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Dentist Tells His Story – “Medicaid for Braces is Over”…

ortho case

TDMR received the following from a Texas Medicaid dentist who wishes to tell his story about his history with the HLD scoring system and the current state of Medicaid for orthodontia. He asked to remain anonymous. When I began working with the Medicaid program about 22 years ago, National Heritage Insurance Company (NHIC) was employed by HHSC to administer it for the dentists in Texas. Since orthodontists do not use the HLD evaluation in private practice, I found it new to me. Most citizens want straight teeth that occlude properly. Any area that is out of alignment is generally not acceptable. The American Association of Orthodontists has never considered anything less and always promoted proper occlusion to avoid areas susceptible to decay or periodontal problems. I found difficulties … Read More...

hammond

There Needs to be a Difference Between Fraud and an Error…

On September 3rd, Rachel Hammond of the Texas Association for Homecare and Hospice testified before the House Human Services Committee on SB 1803 and due process rights for Medicaid providers. Hammond gave examples of difficulties that their members were having with OIG investigations.  One point she made was that there needs to be a differentiation made between fraud and an error.  For … [Read More...]

nazari

$500,000 Spent on Hearings Worthless if HHSC Can Just Overturn the…

Dr. Behzad Nazari of Houston testified before the House Human Services Committee on September 3rd on SB 1803 and due process rights for Medicaid providers. Nazari's Antoine Dental clinics was put under a 100% payment hold for their Medicaid orthodontic billings and went to a payment hold hearing at the State Office of Administrative Hearings in 2013. The hearing lasted four days before two … [Read More...]

evans

$4 Million Mistake – Dentist Didn’t Record Toothbrush…

Dr. Chad Evans of Smile Magic Dentistry in Dallas testified before the House Committee on Human Services last week regarding his experience with due process rights for Medicaid providers under SB 1803 and the HHSC Office of the Inspector General. 117 staff lost their jobs Evans testified that his practice was placed under a 100% Medicaid payment hold by OIG .  Due to the payment hold, 117 … [Read More...]

dunn

Dentist Says Armed Agent Came to His Office After…

Dr. Paul Dunn testified before the House Human Services … Read More...

House Committee on Human Services

Rep. Raymond Tells Medicaid Dentist “We Got…

This past Wednesday, the Texas House Human Services … Read More...

THHSC building

OIG Video Flawed on Educating Medicaid Providers…

This past Wednesday, the same day as the House Committee on … Read More...

ACS Xerox

Xerox Agrees to Temporarily Turn Over Medicaid…

The following excerpt is from the Houston Chronicle about … Read More...

Wilson

Full Testimony of Inspector General Doug Wilson…

On August 14th, the Senate Committee on Health and Human … Read More...

Austin Texas Capitol

House Human Services Committee to Hear Testimony…

The Texas House of Representatives Committee on Human … Read More...

xerox

State Again Sues “Reckless and…

The state is suing Xerox for a second time, afraid the … Read More...

fraud

State Settles $16 Million Medicaid Fraud Case for…

In a stunning reversal of their previous hard-line stance, … Read More...

Wilson

Doug Wilson Tells Senators “We lift payment…

Texas Health and Human Services Commission Inspector General … Read More...

nelson

Sen. Nelson Frustrated with Inspector General over…

Sen. Jane Nelson quizzed Health and Human Services … Read More...

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