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Texas Health Steps
Dental Program
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Dental
check-ups are recommended every 6 months, starting at age 1. Below are
the different types of dental health services offered for Medicaid eligible
children and youth. - Client Eligibility
- Complaint Management System
- Dental Client Rights
- Emergency Dental Services
- Orthodontic Services
- Preventive Services
- Treatment Services
Client Eligibility:
Children, teens, and young adults to their 21st birthday who are enrolled in Medicaid can get Texas Health Steps dental services.
Complaint Management System
Complaints from any source regarding services, providers (including office staff), clients, or program/administrative staff received by the THSteps Oral Health program are reviewed by the Oral Health program staff and referred, if necessary, to the appropriate agencies for investigation/disposition, i.e., the Texas State Board of Dental Examiners (TSBDE), the Office of Investigation and Enforcement at the Health and Human Services Commission (HHSC), Provider Relations staff at the Medicaid fiscal agent, THSteps regional staff, and/or the Regional Dental Directors. Program staff does not investigate nor resolve complaints unless there are exceptional circumstances involved.The complainant is notified in writing that their complaint has been received, and if appropriate, is being investigated. The complaints are documented and tracked via a database to monitor frequency, volume, and trends of complaints regarding each provider.
Dental Client Rights
Dental providers enrolled in the Texas Medicaid Program enter into a written contract with Texas Department of State Health Services to uphold the following rights of the Medicaid client:- The right to receive dental services which meet or exceed the standards of care established by the laws relating to the practice of dentistry and the rules and regulations of the TSBDE;
- The right to receive information following a dental examination regarding the dental diagnosis; scope of proposed treatment, including alternatives and risks; anticipated results; and the need for administration of sedation or anesthesia, including risks;
- The right to full participation in the development of the treatment plan and the process of giving informed consent;
- The right to freedom from physical, mental, emotional, sexual, or verbal abuse or harm from the provider or his/her staff; and
- The right to freedom from overly aggressive treatment in excess of that required to address documented medical necessity.
Emergency Dental Services include:
- Procedures necessary to control bleeding, relieve pain, and eliminate acute infection,
- Pperative procedures that are required to prevent imminent loss of teeth, and
- Treatment of injuries to the teeth or supporting structures.
Orthodontic Services include:
(Prior authorization is needed)- correction of cleft palate,
- provision of orthodontic appliances,
- crossbite therapy,
- treatment for facial accidents involving severe traumatic deviation, and
- treatment for severe, handicapping malocclusion.
Preventive Services include:
- dental examinations, (initial or periodic),
- cleaning (prophylaxis),
- oral health education,
- application of topical fluoride,
- application of sealants to certain teeth, and
- maintenance of space.
Treatment Services include:
- restorations (fillings, crowns, etc.),
- endodontic treatment (pulp therapy, root canals, etc.),
- periodontic treatment (gum disease),
- prosthodontics (full or partial dentures), and
- oral surgery (extractions),
- implant services and Maxillo-facial prosthetices.
Last Updated January 10, 2007
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