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

Dental Braces: Once Again Texas Makes News with Braces

Dental Braces: Once Again Texas Makes News with Braces 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

Dentists Not Impressed with Medicaid (VIDEO)

In this survey, we asked dentists if they accept Medicaid. Two-thirds of dentist respondents revealed that they do not accept Medicaid payments.

Though one in three dentists does take Medicaid, many were unimpressed.

Read more: Medicaid Does Not Inspire Dentists

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

Warning: Dentists in Texas Should Use Internet Dental Marketing

Warning: Dentists in Texas Should Use Internet Dental MarketingWhile direct mail marketing doesn’t even come close that of Internet dental marketing, there are still dentists who prefer it as a method to market new dental patients.

Lord Dental in Fort Worth Texas probably wishes they had gone the Internet dental marketing route after resident Jill Dominguez received their mail piece and thought it was a scam.

The mail piece outlined the upcoming changes for children enrolled in the Texas Medicaid and the Children’s Health Insurance Program and how they will be managed after March 1st. It included an advertisement for the services of dentist Leyla Lord.

Upset, Jill Dominguez wrote to Dave Lieber, the watchdog reporter for the Star-Telegram. She stated, “Nowhere on these forms does it say ‘solicitation’ or ‘advertisement’ or any such thing.” Dominguez felt the mailing could be a violation.

Lieber contacted Stephanie Goodman, a spokeswoman for the Texas health commission who told him,“Our rules do limit direct marketing for health plans and providers, and this mailing violates that rule. We’ve contacted this dental office to let them know. The state rules that apply to our managed-care organizations and providers are new territory for dentists, so the dental office may not have been aware of these rules.”

Goodman further states that, “Direct marketing is defined as marketing that targets an individual. It’s someone calling you, knocking on your door or sending a mail out directly to you. Direct marketing doesn’t include radio, TV or print ads because the audience there is broader. When someone hears a radio ad, they know that the ad wasn’t meant specifically for them.”

The state then contacted Lord’s dental practice after Dominguez’s complaint.

It turns out dentist Leyla Lord’s husband is an attorney and he responded to the claim that Lord’s dental practice was using direct mail marketing for advertising her dental practice by saying, “The mailings blanketed the 76103 ZIP code as a way to alert his wife’s patients and others in the neighborhood about the change (when Texas moves to a managed-care system).”

In response to Watchdog Leiber’s quote of the Texas law, that a dental practice “shall not conduct any direct contact marketing except through enrollment events,” Lord’s husband pointed out the ridiculousness of the “direct contact” statement and asked what it means.

I guess it means you better be careful what you mail to your dental patients in Texas. Stick with Internet dental marketing. It’s safer.

Read more here: Fort Worth dentist’s mailing opens a whole can of worms

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