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
Phillip says
I’m a dentist from the Dallas/Ft. Worth area and the solicitation of children by dentists continues to be a huge problem in this area. Families are offered gifts and cash to come to dental offices whether they need dental services or not. I see children who have been to these other dentists and many times the work they claimed to perform is not being done. OIG publishes information about how this is against the rules, etc., but it has had little to no effect on this practice. OIG’s Quarterly Reports seem to indicate that they have a lot of cases open on dentists, but we never see a highlight on a case where a dentists was punished for solicitation. The Texas Board never says anything about this unlawful practice. What has TDA done to help? What is OIG doing about this? If you never see a police car on the highway, you are probably going to speed more often. This is the same thing. If no one publishes outcomes that show what can happen to dentists who solicit, no one is going to stop doing it. I guess contacting my local legislator might help. Seems State agencies only step up their game when the Governor or legislators start asking them about their business. That’s sad. It is very frustrating and depressing to be a Medicaid dental provider trying to abide by rules and continue to see others go unpunished for doing the wrong thing. I’m sorry, but I cannot provide a good e-mail address or identify myself. I don’t want to risk blowback by dentists in this area.
Jane says
I agree…
Phillip says
‘m a dentist from the Dallas/Ft. Worth area and the solicitation of children by dentists continues to be a huge problem in this area. Families are offered gifts and cash to come to dental offices whether they need dental services or not. I see children who have been to these other dentists and many times the work they claimed to perform is not being done. OIG publishes information about how this is against the rules, etc., but it has had little to no effect on this practice. OIG’s Quarterly Reports seem to indicate that they have a lot of cases open on dentists, but we never see a highlight on a case where a dentists was punished for solicitation. The Texas Board never says anything about this unlawful practice. What has TDA done to help? What is OIG doing about this? If you never see a police car on the highway, you are probably going to speed more often. This is the same thing. If no one publishes outcomes that show what can happen to dentists who solicit, no one is going to stop doing it. I guess contacting my local legislator might help. Seems State agencies only step up their game when the Governor or legislators start asking them about their business. That’s sad. It is very frustrating and depressing to be a Medicaid dental provider trying to abide by rules and continue to see others go unpunished for doing the wrong thing. I’m sorry, but I cannot provide a good e-mail address or identify myself. I don’t want to risk blowback by dentists in this area.