A dozen years ago, Texas health care administrators hired a company to help determine when taxpayers should cover the cost of dental care for the state’s poorer residents, particularly children.
The company, later acquired by the giant corporation Xerox, deployed a team of medical specialists to review the tens of thousands of requests for dental and orthodontic care that flowed in every year. After evaluating each record, including X-rays and molds of the patient’s mouth, the experts rendered a professional opinion as to whether a procedure was medically necessary, the standard to earn Medicaid coverage. The system ensured that public money was responsibly spent.