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Resource ID: #26789
Subject: Health Care
Source: Texas Tribune
Affiliation: 
Date: May through August, 2014

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Description

For nearly five years, the Texas Medicaid and Healthcare Partnership (TMHP), a subsidiary of Xerox, allowed workers with limited expertise to approve dental claims for Texas' Medicaid program, the joint state-federal insurer of poor children. State spending on orthodontic services spiraled out of control: Between 2003 and 2010, Texas Medicaid payments for orthodontic services grew by more than 3,000 percent — from $6.5 million to $220.5 million — while program enrollment only grew 33 percent. Our investigation found that three years later, the state's aggressive campaign to recover misspent Medicaid dollars had failed to prove any dental providers intentionally committed fraud. Meanwhile, the state maintained its contract with TMHP, and continued to pay the company between $168 and $185 million annually to continue processing certain Texas Medicaid claims.

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