Audit of Massachusetts Medicaid Program Reveals Questionable Claims

Audit of Massachusetts Medicaid Program Reveals Questionable Claims

Written by Dentistry TodayWednesday, 13 March 2013 13:02

Dental providers in Massachusetts may have made some faulty Medicaid claims.

A state audit has found that about $1.3 million in bad medical claims were made from January 2008 through June 2011.

The auditor, Suzanne Bump, claims that MassHealth needs to be more thorough when screening payments from dental providers.

Many of the questionable charges stem from detailed oral screenings, which are only allowed for patients undergoing radiation, chemotherapy or organ transplant, according to MassHealth regulations.

The audit, however, discovered that 10 dental providers billed that state and received payments for about 20,000 oral screenings involving patients not eligible for these types of oral screenings.

Roughly 2,000 dentists took part in the state’s dental program during the audit period

New Drug May Aid in Oral Cancer Treatment

New Drug May Aid in Oral Cancer Treatment

Written by Dentistry TodayThursday, 14 March 2013 15:37

There could be a new method to treat mouth sores normally associated with cancer.

Mouse model studies have shown that protein Smad7, when given genetically or topically, could thwart the mouth sores that develop in cancer patients.

Mouth sores are a major problem for some cancer patients. They can become so severe that feeding tubes are necessary for nutrition and painkillers are later needed. Roughly 40 to 70 percent of patients with upper-body radiation encounter this problem. And, unfortunately for these patients, there is no known treatment as of now.

The study involving this new protein appears in Nature Medicine.

The group of researchers would like to further explore the possibilities of Smad7 as a way to combat human oral mucositis. In some of the studies, Smad7 was combined with a short peptide to permit the protein to cross through cell membranes. This was produced from cultured bacteria. After the substance was applied to the mouse’s oral cavity, it prevented oral mucositis, in addition to healing ulcers that were already present.

The ultimate goal from this research is to create a drug that can be given topically that will treat oral mucositis and deter more sores from developing.

The mice were engineered in a manner that they developed oral mucositis similar to the condition that human cancer patients are afflicted with. This made way for numerous tests and experiments.

Colorado Advocates Look out for Children’s Dental Care

Colorado Advocates Look out for Children’s Dental Care

Written by Dentistry TodayFriday, 15 March 2013 11:39

Officials recently called dental benefits an optional treatment for Colorado’s new state insurance exchange. But Colorado health advocates are pushing to make sure the dental care is mandatory.

These dental-care policies will be available in October but there is no federal mandate to buy oral health coverage as of now.

It’s essential for the health of the children in the state to have the same chance to receive dental care as they have to receive medical care.

As of now, however, there are no plans to do anything beyond the federal decision, which focuses on the consumer choice as opposed to state mandates.

Dental and vision coverage will be offered and bundled in some cases but dental coverage is not required for children.

In the three years prior to 2011, the number of children in Colorado without dental insurance rose 17 percent to 2.1 million children, according to a Colorado Trust study. There are some people who will be aided by the Medicaid expansion process, which is part of health reforms in 2014.

Some studies have shown that 240,000 people from Colorado without coverage will receive medical care after the Medicaid expansion.

The state insurance exchange is anticipating 150,000 people will sign up during the first year. Private foundations are doing their part to attempt to close the dental gap in Colorado.