P.O. Box 12068, State Capitol
Austin, Texas 78711
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SENATOR NELSON LEADS REVIEW OF MEDICAID ORTHODONTICS, PUBLIC HEALTH
AUSTIN — Texas State Senator Jane Nelson, R-Flower Mound, today presided over a hearing of the Health and Human Services Committee relating to interim charges on the determination of medical necessity for Medicaid services and on public health. Much of the hearing focused on waste and abuse within the Medicaid system.
"I am very concerned about the level of waste and abuse in the system right now, especially within Texas' Medicaid orthodontics and transportation programs," said Senator Nelson. "Any amount of fraud is unacceptable but – given our budget challenges – we need to be particularly aggressive in protecting our investment in these services. Today's hearing reinforced the need to continue examining the way we authorize expenditures of taxpayer dollars."
The committee heard invited and public testimony on the following two interim charges:
- Review existing policies for prior authorization and medical necessity review across the Medicaid Program, including nursing homes and orthodontic services; and make recommendations on how these policies could be improved to save money by reducing unnecessary utilization and fraud.
- Examine the delivery and financing of public health services in our state, including how federal funds are distributed by the state to local health departments and whether the work done by Regional Health Departments operated by the Department of State Health Services overlap unnecessarily with local health departments.
The committee must file a report of its findings prior to the next legislative session. To follow the progress of this and other interim studies, visit www.capitol.state.tx.us, where you may watch live feeds and sign up to receive meeting notices.
SENATOR JANE NELSON represents District 12, including portions of Tarrant and Denton Counties. She is Chairman of the Senate Committee on Health & Human Services.