Total number of dentists accepting Medicaid
Increase of 57%
Total number of Orthodontists accepting Medicaid
226% increase in providers
Civil Orthodontia "Whistleblower" Lawsuits
Credible Allegations of Fraud (CAF) Payment Holds
- 89 for non-orthodontic services
- 26 Orthodontic services
Criminal Medicaid Fraud Cases
30 % orthodontic are fraud cases
Time needed to complete an investigation
Acronyms for illegal operating dental management companies
DSO – Dental Service Organization
DMSO – Dental Management Service Organizations
NDOE – Non Dentist own entities
OIG re: Jail Time:
There will be, and there are, and it’s a parade of horrors. We don’t see the end of the parade but we are going to make sure that every body that participated in the parade gets to be evaluated to see if we can criminally prosecute them. We’re going to make sure that if there’s an ability to recover under the Texas Medicaid Fraud Prevention Act we will pursue that.
We are coordinating with the Office of Inspector General through our task force, if we find that the quickest way to get resolution and recover the money from them is to go through the Office of the Inspector General processes, through SOA, we will do that. So we are trying to attempt to anything and everything to facilitate the quickest resolution and get the state of Texas money that has been stolen from it, back.
It’s the “quickest resolution” that gives me pause.