The sluggish response of Medicaid officials to millions in Texas Medicaid money spent on free orthodontia has angered the House Oversight Committee, WFAA in Dallas reports:
WFAA ANCHOR: Texas taxpayers paying for millions of dollars to fix crooked teeth—it’s now known as the Texas Medicaid braces scandal; News 8 broke that story last year. Last week, we showed you what the feds are investigating. Tonight, why some in Congress are mad.
BYRON HARRIS: John, three days ago, the House Oversight Committee heard about Texas’ half-billion-dollar problem with Medicaid braces. The federal government often takes years to investigate problems like that, but News 8 has learned that after some jabs from Congress, the pace has quickened and south Texas witnesses are being called in early.
HARRIS: Expert witnesses got a warm welcome. Even News 8 got friendly treatment. Misspent Medicaid treatment was the target.
DR. CHRISTINE ELLIS: Thanks to the investigative reporting of WFAA’s Byron Harris, we now know that orthodontic Medicaid fraud is no exception.
REP. JIM JORDAN: It would seem to me someone would be watching, particularly the Texas situation, where you’ve got one state doing more of this than the rest of the country combined. The first time you found out about is when the press broke a story on it?
HARRIS: The core issue: Federal investigators need to catch up with what’s been on News 8 for the last year.
REP. TREY GOWDY: You have before and after pictures, you have photographs of providers who are advertising free braces. So, it would not be tough—I don’t suspect—to send an investigator to one of these free braces clinics to find out what percentage of patients they actually deny. With that bevy of evidence, what has CMS done about the Texas orthodontia scandal?
CINDY MANN: Well, uh, several things I’d like to note. It should have been detected, it was clearly an outlier claim.
GOWDY: Have any orthodontists lost their license to practice medicine?
MANN: I don’t know.
REP. MICHAEL BURGESS: Here you had Texas charging—or paying more than the rest of the country combined. It seems like that had to get someone’s attention at some level.
GOWDY: I’m just asking how much money you’ve collected in restitution.
MANN: We are looking at which claims were, uh, improperly paid.
HARRIS: But in one case, where the state has questioned claims, the dentists are counter-suing to keep the money.
HARRIS: News 8 paid the state to find data on the top-billing orthodontists in the state for the last three years. Federal officials say they don’t collect that. Then we contacted each state to find out how much they were billing for comparison. The federal government says it doesn’t do that either.