In a blistering 225-page report on the Texas Health and Human Services Commission, the Texas Sunset Advisory Commission recommended that the state’s health and human services system undergo a massive overhaul.

In one instance, for nearly five years, a state contractor — the Texas Medicaid and Healthcare Partnership — allowed workers with limited expertise to approve millions of dollars in dental and orthodontic claims. Now, the federal government says Texas is responsible for paying it back, because the state agency overseeing the contractor failed to ensure its workers followed Medicaid guidelines.

Read more at The Texas Tribune