PUNISHMENT REQUESTED

The health department requested that the state regulators punish Charles by taking actions such as permanently revoking or suspending her licence, issuing a reprimand or imposing a probation order.

However, Charles is disputing the allegations, while insisting that she remains a licensed dentist in “good standing”, both in Florida and Jamaica.

“I can confirm by documents in my possession that this is incorrect. All my patients were verbally and otherwise informed that my professional office would be closed in August 2020 and all records for the last 20 years are accessible and available,” she told The Sunday Gleaner.

Charles was elected to the House of Representatives as member of parliament (MP) for St Thomas Eastern in the September 2020 general election. From as early as February that year, she was tipped to be the JLP’s candidate amid protests from some party supporters.

Her Florida dental licence was originally issued on March 13, 1996 and is set to expire on February 28, 2022, based on the health department’s website that said the information was last updated on January 24.

Asserting that SB’s complaint is “substantially false in every material respect”, Charles said her lawyers in Florida and Jamaica “will deal with this matter”.

Charles did not provide any specific responses when asked to address the statement from the Office of the Attorney General in Florida that she was investigated by the Medicaid Fraud Control Unit.

“I have given you my response on all the matters,” she said when asked again on Friday for a response to the statement from the attorney general’s office.

That response also covered the question asked about her name not appearing on the September 30, 2021 list of dentists that the Dental Council says are complaint.

Medicaid is a US government programme that provides health coverage for low-income individuals and families.

Regarding the investigations by the Fraud Control Unit, the attorney general’s office said the nature of the complaints that triggered three probes involved charging a patient for item(s) covered by Medicaid; billing for services not rendered and billing under the wrong provider name.

That was contained in a response from Kylie Mason, the press secretary in the attorney general’s office.

Mason said the three cases were referred to the Agency for Health Care Administration for recoupment. She also directed further queries on the outcomes of the investigations to the agency.

The agency, meanwhile, said a search of its complaints database, which contains complaints received since 2015, did not yield any results involving Charles.

Up to press time, it did not respond to questions on the cases that the fraud control unit reportedly referred to it.

The November 2021 complaint will not be the first time that Charles, 52, is facing the US authorities since she graduated from Howard University with Doctor of Dental Surgeon degree and started practising dentistry in the Sunshine State in 1996.

A review of the health department’s records reveals at least four previous cases of administrative complaints over the last two decades that were brought before the Board of Dentistry.

The cases did not go to trial as Charles admitted to the allegations as part of settlements. She also waived her rights to certain confidentiality protections.

According to a complaint signed in 2000, the health department alleged that Charles should be cited for failing to hand over a child’s dental records requested by a parent.

Charles was reprimanded and fined. She was also ordered to submit an affidavit stating that she had read and understood the laws and rules governing dentistry in Florida. Those orders took effect April 2000.

For two other cases, the board of dentistry in November 2003 imposed a six-month probation; a six-month suspension of licence that was stayed pending the completion of the probation without any new offences, and that patients be refunded for payments they made for treatment Charles provided.

Charles was also ordered to complete education courses covering diagnosis and treatment planning in prosthodontics and risk management and record keeping.

Those courses were to be in addition to continuing education credits required for licence renewal.

CHARGED MEDICAID PATIENT

In one of the two cases that led to the orders in 2003, the health authority alleged that in July 2000, Charles charged patient LD US$231 for porcelain dentures, although as a Medicaid patient, LD’s dentures were fully covered by the government.

It was also claimed that the dentures ordered did not fit properly and the patient visited another dentist, who discovered errors.

The department contended that Charles did not properly document in plans or chart which of the patient’s teeth needed restorative work and that although she documented doing X-rays during the patient’s initial visit, there was no evidence in the dental records.

In March 2009, the board substituted a one-year term of suspension and ordered that Charles’ practice be subjected to monitoring for 18 months with the first month of active practice to include weekly reports submitted by a board-approved monitor.

That was among several actions taken in relation to two other complaints whose cases were signed off in 2008.

She was also ordered to undertake a two-year comprehensive remedial dentistry programme as well as refund “out of pocket fees” charged on a patient and for charging for treatment provided to Medicaid patient. The board said she had made the refund.

Charles was ordered to pass the laws and rules examination for dentists in Florida.

In one of the cases that led to the orders in 2009, the health department said Charles “failed to meet the minimum standards of performance” in diagnosis and treatment after she did not diagnose a decaying tooth in a patient in 2006. It said Charles also relied on X-rays of poor quality.

The other case involved another patient who was treated between 1999 and 2007 and who claimed that Charles was making inappropriate billings for procedures dealing with full mouth debridement (removing dead tissue from a wound).

Numerous instances were noted where records or full examinations not done, in addition to allegedly making a periodontal diagnosis without performing the appropriate tests.

The Department of Health’s website shows that probation orders issued in the two cases were satisfied as well as refund stipulations.

The November 2021 complaint and the history of disciplinary actions were not known to Jamaican authorities, admitted Dental Council of Jamaica Registrar Dr Lloyd Prince.

“Up to today (Friday), the council is not aware, and once the council is aware and it’s brought to our attention, we are going to vigorously explore it,” he said.

Prince had previously said Charles was in “good standing”, although she was not on the list of dentists who have complied with the mandatory standards for practising certificates.

The current list, which is dated September 30, 2021, has 293 persons in compliance.

Prince said Charles, who was fully compliant up to March 2021, is among those persons who have not completed the required continuing education credits needed to get their practising certificate.

Charles did not explain why her name was not on the list when asked.

An updated list is expected to be published this week and the registrar said it is “unlikely” that Charles’ name will appear on it. Notwithstanding the outstanding credits, he said that she is in “good standing”.

While dentists are registered for life, each practitioner has to apply for licence renewal every two years, and that includes completing 40 credits of continuing education.

Persons with only that element outstanding get a three-month temporary certificate, but with the disruptions from the COVID-19 pandemic, Prince said the temporary certificate can go up to an additional six months.

Registration to be a dentist includes the applicant being required to indicate whether they have practised in another jurisdiction and whether any disciplinary action was ever taken against them.

And Prince said adverse findings recorded in a different country can play a role in whether the licence will be granted.

“Once the person worked abroad and makes a new application, we ask you for your licence to practise, … then we go directly to the source,” he said, adding that “once we are satisfied that the person is fit and proper, then we will give them the licence”.

However, for renewal of licences every two years after registration, there is no requirement for disclosure of adverse action that emerged, exposing a serious flaw in the regulatory functions of the country’s dentistry watchdog.

“Now that you have raised this issue, to prevent this problem from reoccurring, what we’re going to say on the new application is if there is anything in terms of litigation against you, and if you sign and say no and the answer is yes, then that is fraud,” he said.

“We’re not going to sweep it under the carpet; we’re going to deal with it,” said Prince, who asserted that a proposal will be brought at the next meeting of the Dental Council.

Charles is the daughter of former MP, government minister and House Speaker Pearnel Charles Sr. Her brother, Pearnel Charles Jr, is also a member of parliament and the current minister of agriculture and fisheries.

jovan.johnson@gleanerjm.com