If your child is on Medicaid and has had their braces suddenly removed, they may be the victim of recent changes in Texas law.
As of March 1, 2012, the State of Texas introduced changes that impose new limits on how orthodontists can bill Medicaid for reimbursement. As a result, many orthodontists will lose a significant source of income, and they may make choices that are focused more on their business model than on your child’s health.
Do Texas children really have worse teeth than other states?
In recent years, Texas taxpayers paid $184 million in Medicaid reimbursements for braces. One Texas dental practice made more from billing Medicaid than California and Florida combined. WFAA has done a number of stores on Texas Medicaid and braces.
Braces are usually considered a cosmetic procedure, and generally are not covered by Medicaid. In fact, Texas law prohibits Medicaid reimbursement for cosmetic orthodontic procedures, including braces. Yet many Texas orthodontists have found a way to manipulate the system, putting braces on children who do not need them, and filing claims with Medicaid that result in hundreds of millions in tax dollars paid out every year.
With the recent changes to the rules regulating Medicaid reimbursement, some orthodontists are discontinuing treatment, removing braces, or even disappearing all together, leaving children with real medical needs to fend for themselves.
Signs of trouble
Some or all of the following may apply to your child, if they are on Medicaid and have recently visited a Texas orthodontist:
- The orthodontist suddenly stopped treatment, closed shop, or stopped taking your calls
- Your child’s braces were removed too soon
- Your child’s regular, ongoing orthodontic treatment was suddenly denied
- Your child suffered harm due to poor or inadequate orthodontic treatment
- Your child was given braces that they did not need
If your child is on Medicaid and you believe they were harmed by a Texas orthodontist, we want to hear from you. Contact us using the form at the top of this page. Or you can reach us by phone at 800.677.7095.
