Texas cracking down on unnecessary dental treatment

Texas Law Cracks Down on Unnecessary Dental Treatments

June 27, 2013, 11:55 am ET by David Heath Center for Public Integrity

A new Texas law will give regulators more power to crack down on dentists performing unnecessary treatments, especially on children.

A spokesman for the bill’s author — Republican State Rep. Lois W. Kolkhorst of Brenham, Texas — said the law came about largely because of a joint investigation by the Center for Public Integrity and PBS Frontline. The investigation revealed a pattern of questionable practices by Kool Smiles, a chain focused on Medicaid-provided dental care for children. The spokesman also credited independent reporting by Dallas station WFAA-TV on Medicaid fraud.

The joint investigation by the Center and FRONTLINE, titled Dollars and Dentists, quoted former employees who alleged that dentists at Kool Smiles were encouraged by company production standards to put more expensive stainless-steel crowns, rather than fillings, on cavities in baby teeth. Kool Smiles denies those allegations.

“As a mother of two children, I was shocked to learn that in 2010 there were estimated to be over 15,000 Texas children who were given inappropriate dental care, including braces on baby teeth,” Kolkhorst said in a statement.

Kolkhorst said only one dentist has had his license revoked for Medicaid fraud or patient complaints in the past two years. “That’s just not acceptable,” she added.

The law beefs up the ability of the state dental board to investigate complaints. It also gives parents the right to be in the room with their children while they are at the dentist.

In addition, dentists working for corporate dental chains are required to report information about the chains to the dental board. Currently, the state maintains no information about dental chains.

Gov. Rick Perry signed the bill last week. It takes effect on Jan. 1.

Watch Dollars for Dentists

State Representative Lois W. Kolkhorst (R - Brenham) passed Texas House Bill 3201

Dental Medicaid Fraud in Texas Prompts New Legislation for Dental Board Reform and Patient Rights

May 3, 2013

AUSTIN, TEXAS (May 3, 2013) — State Representative Lois W. Kolkhorst (R - Brenham), Chair of the Public Health Committee in the Texas House of Representatives, authored and passed House Bill 3201, a sweeping dental practice reform bill for Texas, calling for parental rights for pediatric dental patient care, additional disclosure information for dental license renewal, and new disciplinary actions by the Texas Dental Board.

“As a mother of two children, I was shocked to learn that in 2010, there were estimated to be over 15,000 Texas children who were given inappropriate dental care, including braces on baby teeth,” said Kolkhorst. “Most of these were Medicaid cases that involved dentists and dental clinics who would not allow parents to observe the dental care given to their children.” Under the bill’s reforms, Texas parents and legal guardians would be given the right to observe most dental services being provided to their children.

Kolkhorst also said her legislation is aimed at cracking down on the millions of dollars in dental and orthodontic Medicaid fraud recently uncovered by both WFAA-TV investigative news reports (in North Texas) and the Texas Attorney General’s office.

Senate Panel Backs Bill That Targets Medicaid Fraud

The Senate Health and Human Services Committee gave its endorsement Tuesday to legislation that tackles Medicaid fraud and could save the state millions of dollars.

Senate Bill 8 will “reduce the epidemic levels of fraud waste and abuse that are plaguing our health and human services,” said Sen. Jane Nelson, R-Flower Mound, the author of the bill and chairwoman of the Senate health committee. She added that “no amount of fraud is tolerable, but given our recent budget challenges it is inexcusable” that the Office of Inspector General has identified more than $6 billion in fraud from 2004 to 2011 tied to Medicaid, the state health program for poor residents.

The legislation will now go to the full Senate.

The committee approved a substitute of the original bill. The approved measure would set up a data analysis team within the Texas Health and Human Services Commission to detect trends in Medicaid claims and take a proactive approach to identifying potential fraud; ensure providers found guilty of Medicaid fraud in Texas or other states would be barred from participating in the state’s program; strengthen prohibitions against directly soliciting Medicaid patients for treatments; and reduce transportation fraud by adding medical transportation services to managed care and setting up a relationship between the Texas Department of Transportation and the Health and Human Services Commission to verify the eligibility of a Medicaid patient for transportation services.

Trueblood Dentistry and their string of Carousel chops shops finally forced to close!

In all the raw data I’ve seen out of Texas, this one would nearly always fall in the top 5.  This one alone is said to have stolen $18 million from taxpayers.  Just imagine the hundreds and hundreds of millions, if not billions stolen from scam dentists and dental companies in the state of Texas!  Perp walk please!!

I’m sure the “pity” party has begun.

 

By Chuck Lindell

American-Statesman Staff

Carousel Pediatrics began shutting down its Austin dental practice Tuesday night, displacing about 28,000 low-income pediatric patients, after state health investigators cut off Medicaid payments over allegations of fraudulent activity.

Carousel’s owner, Dr. Glenn Wood, who disputed the fraud allegations, said the loss of about $400,000 a month in Medicaid payments required him to shut down his dental affiliate, Trueblood Dental Associates, and lay off about 40 staff members and six dentists.

New DSO Regulations on tap for Texas–Batter up!

Texas legislators to consider new DSO regulations

By Donna Domino, Features Editor

December 28, 2012 -- Dental service organizations (DSOs) in Texas would be subject to greater oversight under a bill being introduced by a Texas legislator who accused the groups of "outrageous actions" involving unnecessary pediatric procedures.

SB 151 is designed to "strengthen the Texas State Board of Dental Examiners' ability to ensure that dental treatment is directed solely by licensed dentists, not by corporate entities." The measure would also require DSOs to register with the board and prohibits them from "interfering with dentists' treatment decisions."

“These types of entities have been involved in some of the illegal and, quite candidly, outrageous actions.”

— Sen. Jane Nelson

The bill was prefiled on December 21 by Sen. Jane Nelson (R-Flower Mound) in advance of the 83rd Regular Session of the Texas Legislature, which reconvenes on January 8. It would require DSOs to register with the state dental board, and it also would allow the dental board to impose administrative penalties and disciplinary actions against DSOs that violate the Texas Dental Practice Act. Similar to in many states, the law states that only licensed dentists can own and operate dental clinics.

Currently, DSOs in Texas are not subject to any state regulation, Nelson noted.

"We need to ensure that these organizations are accountable to the board and, more importantly, that they are not substituting their judgment for that of our trained, licensed dentists," Nelson said in a statement.

Read the entire story at Dr. Bicuspid

Related:

Dental Patient Protection SB 151

Dental Patient Protection: SB 151 strengthens the Texas State Board of Dental Examiners' ability to ensure that dental treatment is directed solely by licensed dentists, not by corporate entities. It requires dental service organizations (DSOs) to register with the Board and prohibits them from interfering with dentists' treatment decisions. It also allows the Board to impose administrative penalties and take disciplinary action against a DSO found in violation of the Texas Dental Practice Act. Before performing dental treatment on a child, SB 151 requires that a dentist inform the child's parent or guardian that they have the option to be present in the treatment room, and it prohibits a dentist from performing the dental treatment or procedure without the parent or guardian present if they desire to be in the treatment room. Currently, DSOs are not subject to any state regulation. "We need to ensure that these organizations are accountable to the Board and, more importantly, that they are not substituting their judgment for that of our trained, licensed dentists. No child should undergo complicated, painful procedures without a parent being involved at every point in the process. These types of entities have been involved in some of the illegal and, quite candidly, outrageous actions involving the enticement of children to undergo costly and oftentimes unnecessary procedures at the taxpayer's expense."

Senator Jane Nelson
P.O. Box 12068, State Capitol
Austin, Texas 78711
Tel. (512) 463-0112
Fax (512) 463-0923