What is it with Medicaid dental care and braces in Texas?
The Texas Health and Human Services Commission, which administers Medicaid in Texas for dental braces, has filed a request to be reimbursed for $7.5 million in alleged fraudulent claims it paid to Amarillo orthodontist Dr. Michael Goodwin.
Federal authorities also moved to seize the commercial and personal bank accounts of Dr. Goodwin and his wife as part of a probe linked to a Medicaid fraud scheme, according to the Amarillo Globe-News.
In 2008, Dr. Goodwin became an individual Medicaid provider, which allowed him to bill Medicaid only for services personally provided by the orthodontist.
Soon after the change, the Amarillo orthodontist was reported as scheduling up to 400 Medicaid patients a day and allegedly billing the government for orthodontic treatment he did not perform. The Globe-News further reports that patients and former employees likened the Amarillo Medicaid fraud scheme to “herding cattle.”
In 2009 the Texas Attorney General’s Office’s Medicaid Fraud Control Unit was alerted to the fact that Goodwin was likely billing Medicaid for work done by dental assistants, who worked on dental patients that state law prohibits them from doing “at Goodwin’s direction and without his direct supervision while Goodwin was out of town, away from the office or even while present in the office,” according to an affidavit for the case.
The affidavit further states that Dr.Goodwin scheduled patients in 10-minute increments, “causing pressure for assistants to practice dentistry quickly” and eventually billed Medicaid for their work.
It goes on to outline the fact that Dr. Goodwin would fly from Texas to dental offices in Indiana almost every month, while billing Medicaid for orthodontic patient services in Amarillo on dates when flight records showed he was clearly in Indiana.
The majority of Goodwin’s patients were Medicaid recipients with some reporting that figure could be as high as 95% of his dental practice.
Unfortunately, this is not a new dental braces trend in Texas …
Last June, The Wealthy Dentist reported that in 2010, Texas spent $184 million on Medicaid orthodontics — more than the rest of the United States combined. Dentist Richard Malouf’s All Smiles Dental Centers of Texas collected $5.4 million from Medicaid orthodontics. Since that time, All Smiles’ Medicaid orthodontics billings nearly doubled to $10.2 million.
In September we further reported that WFAA-TV had uncovered that Texas taxpayers had spent $424 million on orthodontics for children under Medicaid. Taxpayers spent $100 million in 2008 and $140 million in 2009 — above the $184 million spent in 2010.
On March 1, 2012 Texas implemented a new managed care Medicaid dental program, only time will tell if this will stem the bleeding of taxpayer money on braces in Texas.
For more on this story see: Feds Link Orthodontist to Medicaid Fraud Scheme