Friday, August 26, 2011

Video: Federal Investigators Auditing Texas Dental Medicaid Over Orthodontic Treatment for Tens of Thousands

Orthodontic treatment with Medicaid? And, for that many patients?
For the past six months, News 8 investigations have revealed hundreds of millions of dollars of questionable Medicaid spending on braces for children in Texas.

Now federal investigators are auditing the Texas Health and Human Services Commission, which controls those funds. Taking the lead in the audit is the Office of Inspector General of the U.S. Department of Health and Human Services.

In a letter to the state, the inspector general says it will examine the "authorization process for orthodontic treatment" under Texas Medicaid. "The objective of our audit," the letter continues, "is to review the State's controls to ensure that only medically necessary orthodontic cases are paid." The time period covered by the audit is September 1, 2008 through May 28, 2011.

A News 8 investigation revealed that during that period, Texas taxpayers spent $424 million on orthodontic treatment for children under Medicaid. Taxpayers spent $100 million in 2008, $140 million in 2009, and $184 million in 2010, state records show.

Last year, Texas spent as much as the other 49 states combined.
Somebody is going to be in trouble here.

Medicaid funds should be used for the poor and disadvantaged and in California all adult dental Medicaid has been eliminated because of budgetary issues. Yet, Texas is using this for cosmetic orthodontic treatment?
Millwee said he's been working with the TMHP program for a decade. He said his office noticed an increase in Medicaid orthodontic claims in 2007 after a lawsuit ruled that Texas children needed improved access to health care under Medicaid.

He said Texas children do not receive cosmetic braces on their teeth under Medicaid. Many dental professionals argue that they do, because orthodontics is essentially a cosmetic procedure.

Texas spent $184 million on Medicaid orthodontics last year; that's nine times as much as California, which spent $19.5 million.

One state's program is not another's, Millwee said.
Indeed, it isn't.

But, American taxpayers expect fair use of their tax dollars and not a crony system of abuse and excuses.

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