DALLAS - Tens of thousands of Texas kids are getting fired -- as patients -- by their Medicaid dentists.
A boom in putting braces on poor children has now come to a screeching halt after a News 8 investigation and a change in state policy, and children from border to border are suffering the consequences.
Texas put braces on 80,000 Medicaid children in 2010, and at least 40,000 in 2011.
Now the state has realized it made a mistake, and has quit paying many clinics for treatment now underway (It usually takes about two years for a child's orthodontic treatment). Some of those dentists are telling Medicaid parents their children they won't be treated anymore. It's happening all over the state.
In Wichita Falls, one orthodontist simply closed his office and sent letters to patients. In Dallas, clinics are suddenly telling their patients they're no longer taking Medicaid. In El Paso, Sun Orthodontics, the largest biller in the state in 2010, is stopping treatment on Medicaid patients.
"You're halfway through my treatment, and you're just going to abandon my kid?" Erika Mendoza said.
In Dallas, Luz Velasquez, whose daughter just got her braces last fall, has been told the same thing by Straight Teeth Orthodontics. Although Imelda, Mrs. Velasquez' daughter, has been assigned to another clinic, her paperwork is stuck somewhere in between, and treatment is stalled.
Dr. John Roberts, the new director of Medicaid dental at the Texas Health and Human Services Commission (HHSC), promises all children will be taken care of.
"The message of HHSC is that no kid is going to be left untreated," Roberts said. "And we are not aware of any instances where that particular issue is not being addressed through proper channels."
The problem for many parents is trying to figure out what the proper channel is.
Some are being dismissed by their clinics. Others are told to go to other clinics. On top of that, the state began a new managed care system in March. Many families have been assigned to insurance providers, but they don't know who those providers are.
With funds cut off, many chains appear to be trying to get out of the business as fast as possible.
All Smiles, which had dozens of clinics last year, is closing all its orthodontic operations and giving parents the option of having their children's braces removed, regardless of where they are in their treatment.
"Leaving braces on without treatment is going to effect them," said Emma Diaz of El Paso, whose son is a Sun Orthodontix patient. "However, what effect is it gonna do if I just go and have them removed? Is it going to move [his teeth,] shift them, is it going to be worse than before?"
"It has been difficult," Dr. Roberts said of the transition to managed care and the change in orthodontics. "But we're getting these solved on a case-by-case basis."
The Texas Dental Practice Act says its illegal to abandon a patient.
Many clinics say that even if their original diagnosis of a child's need for braces may have been faulty, the state approved them, and should continue to pay. Some clinics say if the state quits paying, they'll quit treating.
Caught in the middle are the children.
Who to call for answers on Medicaid braces:
Stephanie Goodman of the Texas Department of Health and Human Services writes:
Medicaid clients should have chosen a Medicaid dental plan on March 1st. Those who did not choose one, should have been assigned to a plan. They should have received a card from their dental plan, and their plan is also listed on their Medicaid card. If a client doesn’t know their DMO, they can call 800-964-2777 to find out.
Patients who need to find a new orthodontist should call their Medicaid dental plan. Children on Medicaid select a dental plan or are assigned to one if they don’t make a selection. The dental plan can help them find a new orthodontist. Here are the numbers for the three dental plans:
Delta Dental: 1-877-576-5899