Tuesday, December 06, 2011

Child in braces for 9 years!–More Texas Medicaid Fraud Exposed


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Posted on December 6, 2011 at 10:41 PM

DALLAS - When you don't have much money, and receive medical and dental care at state expense, it's rare to complain.

Texas received only 712 complaints from Medicaid patients in the last year. But sometimes the quality of care becomes so questionable, patients speak up.
The case of a Garland girl points to some weaknesses in Medicaid Orthodontics, a program that's paid out hundreds of millions of dollars to Texas dentists in the last three years.

You can actually watch Anntornett Taylor grow up through her dental records, in the still photos taken of her when she visited her orthodontist. Medicaid paid for her first set of braces when she was 12 years old. Now she is 21. She has had braces for nine years. And they are still on.

"It would be extremely unusual for a patient to be in braces for nine years," said Dr. Larry Tadlock, Associate Clinical Professor at Baylor College of Dentistry.
That fact is lost neither on Anntornett, or her mother. Her records show her treatment was to have been completed several times in the last six years - in 2006, in 2008, and 2010. But inexplicably to the Taylors, the braces have not been removed.

"Every time they told me they'd be through in a couple of months," Antornette said. "Then a couple of months come, we'll be through in a couple of months. There's always something."

Under Medicaid, orthodontists get paid for 26 visits per patient, with extensions in rare cases.  Antornett's Medicaid coverage ran out in 2005, six years ago. Her orthodontist told her to keep coming to the office, and records show she did. But her mother, Jackie Taylor, said that after the Medicaid money ran out, her orthodontist seemed to lose interest in her case.

She says she knows why. "It's all about the money," Mrs. Taylor said. "Because we're not paying. Medicaid's paying. We're not paying a dime."

Antornett's orthodontist, Dr. Stephen Chu, did not return phone calls. As previously reported by News 8, last year, Dr. Chu collected $2.7 million in orthodontic payments, according to state records.

The Taylors have complained to Texas Medicaid, which responded: "Dr. Chu was made aware of your concerns and states that due to your condition; [sic] you were informed that the braces should not be removed at this time. Additionally, he states that he is working with other doctors to provide you with the proper treatment that is needed."

Ms. Taylor's records show other dentists say she needs dental implants. Medicaid does not pay for implants. She said on her last visit, Dr. Chu suddenly changed his diagnosis. Now, according to Anntornette,  Dr. Chu told her her braces must come off.

Anntornette's mother said she's complained to both Dr. Chu and Texas Medicaid. Mrs. Taylor also says she has complained to the Texas Dental Board, without reply.
The Dental Board, formally called the Texas Board of Dental Examiners, is the primary enforcement agency for dentists in the state. The Board can only investigate a case with a written complaint, and not every complaint will merit an investigation.

The Taylors say they will be complaining to the Dental Board again.
After nine years of braces, Antornette will turn 21 this week. Although her problems with her braces are still not resolved, she is no longer eligible for Medicaid.