Texas Medicaid Awash in Dental Fraud

Shenanigans followed on four-fold expansion


Texas has yet to get a handle on millions of dollars in fraud, an unintended consequence of a fourfold increase in spending on dental services provided by the state's Medicaid program.

The state Department of Health and Human Services has denied $8.2 million in Medicaid claims made by 26 dentists and orthodontists across the state under suspicion of fraudulent billing for procedures like cosmetic braces not normally covered by Medicaid or unnecessary root canals, the Wall Street Journal reports.

An audit of the 600 reimbursement requests done at the state's request by Christine Ellis, a Dallas orthodontist, found in more than 90 percent of the cases the dental work was not covered by Medicaid.