One of the main items of interest to Medicaid dentists from the latest quarterly report from the Health and Human Services Commission Inspector General Stuart Bowen is that a “Pediatric Dentistry Action Team” has been created within his agency.
The impetus for the team’s creation is, per the report, the “recent incidents involving the pediatric sedation or anesthetization of Medicaid pediatric dental patients.” There was a tragic incident in Houston earlier this year with a young girl whose family is now represented by Houston attorney Jim Moriarty who specializes in dental injury cases.
The report states the following:
Responding to a series of recent incidents involving the pediatric sedation or anesthetization of Medicaid pediatric dental patients, the IG launched the Pediatric Dentistry Action Team (PDAT). The PDAT organizationally integrates key elements from across the agency — i.e., inspections, investigations, audit, medical services, data, and legal — to address a key public safety issue: the endangerment of Texas Medicaid children. The IG effort embraces collaborative engagement with the Texas Dental Board.
Consistent with the IG’s mission to detect and deter fraud, waste, and abuse in the delivery of health-care services by Medicaid providers, the PDAT is examining the following two critical issues:
• Are Medicaid dental providers meeting the required medical necessity criteria for performing procedures that use anesthetization and sedation?
• Do the anesthetization/sedation services performed on children meet Medicaid standards?
The PDAT will finalize its survey work in July, conduct field work in August and September, and issue a final report with recommendations and lessons learned in October.