One Dentist in Three Accepts Medicaid (video)

Two-thirds of dentist respondents do not accept Medicaid payments, this survey found.

General dentists are three times as likely to accept Medicaid as are specialists. In addition, the majority of rural dentists do accept Medicaid, whereas most of their urban and suburban colleagues do not.

“I don’t treat these patients for the money,” said a Rhode Island orthodontist. “I treat them because they are children who need orthodontic care that may influence the rest of their lives. A healthy smile may open the world to them! That’s what we went into this profession for.”

A Minnesota pediatric dentist agreed: “It is an ethical and moral obligation to see these people. It is embarrassing that more of our colleagues do not treat some portion of this population in need.”

“Any dentist would have to be NUTS to accept Medicaid,” offered a Florida dentist. “If you are even suspected of impropriety, say by a disgruntled employee, the Feds can SHUT YOU DOWN. Yes, on suspicion only! They can freeze your assets and shut your practice down. It could be years before you get due process. The risks are truly tremendous. And it’s for a pittance, for pennies on the dollar. I know of one dentist who is in JAIL and lost his license over $8000 in clerical errors over a period of five years! I wouldn’t accept Medicaid if they offered DOUBLE my fees.

Read more: Dentists Avoid Medicaid

Dentists with Unpaid Federal Taxes Still Received Medicaid Reimbursements

Dentists with Unpaid Federal Taxes Still Received Medicaid ReimbursementsThe U.S. Government Accountability Office, the investigative arm of Congress, is reporting that approximately 7,000 health providers in New York, Texas, and Florida owed back taxes while collecting payments from Medicaid.

As reported in Bloomberg News, dentists and other health care providers in these three states allegedly owe $791 million in back taxes on the $6.6 billion they made in 2009 from Medicaid.

This represents about 5.6% of the Medicaid providers reimbursed by these same states during 2009.

From the GAO report: The 40 Medicaid providers GAO reviewed received a total of $235 million in Medicaid reimbursements (including Recovery Act funds) in 2009 and had unpaid federal taxes of about $26 million through 2010. The amount of unpaid federal taxes ranged from approximately $100,000 to over $6 million. In addition, IRS records indicate that providers in two of GAO’s cases are currently, or have previously been, under criminal investigation. For example, in one case a provider was caught participating in a medical billing fraud.

From the GAO report

The Recovery Act increased the federal share of Medicaid funding. Since Federal law does not prohibit providers with tax debt from enrolling in Medicaid, GAO discovered that thousands of Medicaid providers do have unpaid federal taxes.

The Recovery Act required that the government track how the funds were distributed and how the recipient’s taxes were paid.

GAO compared Medicaid reimbursement information from these three states to known IRS tax debts as of September 30, 2009 and found that they were among those that received the largest portion of Recovery Act Medicaid funding.

Since Medicaid is administered by states, and not by the federal government, Medicaid payments aren’t considered federal and are more difficult to garnish by the IRS.

Dentists, what do you think the real issue is here?

For more on this story see: Medicaid Providers Owe $791 Million in Taxes, U.S. Says

Dental Management Company Pays $24M Settlement

Dental management company settles pediatric dentirsy billing lawsuitsThe largest dental management company in the US is paying $24 million to settle claims of Medicaid fraud.

Forba Holdings LLC owns 68 “Small Smiles” dental clinics where pediatric dentists serve half a million low-income children in 22 states.

According to the Justice Department, the clinics filed claims for unnecessary pediatric dentistry – including so-called “baby root canals” and other possibly risky procedures.

Forba has agreed to pay $24 million to settle the lawsuits, but did not admit wrongdoing. Their clinics remain open, still providing dentistry for children, though the dental management company will add precautions against future Medicaid fraud.

Of course there’s a pediatric dentist here and there who’s unscrupulous… but a dental practice management company with chronic billing “inconsistencies”?!? Not a good sign.

Read more: Forba Settles Suits Over Unneeded Child Dental Work

Utah Tries (and Fails) to Slash Medicaid Payments to Dentists

Cutting costs: Utah dentists get less from MedicaidLucky for Utah dentists, a federal agency has vetoed Utah’s plan to slash Medicaid payments to dentists.

While the state’s dentists received a one-time 24% pay raise in 2008, Utah lawmakers recently reversed that. (And the dentists didn’t get their 4.5% cost-of-living raise either.)

Understandably, Utah’s dentists objected… and so did the Centers for Medicare and Medicaid Services (CMS), which rejected the plan on the grounds that it would make accessing services even more difficult for dental Medicaid patients – particularly kids seeking a pediatric dentist – not to mention seniors in need of false teeth.

Utah’s Medicaid program will now have to scramble to cut other programs, as the 2010 budget relied on cutting dentist payments by $1.4 million.

Read more: Feds reject Utah’s low Medicaid pay for dentists

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