Tuesday, February 07, 2012

Babies for braces? News 8's Medicaid investigations continue | wfaa.com Dallas - Fort Worth


DALLAS - No one would say being a single mom is easy. Especially being a single, teenage mother.
But the State of Texas appears to be encouraging teenage girls to become pregnant so they can receive free dental care under Medicaid.

Our investigation last year found hundreds of millions of dollars of taxpayer money spent for free braces on kids' teeth under Medicaid. That spurred a federal investigation, because cosmetic braces aren't supposed to be paid for under Medicaid.
If that is an example of good intentions gone bad, Latricia Banks and her mom, Patricia Jones, may exemplify a good idea gone terribly wrong.

For them, home is a tiny, wooden house in the shadow of Dallas' skyscrapers, which they share with Latricia's 82-year-old grandfather. It is a household held together with love, not money. Medical and dental care came mostly through Medicaid.
A little more than two years ago, Latricia's mom got a postcard in the mail, like many people in the neighborhood.  Access Dental was offering to provide free braces for qualified children like Latricia, then 17 years old.

Mother and daughter responded.
Access Dental pulled one of Latricia's upper front teeth, the mother and daughter say, and put braces on remaining upper teeth. Latricia was left with a huge gap in her smile.

But the job went unfinished, because the clinic said Latricia needed a dental implant, which is not covered under Medicaid. The clinic installed a false tooth, held in place by her braces.

"On my right hand side, I have a tooth that's really fake," Latricia said. "It even moves." If her braces were ever removed, she would be left with an unsightly gap between her front teeth.

Three months ago, Latricia turned 19. Her Medicaid counselor told her she was now too old to receive Medicaid Orthodontic treatment, unless she got pregnant.

"Why do I have to have a baby just to get my teeth fixed?" Latricia said. "That's just not right."
Latricia's mother asked the state to explain the pregnancy policy, in writing.

They did."Ms. Latricia Banks is now 19, and no longer eligible for Children's Medicaid," the Dallas office of the Texas Health and Human services wrote Mrs. Jones, in a letter. "If she becomes pregnant, she can apply for Adult Medicaid." Latricia's mother was infuriated.

"What you're saying is telling my daughter to go get pregnant!" Jones said.
Fifteen miles away in Carrollton, obstetrician Dr. Lou Montanaro has hundreds of teenage Medicaid patients. As an obstetrician, he both delivers babies and provides birth control under several state and federal programs.

A couple of years ago, he began noticing that many of his pregnant teenagers also had braces on their teeth.
"I thought, there's something seriously wrong with this picture," he said.

He gradually realized that state policies might be encouraging emotionally immature girls to become pregnant when a 14-year-old girl came to his office.

She'd already delivered one baby, and he'd implanted a birth control device under Medicaid. Then she lost her Medicaid coverage and came back to his office, offering to pay cash for him to remove it.
"She said, 'I need to get back on Medicaid, because I want to get braces,'" the doctor said. "Her means to get back on Medicaid was to get pregnant again. ...And she said, 'My sister has [braces] too, and she's pregnant.'"

"I'm thinking there's a pattern here," Montanaro said.
Montanaro says pregnant teenagers receive expanded health care under state and federal programs, Medicaid among them. He estimates that at least five percent of his pregnant Medicaid patients have braces on their teeth.

According to the Texas Health and Human Services Commission (HHS), the state provided braces for nearly 1,181 pregnant girls last year under Medicaid.

At HHS headquarters in Austin, spokesperson Stephanie Goodman responded to News 8 questions in writing.

Ms. Goodman said Medicaid Orthodontic coverage extends through age 20, not until age 19, as Patricia Jones had been told. Latricia's care would be finished under Medicaid expense. If care is begun before age 21, it is not possible to "age out" of the program. Pregnancy is irrelevant to orthodontic coverage.

Further, Ms. Goodman wrote, "The line about Medicaid for pregnant women was inappropriate and should not have been included [in the letter to Patricia Jones.] I can understand why the family was offended and I apologize for the misunderstanding."

Latricia Banks is still worried about her teeth, but a kindly dentist, not affiliated with Access Dental, has begun the process of putting an implant in her mouth for free. That should ultimately allow her orthodontic care to continue.

She's started college at Navarro Junior College in Corsicana, where she plans to learn to become a dental hygienist. "I don't want anyone else to experience what happened to me," she said.
E-mail bharris@wfaa.com

Babies for braces? News 8's Medicaid investigations continue | wfaa.com Dallas - Fort Worth