Medicaid dollars are a precious resource. So many good people fight so hard for them. It’s excruciating to see them wasted.
I remember in 2009, the Legislature refused to spend $38 million over two years for a CHIP buy-in program that could have covered as many as 80,000 more kids. A small amount that would benefit so many. But no.
So, to see Texas Medicaid’s dental benefit so totally mismanaged and costing $500 million… It’s unbelievable that we haven’t seen more outrage. Earlier this month, the Texas Trbune ran a story, Texas Dental Board is Accused of Ineptitude, about how Texas toddlers enrolled in Medicaid were being held in restraints as dentists performed unnecessary root canals. Some blamed “an underfunded and understaffed state board” that was supposed to be regulating the industry.
Then, last week, the House Committee on Oversight and Government Reform had a hearing on Medicaid fraud and oversight in which Texas was on center stage. Here is the testimony of UT Southwestern orthodontist Dr. Christine Ellis:
“Texas has learned a painful and expensive lesson in the folly of simply increasing public funds in hopes of increasing access to care. Several years ago, Texas settled the long running Frew class action lawsuit. It claimed, among other things, that children covered by Medicaid did not have access to care mandated under EPSDT (Early and Periodic Screening, Diagnosis, and Treatment program). Part of the settlement mandated the increased spending of $1.2 billion to increase their access to care… “Five years and over half a billion dollars later, Texas has spent a lot of money straightening basically already straight teeth and has gained a lot of fraudulent orthodontic providers…The sad conclusion to this entitlement driven transfer of money is that in Texas we have used the mouths of children to enrich unethical providers and private equity investors. While access to care has increased, access to quality care remains a problem.
“In fact, it is possible that these children are more at risk of receiving unneeded poor quality care than they were before the changes mandated by Frew took effect.”
This makes me so angry. On one hand, we hear from proponents of Medicaid block grants that Texas could do a better job managing its own Medicaid dollars without strings from DC. But then, I see this. This should be Exhibit A in what a poor job Texas has done managing Medicaid spending.
To waste millions is bad enough, but to hurt children while doing so is excrutiating. Obviously, the state is focusing on the wrong villains. We’ve got hundreds of state workers triple-checking to make sure some poor mother mails in the right pay stubs to qualify for Medicaid, but far too few people looking to make sure providers are actually delivering quality care.