Byron Harris of WFAA-Dallas reports authorities there are investigating cases in which at least six children allegedly were recruited at a convenience store, paid $10 and then taken to a dental clinic where they underwent procedures without parental consent.
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WFAA obtained one child’s medical records and found the clinic billed Medicaid for more than $2,000 for 25 procedures.
The clinic, All About Dentistry, “admits it employs recruiters to bring in new Medicaid patients, but will not reveal how much it pays for each new patient a recruiter brings in.”
In July, Harris reported that Texas is cracking down on “questionable Medicaid dental payments” and, as a result, dentists who previously treated Medicaid patients are turning those patients away because their claims are being rejected.
Tens of thousands of patients are affected. In 2010, Medicaid paid for braces on about 80,000 kids in Texas. Treatment commonly takes two years.
Last year, Harris and producer Mark Smith, in a nine-month investigation, found that Texas regulators seldom deny procedures for hundreds of thousands of children. WFAA aired a half-hour news special, “Crooked Teeth,” raising questions about other Medicaid reimbursements nationally, including a troubling payment policy by one of the nation’s largest government contractors.
Strict Medicaid regulations prohibit payment for braces installed for merely cosmetic reasons. WFAA-TV, however, discovers through statistical analysis and basic “gumshoe” reporting that Medicaid orthodontic payments are widespread in Texas. In fact, dental offices have signs and advertisements that promise “free” braces and travel to children.
Elsewhere in Texas, a jury has indicted an Amarillo orthodontist on 11 counts of Medicaid fraud of more than $1.5 million. Authorities allege he performed services he knew were solely cosmetic and scheduled dozens of patients on a daily basis.
In another recent case, a Brooklyn, N.Y., dentist “pleaded guilty to fraud, admitting he paid recruiters to solicit homeless Medicaid patients with cash.”