NEWS 8 INVESTIGATES
AUSTIN — A six-month News 8 investigation has led to changes for the dental Medicaid program in Texas.
The Texas Health and Human Services Commission announced a series of corrective changes after News 8 found $184 million in Medicaid payments for braces last year. That's more than the other 49 states combined.
State regulations require that braces paid for by Medicaid are a medical necessity — not merely cosmetic.
Last week, News 8 tried to interview Dr. Jerry Felkner, the dental director who oversees the approval of Medicaid spending in Texas, but he sped off from our cameras.
Dr. Felkner has now left the program.
He worked for ACS Texas Medicaid Health Partners, the company that was contracted to monitor taxpayer-financed dental claims under Medicaid.
ACS has now hired a new dental director and added two more orthodontists and 10 additional staff to its dental unit. The agency also said it will begin requiring full-cast dental molds with all requests for braces.
State regulators also will pull hundreds of cases to review the contractor's approval process.
If the review finds the approved services don't meet state criteria, state regulators hope to recover the costs from the contractor.