Dental Medicaid Fraud and Drug Cartels–The Connection In Texas

AUSTIN, TEXAS, May 26, 2013 - The vice chair of the homeland security committee in the Texas House says there is a direct connection between drug cartels and Medicaid fraud being perpetrated along the South Texas border region.

For this and other reasons, state Rep. Allen Fletcher said he offered an amendment to Senate Bill 8 that will allow the Office of Inspector General (OIG) to hire commissioned peace officers for their investigations into Medicaid fraud. Senate Bill 8 is a major piece of legislation dealing with fraud, waste, and abuse in the Medicaid program.

“There is Medicaid fraud all over the state, Dallas, Houston, you name it. The cartels are in Dallas and Houston. But way along the border, and all along the border, McAllen, Brownsville, Cameron County, Hidalgo County, Starr, all those areas, there is huge cartel influence and I assure you that these individuals that are involved in setting up these bogus clinics and hiring these dentists and doctors to file these fraudulent Medicaid claims, it’s cartels,” Fletcher said.

Fletcher is one of just a few retired police officer serving in the Texas House. He investigated white collar crime for Houston Police Department for many years. Fletcher said he spoke to Jack Stick, deputy inspector general for enforcement for the Office of Inspector General Texas Health and Human Services Commission, about carrying an amendment for Stick to allow OIG to have commissioned peace officers working as investigators.

In the wake of Sen. Nelson’s Bill introduced in Texas, two of the worst DSO’s rush to self-promote

December 21, 2012 Texas Senator Jane Nelson introduced SB 151 to require, among other things, DSO’s to stop hiding behind fake owners as they do now. A few months ago, several DSO’s formed a coalition in preparation for their fight in Texas. Evidently, they want to remain in hiding.

Today two DSO’s who are members of the coalition of DSO’s issued a press release; throwing down the gallant so to speak. It’s a great piece of fiction you must read:

AUSTIN, Texas, Jan. 3, 2013 /PRNewswire via COMTEX/ -- National Recognition Includes TCDSO Members in its Inaugural "Hire Power" List of "Real Heroes of the American Economy"

The Texas Coalition of Dental Support Organizations (TCDSO) - whose members provide non-clinical business support services to Texas dentists - today congratulated four of its members - Great Expressions, Heartland Dental, Pacific Dental Services, and Smile Brands - who were recognized on Inc. Magazine's "Hire Power" list of "Real Heroes of the American Economy."

Inc.'s inaugural list of 100 Hire Power Award honorees recognizes businesses that are making a substantial contribution to the nation by "adding jobs and rebuilding the economy."

Of note, two TCDSO members - Pacific Dental Services and Heartland Dental - were included in Inc.'s list of the "Top Ten Heroes of the American Economy." They were featured as creating the 4th and 6th most new jobs in America in 2012.

Great Expressions and Smile Brands were similarly featured as creating the 25th and 31st most new jobs in the nation.

Texas Stakeholders meeting today at 1PM Central time: Orthodontics on the menu.

Click reserve my seat, fill out the form and they will send you a link to the meeting.

http://www.hhsc.state.tx.us/news/meetings/past/2012/072712-Dental-Stakeholders-Meeting.shtml

Medicaid Dental System an Ongoing Challenge

Texas Tribune July 27, 2012

While Texas works to fix a system that allowed dental clinics to charge the state millions of dollars in questionable Medicaid bills, dental providers say impoverished Texas children do not have adequate access to care and that the state’s rocky transition to Medicaid managed care is compounding the problem. 

Concerns over the system will be addressed Friday, when the state’s Health and Human Services Commission holds a "dental stakeholders" meeting in Austin. John Roberts, an official with HHSC, said the dental directors of managed care health plans, members of state government and other state officials will address 14 questions previously submitted by dental providers across the state. One topic on the agenda: "Discussion on orthodontic continuation of care for abandoned patients."

Shannon Ash of Lewisville says her three teenagers haven’t been able to get their braces checked by an orthodontist for two months and are using wax to hold off the pain from wires cutting into their cheeks. After the dental clinic that had gotten state approval to put braces on her children shut down, the children’s new orthodontist told Ash that the Medicaid managed care dental plan assigned to her children by the state didn’t think her children’s braces were medically necessary. Therefore, it wouldn’t reimburse the orthodontist for treatments.

“I don’t have money to take care of the issue, or else I would have had it done myself,” Ash said. “If I had known this [would happen], I would have just let my kids’ teeth be crooked.”

After news broke last fall that Texas was paying millions to dental clinics for fraudulent or unnecessary Medicaid activities, such as putting cosmetic braces on low-income children, the state cracked down. The Health and Human Services Department's Office of Inspector General has put 23 orthodontic clinics on payment holds since October while it investigates fraud allegations. And managed care organizations that began administering Medicaid dental plans in March are placing stricter requirements on dental providers to prevent fraud.

Who is the new Texas Coalition of Dental Support Organizations?

Five Private Equity firms, who are steadily marking their territory, it’s not a coalitions, it’s a cartel.

 

 

Coalition Launched to Protect Texans' Access to Quality and Affordable Dental Care

PR Newswire

AUSTIN, Texas, July 9, 2012

AUSTIN, Texas, July 9, 2012 /PRNewswire/ --  Leading providers of dental office administrative support services today announced a new group called the Texas Coalition of Dental Support Organizations (TCDSO).

Members of the coalition - known as dental support organizations or DSOs - help increase access and lower the cost of dental care for Texans at a time when access and affordability are a critical challenge for many Texas families: Texas currently ranks among the bottom eight states in the number of dentists per 10,000 residents, according to data from Kaiser State Health Facts.

TCDSO members provide vital business and administrative support services - including facility maintenance, supply management, billing, scheduling, accounting, taxes, payroll and marketing - that simplify the process of running a dentist office and enable dentists to spend more time caring for their patients.