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

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.

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.