Tag Archives: orthodontics

Reporter looks into rise in kids’ orthodontic care in Wash.

Image by Jlhopgood via flickr.

Image by Jlhopgood via flickr.

Though a state investigation has failed to prove that any dental providers committed fraud, scandal still hovers over Texas’ Medicaid orthodontic program.

Now questions are being raised in Washington, where there has been a spike in the number of poor kids with braces. Medicaid orthodontic spending in the state jumped from $884,000 for braces for just 1,240 kids in 2007 to nearly $27 million for 21,369 children last year, Sheila Hagar reported in a July 5 package for the Union-Bulletin in Walla Walla, Wash.

What is going on? Hagar talked to a Walla Walla orthodontist, Thomas Utt, D.D.S., in her quest to find out. Utt has been worrying about the increase and has been raising concerns on the state level.

“We should be taking care of people who really have a need,” Utt told Hagar. But “need” appears to be a moving and subjective target in the state when it comes to braces, Hagar reported. Continue reading

Despite settlements, fraud allegations in Texas Medicaid program still unclear

Texas Tribune health writer Becca Aaronson has been providing in-depth coverage of the state’s unfolding Medicaid orthodontic scandal.

The allegations of widespread fraud and abuse related to braces for poor children first came to light in the 2011 “Crooked Teeth” investigation aired by WFAA-Dallas.

The “Crooked Teeth” stories revealed that Texas was spending more on Medicaid orthodontic services than the nation’s nine other most populous states combined. The reports raised questions about whether dentists were providing unneeded braces to Medicaid children and sending the program the bill.

Three years later, a state investigation has failed to prove that any dental providers committed fraud.

Continue reading

Reporter’s follow-up on dental reconstruction reveals the importance of a healthy smile

It was more than two years ago that Marc Ramirez offered the first part of the story to readers of The Dallas Morning News. Last month they got an update on the tale of a young woman and her smile.

“Robina Rayamajhi used to practice smiling with her lips closed, so self-conscious was she about the turmoil that lay behind,” Ramirez explained in October 2011.

Though legally blind, the University of North Texas student was excelling in school. Her heart was set on becoming a lawyer, Ramirez noted. But severe dental problems left unaddressed in her native Nepal were impacting her health, as well as her confidence.

The young woman had an underdeveloped jaw, which caused crowding among the teeth that had grown in. Meanwhile, other teeth were missing.

“Some teeth seemed too big, others too small. Another seemed totally superfluous. Her lips couldn’t comfortably close, and she constantly bit her tongue,” Ramirez wrote. Her gums were often inflamed. And she was shy about her appearance.

“Smiles are the green lights of human interaction. They lift moods, enhance beauty, indicate approachability,” Ramirez observed. Rayamajhi’s smile was holding her back. Continue reading

Investigators look into allegations of Medicaid dental recruiting of Dallas children

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.

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.”