On Wednesday of this week (November 16, 2016) at 1:30 there is to be a public hearing held by Texas Health and Human Services (THHSC) in the Brown-Heady Building, 4900 North Lamar Blvd, Austin, TX. The purpose of the public hearing is to receive comments related to a 10.45% reduction in reimbursement to Ambulatory Surgical Centers for Dental Rehabilitation and Restoration. My sourse says this reduction is spear headed by the Dental Service Organizations (DSO') whose target patients are children on Medicaid and is to take effect January 1, 2017.
(Why aren’t these “hearing” held at a time when the actual public or interested parties are available? It shall be interesting to see who is there to offer “public comments”. THHSC website indicatged the hearing will be webcast and available to watch here: http://legacy-hhsc.hhsc.state.tx.us/news/webcasting.asp.)
The source states the long term plan is to reduce the number of licensed pediatric dentists and oral surgeons from accepting children who currently require sedation for treatment, whereby those dentists will drop out of the program thereby limiting the access to quality care for the children. This is outrageous!
I’m told the DSO's plan to hire young new graduates carrying loads of student debt general dentists to perform these procedures, The source hinted a system is already in place to make sure all children meet the qualifications to require sedation.
As it was told to me, it is planned to be much like the orthodontic scam that took place in Texas just a couple of years ago whereby nearly all children suddenly qualified for braces and the per-authorization process was to rubber stamp and approve every child!
(Let’s not forget how dentists were trained on how to scam the system by Dr. James (Jim) Orr and attorney Robert (Bob) Anderton, in Anderton’s private office. Orr, at the time was Dental Director of the claims agent for Texas. In sworn testimony before the State Office of Administrative Hearings (SOAH) witnesses stated Orr and Anderton taught them how to “utilize” the HDL scoring system in place to qualify children for orthodontic braces. In addition the processors, who worked from home, were paid $50 for each approved application! For more on there click here.)
No doubt the Ambulatory Surgical Center’s are not going to complain too much about a reimbursement rate reduction when they expect their patient volume to skyrocket. Win, Win for everyone, right? Well except the children who are needlessly sedated for what is likley to be unnecessary dental procedures, like 4 year old Navaeh Hall who was left brain damaged or Daisy Lynn Torres or 3 year old Marvelena Rady who both died this year.
For the public who would like to make comments by mail:
Health and Human Services Commission
Attention: Rate Analysis, Mail Code H-400
P.O. Box 149030
Austin, TX 78714-9030
Overnight mail, special delivery mail, or hand delivery:
Health and Human Services Commission
Attention: Rate Analysis, Mail Code H-400
Brown-Heatly Building
4900 North Lamar Blvd.
Austin, TX 78751
Phone number for package delivery: 512-730-7401
Fax: Attention: Rate Analysis at 512-730-7475
Related Links:
November 16, 2016 Hearing Briefing Package
Link to Webcast page
