Texas officials are clamping down on funding for orthodontic and dental services amid a widening investigation into allegations that doctors have routinely sought reimbursement for procedures that aren't covered by Medicaid, including putting braces on youngsters for purely cosmetic reasons and performing unnecessary root canals on small children.
Medicaid, a federal-state program that insures lower-income people, typically covers only severe orthodontic conditions, such as children born with a cleft palate or those with dental problems resulting from Down syndrome or muscular dystrophy. The program also covers periodic dental checkups and, when necessary, fillings, crowns and root canals.
While dentists and orthodontists in other states have been accused of Medicaid fraud, the problem appears to be particularly acute in Texas, partly because the state settled a civil lawsuit in 2007 that required it to increase Medicaid funding for dental services, state officials say.
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