In case anyone missed the Stakeholder’s webinar yesterday. Here is a link to it: July 27, 2012 Texas Dental Stakeholder’s Meeting
They talked about patient recruiting. They talked about the criminal behavior and the $10k fines for each of the people who recruit each time they approach a person in one of their vans. But I didn’t hear anything about who was going to start stopping these vans and handing out those $10K “patient recruiting tickets”. They also mentioned how illegal it was to “hire” a company to recruit and it was illegal to work as a recruiter.
They talked about the horrors and trauma small children are experiencing at the massive number of low quality dental centers, like Kool Smiles, Small Smiles, All Smiles, The Smile Center. They even mentioned babies being tied down and traumatized by hundreds of Texas dentists who are committing Medicaid fraud. Needless to say they skimmed over that subject as fast as possible. Mentioned a couple of words about standards and tabled it for later discussion, as they have for the past 10 years! Hey guys, it’s still on the table, don’t you see it!
The attorney for the Texas Dental Board admitted they have the power to make the rules, but didn’t say a word about if they planned on enforcing the rules they already have in place or any news ones they might create.
They talked about the $63 thousand dollars the government is handing out to Medicaid providers, and stressed the dentists are in the category. Then they told how to apply, what criteria must be met and I believe someone gave a count of 461 dentists who have already signed up for their piece of the pie. I’m not sure but I thought I heard applause.
by BYRON HARRIS
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WFAAPosted on July 27, 2012 at 7:42 PM
Updated yesterday at 7:42 PM
DALLAS - As Texas cracks down on questionable Medicaid dental payments, dentists' offices are going dark all over the state.
From 28th Street in Fort Worth, to Eureka Circle in Wichita Falls, to Amarillo, dentists who've already collected money from the state to treat Medicaid patients are now turning away those patients, because the dentists' Medicaid claims are being rejected. There are more than 4,300 Medicaid dentists in the state.
Tens of thousands of patients are affected. In 2010, Medicaid paid for braces on about 80,000 kids in Texas. Treatment commonly takes two years.
Since March, the Medicaid dental is managed by three Managed Care Organizations (MCO's) which have stiffened standards. One MCO said 91 percent of new claims are being rejected.
Moms whose kids already have braces on their teeth are being told children's braces must come off halfway through treatment, that they must go to another clinic far from home, or that there will be no more treatment whatsoever.
Friday, Dr. John Roberts chaired his first stakeholder meeting as Texas HHS dental director. The old director left after News 8 discovered hundreds of millions of dollars of questionable payments under Medicaid orthodontics.
Dentists learned the three MCO's have different payment rates and differing standards. But the overall impression was that moving forward, the children with braces already on their teeth would receive treatment somehow.
"There are plans in place to continue treatment on patients, to re-evaluate patients, and to complete every patient's braces," said Dr. Robert Morgan of Children's Medical Center in Dallas, who attended the meeting.
The meeting was also broadcast over the web for reporters and interested parties.
It was not clear how the process would exactly work.
If the state reassigns patients to new dentists, regardless of their original need for braces, it will cost millions for treatment which may have been unnecessary in the first place.
One example is All Smiles Dental Centers, which is being sued by the state for fraud. All Smiles told The Dallas Morning News it is eliminating orthodontic treatment at 13 clinics. One witness in the state's case against All Smiles said 95 percent of the dental chain's claims in a 300-patient sample were fraudulent.
All Smiles did not respond to News 8 efforts for clarification.Related:
- Texas taxpayers pay big for straight teeth
- Questions surround lucrative Medicaid dental business
- Texas Medicaid problems may apply nationwide
- Crooked Teeth: Medicaid Millions
- Texas, feds take action on orthodontic fraud
- Outrage on Capitol Hill follows News 8 Medicaid probe
- Texas AG lawsuits spurred by WFAA dental investigation
- More stories about WFAA's Texas Medicaid orthodontics investigation
