Medicaid Dental System an Ongoing Challenge
While Texas works to fix a system that allowed dental clinics to charge the state millions of dollars in questionable Medicaid bills, dental providers say impoverished Texas children do not have adequate access to care and that the state’s rocky transition to Medicaid managed care is compounding the problem.
Concerns over the system will be addressed Friday, when the state’s Health and Human Services Commission holds a "dental stakeholders" meeting in Austin. Dr. John Roberts, the dental director for CHIP and Medicaid at HHSC, said the dental directors of managed care health plans, members of state government and ...
Comments (13)
Rene Ocelot via Texas Tribune on Facebook
When I was on medicaid and chip it didn't cover braces, they said it was 'cosmetic' so my parents had to pay for them.
chazz dent
Every single Medicaid child in braces was individually approved by the State to receive those braces. The State required the orthodontists to submit several X-rays, a series of photographs, and a Medical necessity score sheet.
With that info, the State then chose to approve or deny the proposed ortho treatment. Once the state began to be criticized for the cases they approved, they immediately stopped payments to providers who were only treating State approved cases.
Upon payments being halted, many Dentists were then forced to "dismiss" the patients that the State and MCOs had abandoned. No dentist likes to "dismiss" a patient but many of these Drs faced the prospect of bankruptcy or dismiss the patients the State had abandoned.
As a result of the State and MCO abandonment, the estimates are as high as 100,000 kids that are left with braces on their teeth and no one able to see them. These kids will experience a degrading oral condition that will cost the State far more than finishing what they started. Even more importantly these kids will experience a lifetime of consequences associated with accelerated dental deterioration due to unmonitored braces.
Brenda Herndon Johnston via Texas Tribune on Facebook
A corporate dental clinic I went to found I needed three crowns; went to a private dentist later and was dx with having only ONE cavity! I stay far away from chains...
David Spratt
Man that government run health care is great,,,,, Lets expand it even more.
Another 99%
Lets just start giving, the declining healthcare in Texas a name.......PerryCare.
............“I'm Rick Perry and I don't give a damn about your health Why am I suppose to care ?”.
Everett Chad Evans via Texas Tribune on Facebook
If you went to 2 Neurologists and one discovered you had brain cancer, while the other missed it; would you consider the one that missed the cancer the superior Dr? Why do you take that approach with Dentists?The guy who discovered need for three crowns was likely more thorough and superior to the one that told you what you wanted to hear.
patricia allen
I have medicade on my grandchild and we have had a nightmare dealing with the insurance co. issued for dental work . i myself have contacted them numerus times to find out they dont know , and had tried to transfer her to a different dentiest and they too are having too much trouble yet the insurance thru medicade is pointing fingers elese where. The first company doing her braces skipped out on BRianna , and many other kids left to defend for themselves. the goverment only gives a dentest so long to get this done ,my grandchild is unsure if she will be allowed enough time for her teeth to be fixed and I to am conserned. its been a few months now and still unsure .
Janna McB
Why dentists don't like Medicaid.
The dentist does the required patient care and files the paperwork for payment from Medicaid.
4-6 weeks later Medicaid sends him a notice that he forgot to fill out #?? form and can't be paid until it's filed.
Dentist files form #?? as requested and waits.
4-6 weeks later he gets another notice that he also must file form #?!.
He files form #?! and waits. This goes on for however long it takes until......
He receives a notice that the time limit for filing ALL paperwork is past due and the case is no longer eligible. His hours of dentistry and paperwork on your behalf have all be at HIS expense and Medicaid pays nothing.
That is how the government handles dental care and why some professionals pad the bill with over inflated prices when the opportunity arises.
Come on people, we all know the government is financially and morally inept. Do you really expect them to hand over money for YOUR health care when they can easily weasel out of it by delaying paperwork?
I got this bit of information from a retired dentist who said he had nothing left to lose by telling the truth. Had he spoken out before his practice would have been closed down.
Adele Roberson
Are you willing to pay more taxes and higher insurance premiums so Gov. Rick Perry and other Republicans can try to score points against President Obama?
Perry's decision on health care for the State of Texas.. means local taxpayers are going to get stuck with another big tab. When health care services are offered to a person who cannot afford to pay. which happens hourly, your taxes go up. Do not be deceived. Pay attention. Don't let Perry get away with this. Rick Perry is saying no to a fully funded Medicaid plan to help almost two million Texans for no other reason than stubbornness, politics and defiance against President Obama. Please speak up.
Adele Roberson
According to the Center for Public Policy Priorities, whose expertise on budgetary and health care issues is widely respected, Texas would get an average of $20 billion a year for expanded health care at an annual cost to the state of about $1 billion. That would be a huge return on the state's investment, a huge step toward improving the health of vulnerable Texans and a huge break for Texas taxpayers. If Texas does not participate, Texans will continue to pay federal taxes, but those taxes will pay for expanded health care , and local tax relief, in other states. Rick Perry will have his "sovereignty" and the rest of us will get the shaft. Don't let Rick Perry get away with still another con job.
Adele Roberson
http://www.motherjones.com/kevin-drum/2012/07/new-study-shows-medicaid-expansion-really-does-save-lives
A new study shows that Medicaid expansion really does save lives.
David Spratt
Ther are several ten thousand children who apparently cannot find a dentist to continue treatment. Some probably are just taking advantage of the system and either did not really need them or their parents could probably afford the braces but choose to ride the system. A % of them probably do need them.
Adele complains several million people are being denied health care becasue of Perry. Where are the doctors that are going to trat these additional 2 million people, probably vastly understated if the " Free Healthcare" was expanded ? Doctors are opting out of Medicaid daily,,, it does not pay. Too much paperwork, to many regulations, low fees and obviously too much scutiny.
Since it seems acceptable to ban Chick-fil-A from opening stores because the owner is a Christian . It seems reasonable to round up the doctors , put them in camps and make them treat people for whatever the government determines they want to pay. Give them three hots and a cot and everyone will have free healthcare. The next question would be , do you have to have an ID to enter and leave the camp?
The moral to this story is children cost money. You have to feed, house, clothe them and provide medical care amoung many other things. They are not cheap. Why should you expect everyone else to pay for them, or for you for that matter? Do not have them if you cannot afford them,,, adopt a dog or cat at a shelter,,, it's much cheaper.
Teresa Clark
I work in a Texas suburb school system and most of the kids in low income areas have braces. I know my parents paid out the nose for my braces. Its cosmetic. Not necessary for life. I don't feel sorry for the orthodontists or the kids. You're low income. That means you don't get luxuries. Deal with it or get of crack, go to school and get a job so you can have luxuries.