Back in June of 2019, a representative of HHSC-OIG did a presentation on dental solicitation of Medicaid patients to several dental associations. This was mentioned in their Quarterly Report – 4th Quarter report we reported on last October.
However, we did not provide a copy of this presentation or provide details about it since OIG also published a pamphlet on the subject at the behest of the Texas Dental Association which we did provide.
Looking at it recently, we thought it might be good to provide this presentation for Medicaid dentists as well.
This is what OIG said about it.
“Jonathan O’Reilly, Director of Fraud Analytics in DAT, delivered a presentation of a data review to two dental associations in June. It focused on Medicaid dental billing that may demonstrate illegal patient solicitation activity. The presentation offered a deep dive into what the problem is and what data analysis revealed about the scope of the problem across the state. The OIG conducted a statewide examination of Medicaid dental claims between September 1, 2017 and August 31, 2018. Nearly 5,400 non-specialist billing providers were included, along with 2.3 million patients who had received a general dental service. The OIG used these data findings to prioritize provider investigations. The presentation help foster discussions among the OIG, DMOs, Medicaid/CHIP, and dental associations on how to collectively address the issue that illegal dental solicitation poses to the integrity of the Medicaid program.”
Here is the presentation. We hope it is helpful.DAT-Dental-Solicitation-Analysis-June-2019