Thursday, June 4, 2015

Texas orthodontic Medicaid Scam uncovered

Texas paid $191,410,707 for unallowable orthodontic services from 2008 through 2010, one of the largest scandals in the history of the Texas Medicaid program according to a federal investigation. As many as 90 percent of those procedures were against state rules, federal investigators found. Federal investigators based in Dallas checked random claims submitted by Texas dentists over a 33-month period from 2008 to 2010.

One in 10 claims that were approved for payment by the state did not have proper documentation.
Eight in 10 claims approved by the state were improper, even though they did include requisite documents. Only one dentist — Dr. Jerry Felkner — was involved in examining all the dental claims submitted statewide in a program that served as many as 80,000 children per year at its peak.

My thought: Really wondered why everybody on the streets seemed to be wearing braces.


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