Tag Archives: texas

Pain, profit and accountability in Medicaid managed care

Joanne Kenen

About Joanne Kenen

Joanne Kenen, (@JoanneKenen) the health editor at Politico, is AHCJ’s topic leader on health reform and curates related material at healthjournalism.org. She welcomes questions and suggestions on health reform resources and tip sheets at joanne@healthjournalism.org. Follow her on Facebook.

Tom Fox/The Dallas Morning NewsA mobility and orientation specialist slowly moves an amber rope light above D’ashon Morris’ eyes during a visual stimulation therapy appointment at his Mesquite, Texas home on March 6, 2018.

A powerhouse series on patient harm under Texas’s Medicaid Managed Care program won the Shorenstein Center’s Goldsmith Prize for Investigative Reporting and was recognized with an AHCJ award.  We’ve posted a “How I Did It” piece by the Dallas Morning News reporters, David McSwane and Andrew Chavez.

Their work showed the lack of oversight endangering about 4 million Texans, including about 720,000 who are medically fragile – both adults and children, including some in foster care. Continue reading

Study of decade of data backs argument for community water fluoridation

Mary Otto

About Mary Otto

Mary Otto, a Washington, D.C.-based freelancer, is AHCJ's topic leader on oral health and the author of "Teeth: The Story of Beauty, Inequality, and the Struggle for Oral Health in America." She can be reached at mary@healthjournalism.org.

Photo: Jonathan Cohen via Flickr

Children living in counties with fluoridated water have significantly less tooth decay than those living in counties that lack water fluoridation programs, according to a newly published large-scale study.

Reduced decay rates were most pronounced in the primary teeth of children living in fluoridated counties. Yet community water fluoridation (CWF) also was credited with conferring a meaningful level of protection to the permanent teeth of children and adolescents. Continue reading

Reporting uncovered one of Texas’ largest Medicaid scandals

Mary Otto

About Mary Otto

Mary Otto, a Washington, D.C.-based freelancer, is AHCJ's topic leader on oral health and the author of "Teeth: The Story of Beauty, Inequality, and the Struggle for Oral Health in America." She can be reached at mary@healthjournalism.org.

GraphicStock

GraphicStock

The tip about troubles in Texas’ Medicaid dental system was part of a routine conversation. But it was enough to make reporter Byron Harris start digging.

He and his colleagues at WFAA-Dallas spent nine months scrutinizing data, wearing out shoe leather, following up on leads and trying to get people to talk.

In  2011, the “Crooked Teeth” stories raised profoundly troubling questions about oversight of the Medicaid dental program in Texas; the millions upon millions spent on orthodontic services for beneficiaries; the suspect billing practices of many providers. The 11-part investigative series uncovered one of the largest Medicaid scandals in the history of Texas. Government audits, reform efforts and lawsuits followed in its wake.

Harris continues reporting on the issue. He recently filed another story after federal officials concluded that the state owes $133 million for unnecessary dental work. “Texas paid $191,410,707 for unallowable orthodontic services from 2008 through 2010, according to a federal investigation,” Harris told viewers on June 3. “And officials say the federal government now wants a large portion of that money back.”

In this “How I Did It” article, Harris takes us back to the very beginning of “Crooked Teeth.” He explains how the project began, and how it unfolded. He also shares some wisdom on how to use data to follow up on a tip.

Texas poses challenges for insurance enrollment under ACA

Joanne Kenen

About Joanne Kenen

Joanne Kenen, (@JoanneKenen) the health editor at Politico, is AHCJ’s topic leader on health reform and curates related material at healthjournalism.org. She welcomes questions and suggestions on health reform resources and tip sheets at joanne@healthjournalism.org. Follow her on Facebook.

Texas Gov. Rick Perry

Image by Talk Radio News Service via flickr.Texas Gov. Rick Perry

Few states have been as hostile to the Affordable Care Act as Texas under Gov. Rick Perry. And, with its 6.3 million uninsured people, few states are as important to its success.

So how do people learn about coverage options and get enrolled? Here are two good stories that explore that. 

In this overview, Shefali Luthra of the Texas Tribune reports that the state government is proudly doing just about nothing to educate people. And it’s not expanding Medicaid so that keeps the poorest people from tapping into coverage that would have been available. She writes:

“In response to questions about publicizing the exchange, Lucy Nashed, a spokeswoman for Gov. Rick Perry, wrote in an email that the state was ‘not interested in implementing Obamacare, including the exchange.’”

Continue reading

Health reporters can cover safety claims in abortion fight

Brenda Goodman

About Brenda Goodman

Brenda Goodman (@GoodmanBrenda), an Atlanta-based freelancer, is AHCJ’s topic leader on medical studies, curating related material at healthjournalism.org. She welcomes questions and suggestions on medical study resources and tip sheets at brenda@healthjournalism.org.

The dramatic filibuster of Texas Senate Bill 5 has refocused the nation’s attention on abortion.

State Sen. Wendy Davis, D-Fort Worth, and her staunchly planted pink sneakers – along with help from a raucous crowd of spectators – delayed a vote on SB5 until three minutes past midnight on Wednesday, blocking its passage. It may be a short-lived victory for the Democrats, however.

Gov. Rick Perry quickly called another special session, starting today, to take up the bill again.

The bill and supporting documents – including the list of witnesses that testified for and against the legislation (AKA potential sources) – can be found here.

According to a report by the nonprofit Texas Tribune, there are two flashpoints in the proposed law.

The first is that it would prohibit abortions after 20 weeks gestation.  That provision is similar to a bill passed by the U.S. House of Representatives in June. The rationale for the legislation, which has been disputed by some doctors, is that fetuses older than 20 weeks can feel pain.

The second is this:

On and after September 1, 2014, the minimum standards for an abortion facility must be equivalent to the minimum standards adopted under Section 243.010 for ambulatory surgical centers.

Those minimum standards, which are set by the Texas Department of State Health Services, can be found here. Continue reading

Texas psych clinics take Medicare’s millions without oversight

Andrew Van Dam

About Andrew Van Dam

Andrew Van Dam of The Wall Street Journal previously worked at the AHCJ offices while earning his master’s degree at the Missouri School of Journalism.

The Houston Chronicle‘s Terri Langford reports that for-profit outpatient psychiatric clinics in the state, most located around Houston, are collecting millions in Medicare dollars yet “require no license to operate in Texas.”

She writes that, despite access to significant federal funds, the clinics are subject to little oversight from any level of government, especially when it comes to patient care.

…other than a one time inspection conducted by Medicare when clinics start operating – these programs have no detailed standards or “conditions of participation,” that must be met before filing claims and collecting taxpayer money.

The U.S. Department of Health and Human Services flagged the problem earlier this year, saying “no regulatory basis exists to ensure basic levels of quality and safety” for CMHC care.

The loopholes, including the lack of an established means to kick poorly performing centers out of the medicare system, apply nationwide, but their exploitation remains localized.

Records show that in 2009, Medicare paid $287 million on these programs nationwide, 74 percent of them located in the three states that have no state licensing requirements: Florida, Louisiana and Texas.