Emails (excerpted), responses to PolitiFact Texas, Stephanie Goodman, communications director, Texas Health and Human Services Commission, Dec. 14, 2012

From: Selby, Gardner (CMG-Austin) []

Sent: Friday, December 14, 2012 11:30 AM

To: Goodman,Stephanie (HHSC)

Subject: PolitiFact Texas Query




Good  morning.


We are looking into a claim that Texas spent more on orthodontia than the other states combined, which traces to a WFAA-TV news report on Medicaid spending. A US House majority staff report issued in April 2012 says: “Last year, the Texas Office of the Inspector General for the Department of Health and Human Services launched an audit of Medicaid spending on dental services.” Did that report get published? I did not spot anything here.

1114 am

Dec. 14, 2012

No, the OIG report isn’t complete. We have expenditures for orthodontic expenditures in Texas Medicaid, but we don’t have data from other states. We checked with the U.S. Centers for Medicare and Medicaid Services some time ago to see if we could get it, but we were told it would be difficult to compare states because of the different ways state Medicaid programs cover orthodontic services.


I’ve enclosed Texas Medicaid dental costs, and it has ortho costs broken out.


The Legislature increased rates for the most common dental services at the beginning of FY08 so expenditures doubled that year. That increase did not extend to orthodontic services. The rate increase was in response to the Frew lawsuit over children’s access to preventive services in Medicaid.


No doubt, there have been problems with orthodontic services and we paid for claims that didn’t meet the criteria for medical necessity. But it’s also true that Texas has done a much better job than most states in getting children into basic dental checkups. That’s been a problem in Medicaid programs across the nation.


1225 pm

Assorted resources:


n  News release about changes to orthodontic policies in the fall of 2011:


n  Recent lege presentation on orthodontic services:


n  CMS report that includes state-by-state breakdown on dental care rates. I’m trying to find more recent info.


n  CMS report that includes Texas among the states that have done a good job of getting kids into dental care:

129 pm

Here’s much more succinct and slightly more recent info on national issues about Medicaid dental services:


And I’ve enclosed stats on how Texas has seen improvement