Looks like the spin has started in Texas. I’m hearing many Orthodontic clinics will close up shop on July 1, 2012.
In the piece below, Dr. Michael Newman's says, "...about 5 percent of them would meet the requirements now."
Fact is, about 5% qualified EVER! Only thing that is changing is maybe, just maybe, stricter enforcement of standards already in place.
Surely Dr. Newman really meant to say, "about 5% is all we can bill for and not get nailed for Medicaid Fraud, now"
TIMES RECORD NEWS - Wichita Falls, Texas
Orthodontist office braces for closurePractice was only one in area taking Medicaid
Wichita Falls, TX May 26, 2012 -The only orthodontic office accepting Medicaid payments in Wichita Falls has stopped seeing patients and has locked its doors.
Red River Orthodontics set up shop on Euerka Circle in mid-2010. A sign in the door of the vacated Wichita Falls practice directs patients to an office in Fort Worth.
Representatives of Red River Orthodontics declined to comment, and referred questions to an attorney who could not be reached Friday.
The business was registered in the Wichita County Clerk's office under the title John Gremmels, Grill Repair, PA. The address given was in the 3300 block of Monterra Crest Drive in Fort Worth.
Last year Texas paid out $184 million in Medicare for orthodontics. That's more than every other state combined.
Dr. Bill Hendrickson, of Hendrickson Heetland Orthodontics, said he suspects Red River Orthodontics bolted for the door when they realized the Medicaid money was drying up.
"Their words were, 'It's a good investment,'" said Hendrickson, who visited the office personally. "They said, 'This is a very lucrative business.'"
Hendrickson now is in talks with state officials. He said he's trying to take on the patients who were displaced when Red River Orthodontics jumped ship.
Technically, at least one dental office that offers orthodontic services still accepts Medicaid, but is actually kept from doing so because of more stringent, state-mandated requirements.
In 2005 about 80 percent of dentist Dr. Michael Newman's patients were on Medicare. Newman, who operates Texas Orthodontics in Wichita Falls with his wife Denise, practices orthodontics as well as other dental procedures. Until October 2011 he was able to treat most of the patients who needed Medicaid to pay for his services.
But stricter enforcement of Medicaid standards mean that most of them, even patients who have already been fitted with braces, won't receive his care.
"I would say about 5 percent of them would meet the requirements now," Newman said.
In fact, only one of his potential patients received the go-ahead from the state for treatment. Newman wasn't allowed to treat that patient because he isn't a specialist.
A few factors have contributed to this, he said.
One is that some orthodontists have been accused of taking advantage of Medicaid funds. One case, detailing taxpayer money given to All Smiles Dental Centers in Dallas, has drawn significant media attention.
Another factor is the splitting of the third-party entity that paid Medicaid funds to orthodontists, the Texas Medical and Healthcare Partnership. About a year ago, he said, the company was divided into three new agencies, DentaQuest, Delta Dental, and Managed Care of North America. Newman said it hasn't been the same since.
He said the companies have drawn up constricting new rules that makes it virtually impossible to get a patient approved for payment.
"They started cutting back so that we couldn't get the cases approved," he said.
One rule that's being more strictly enforced is that an orthodontist must prove that a procedure is "medically necessarily" to maintain a patient's health. Newman said this is laughable.
"There is no patient I have ever seen who is going to die because of their teeth," said Newman, an officer of the American Orthodontic Society.
