Showing posts with label MassHealth Dental Reimbursement Rate. Show all posts
Showing posts with label MassHealth Dental Reimbursement Rate. Show all posts

Monday, September 26, 2011

The Real Cheaters

Boston Herald Monday September 26, 2011

The cheating done by food stamp recipients is peanuts compared to vendor fraud (“Life’s a beach on EBT street,” Sept. 22).

Most fraud is done by pharmacies, doctors, dentists, nursing homes, hospitals and sellers of medical equipment. The government recovered $2.5 billion in overpayments for Medicare in 2009 as the Obama administration focused attention on fraud enforcement efforts in the health industry.
Click here to read the full story
The Real Cheaters

Wednesday, June 22, 2011

Straight Smiles - Another illegal dental clinic owned and operated by Church Street Health Management opens in Worcester, MA


I hope the folks at “Straight Smiles” are paying real close attention to the Medicaid Orthodontics scams being exposed in Texas, since I’m sure that is exactly what this is as well, if not worse.

[honestly I can hardly even say “straight smiles” since I immediately think of “straight face” and how they keep one I’ll never know]

In the article below the “Lead Orthodontist” said about the patient she was examining:

“ Zulanihs had a loose tooth and small signs of a posterior cross bite. Although she was not ready for braces, interceptive treatment would widen the upper arch of her palette”

(her licenses say she is a “general dentist, searching the Dentaquest site for MA Orthodontists, there is only 2 in a 30 mile radius, and she is NOT one of them)

[she means a palatal expander as seen here and here ] hyraxmodelRPE

“If this wasn’t found or not acted upon, it could result in trauma as well as recession of her lower anterior teeth.” 

[trauma!  really? well dang good thing the child got in there in time to prevent such a trauma]

It really means we found something, ever so tiny and insignificant but I think I found something so we can bill the taxpayers of Massachusetts.

Is it legal?  Well, of course not.  However I asked a dear friend, a dentist, living in Massachusetts about having to be a “real” orthodontist and advertising as a “specialty” when you are NOT a specialist?  Here is their reply:

As for the ortho question, you are going to just love my unclear and muddled answer! In the wacky state of Massachusetts, general dentists can do ortho, provided that they can "perform to the same standards" as specialists. (If that truly is the case, then why would any Orthodontist spend the extra 2-3 years in residency?)
In medicine, that is almost like your ear/nose/throat guy deciding he'll take a swing at open heart surgery.
The regulations, as far as I'm aware mostly have prohibitions against advertising to the public as a specialist. This pretty much falls in line with the ADA position. Hope this helps.