I am not condoning fraud, but at least I can wrap my mind around someone's motivation to commit fraud. What I can't wrap my mind around is an office staff willing to torture children by not administering anesthesia. I'm pretty sure Peachcare covers anesthesia. Of course, they may have filed as if it were provided and not given it.

Either way, assholes.

This is the story ABC News Nightline touched on several times over the years. Horrifying.

OMG THAT IS DISGUSTING.

I don't recall either of my parents ever coming into the dental exam room with me when I was a child, but IIRC, there were no doors between the waiting room and the exam room, and if I had screamed, my parents would have run in to see what was going on. (Fortunately, my exams pretty much amounted to, "Let's check your teeth - hey, no cavities, congratulations! I'll do a cleaning and then we'll take a Polaroid of you for our 'Kids With No Cavities Wall'.")

These poor children could be traumatized for life. In these cases, we're talking about baby teeth, but they may grow up so fearful of the dentist that they avoid getting regular cleanings of their adult teeth, and that can lead to gum disease and other nasty things.

http://rn-t.com/view/full_story/2097...ance=home_news

This is really snowballing. :(

aephialum, I think some were adult teeth that were hacked out of the kids' mouths. I can't imagine.

PeachCare is subset of Georgia Medicaid, but those on PeachCare aren't always "medicaid eligible" per se. The state decided a couple years ago that children of State of Georgia employee's would be enrolled under PeachCare through Georgia Medicaid as a cost saving effort while the parents are enrolled in whatever commercial carrier the state chooses to contract with for the plan year (Blue Cross, Aetna, whoever. I'm not sure who they are offered). The parents can be making well over the medicaid requirement for state assistance and wouldn't typically be eligible, but because they are state employee's their children roll under the Georgia Medicaid PeachCare umbrella. I don't think employees have the option to opt their children into the commercial carrier rather than PeachCare.

Doctors were up in arms about it when the state announced it because it impacted their revenue. Commercial carriers pay A LOT more than medicaid. Parents weren't thrilled either because they felt their services could be impacted as well as their provider network. It's true (especially in the Rome area!) the many doctors do not want to take Medicaid members.

I may have mangled this explanation a bit, so don't flame me if it isn't exactly right. :)