The Texas Attorney General’s office is investigating an attempt to build the state’s social safety net out of $185 million in dental brace materials.
Investigators are looking into fraudulent Medicaid billing by 31 orthodontists after state health officials discovered spending on braces and dental visits for low-income children shot from $102 million a year in 2008 to $185 million in 2010, the Dallas Morning News has posted on its blog this morning.
David Maxwell, deputy director of law enforcement for the Attorney General, disclosed the investigation during testimony before the House Public Health Committee Tuesday at the Capitol.
Thomas Suehs, executive commissioner for the state Department of Health and Human Services, testified that program heads were tightening requirements that had allowed some orthodontists to bill for an average of 22 visits a year from children receiving Medicaid dental benefits.
Almost 80,000 children got orthodontic care through Medicaid in 2011, the committee chair, Rep. Lois Kolkhorst, R-Brenham, said.
"Some of our providers out there gamed and manipulated the system," Suehs told the Committee. "I won't use the word fraud. ... Clearly, we didn't have some of the controls we should've had."
Suehs submitted to the Committee a 34-page report outlining their findings. You can find the specifics of the dental case abuse here, on pages 24 through 31.
The scrutiny stems from reporting by Byron Harris with WFAA Channel 8 in Dallas, who revealed last year that Texas was spending more annually on orthodontic care than the other 49 states in the Union. He’s also reported on the corporate jets owned by the founder of All Smiles dental clinics -- which collected more than $10 million from the orthodontic program in 2010 --- and the $13 million taxpayers forked over to transport children to orthodontists’ offices.
David Maxwell, deputy director of law enforcement for the Attorney General, disclosed the investigation during testimony before the House Public Health Committee Tuesday at the Capitol.
Thomas Suehs, executive commissioner for the state Department of Health and Human Services, testified that program heads were tightening requirements that had allowed some orthodontists to bill for an average of 22 visits a year from children receiving Medicaid dental benefits.
Almost 80,000 children got orthodontic care through Medicaid in 2011, the committee chair, Rep. Lois Kolkhorst, R-Brenham, said.
"Some of our providers out there gamed and manipulated the system," Suehs told the Committee. "I won't use the word fraud. ... Clearly, we didn't have some of the controls we should've had."
Suehs submitted to the Committee a 34-page report outlining their findings. You can find the specifics of the dental case abuse here, on pages 24 through 31.
The scrutiny stems from reporting by Byron Harris with WFAA Channel 8 in Dallas, who revealed last year that Texas was spending more annually on orthodontic care than the other 49 states in the Union. He’s also reported on the corporate jets owned by the founder of All Smiles dental clinics -- which collected more than $10 million from the orthodontic program in 2010 --- and the $13 million taxpayers forked over to transport children to orthodontists’ offices.
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Contact Mark Lisheron at 512-299-2318 or mark@texaswatchdog.org or on Twitter at @marktxwatchdog.
Keep up with all the latest news from Texas Watchdog. Fan our page on Facebook, follow us on Twitter and Scribd, and fan us on YouTube. Join our network on de.licio.us, and put our RSS feeds in your newsreader. We're also on MySpace, Digg, FriendFeed, and tumblr.
Photo of braces by flickr user phossil, used via a Creative Commons license.
Contact Mark Lisheron at 512-299-2318 or mark@texaswatchdog.org or on Twitter at @marktxwatchdog.
Keep up with all the latest news from Texas Watchdog. Fan our page on Facebook, follow us on Twitter and Scribd, and fan us on YouTube. Join our network on de.licio.us, and put our RSS feeds in your newsreader. We're also on MySpace, Digg, FriendFeed, and tumblr.
Photo of braces by flickr user phossil, used via a Creative Commons license.
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