What Do You Think About Texas Medicaid Now?

Back in July 2013, TDMR surveyed Medicaid dentists about their opinions and problems with Medicaid at that time. 139 providers answered up and "provider rights" was the most popular response for the challenges Medicaid providers were facing then. Things have changed.  The Medicaid enforcement environment has reformed over the last three years and there have been numerous … [Read more...]

Dentist To Publish Book on Texas Medicaid Ordeal

Dr. Juan D. Villarreal of Harlingen Family Dentistry and founder of Texas Dentists for Medicaid Reform has completed the writing of a book about his personal experience with Texas Medicaid and its attempt to falsely accuse Texas dentists of healthcare fraud over dental and orthodontic treatment given to thousands of indigent children from 2007 to 2012. Book documents … [Read more...]

What Happened at the Edinburg Medicaid Managed Care Townhall Meeting in May

Back on May 19, Sen. Chuy Hinojosa and Rep. Richard Peña Raymond hosted a town hall meeting for providers on Medicaid managed care in Edinburg at the Edinburg Conference Center at Renaissance. It has taken a while but here are some collected observations about what occurred at the meeting. Well attended but geared more for medical providers First of all, the meeting … [Read more...]

Video of Texas State Board of Dental Examiners Public Hearing Available

On Thursday, June 23, the Texas Sunset Advisory Commission held its mandated public hearings on state agencies under review this legislative session. Four hours of testimony Over the 12 hours of testimony were given before the Commission on that date with four of those relating to the State Board of Dental Examiners. The staff of the Commission had already submitted a … [Read more...]

Dentists in Texas Participating in Medicaid Increasing, Number of Orthodontists Decreasing

Recently, TDMR filed an open records request with the Texas Health and Human Services Commission to find out how many individual Texas dentists are currently participating in Medicaid and how those participation numbers have changed since the Frew settlement in 2007. Overall participation up by 223% The results are now in - the total number of dentists providing Medicaid … [Read more...]

Sunset Review Public Hearing on State Board of Dental Examiners Next Week

Those that want to make their views known about the current state of the Texas State Board of Dental Examiners can testify in Austin next week before the Sunset Advisory Commission.  The staff report from the Commission is highly critical of the board's operation - see our previous story on this from April. The public hearing is taking place on Thursday, June 23, starting at … [Read more...]

Texas Ranger Investigation into Trueblood Settlement Still Open After Nearly Two Years

You might remember the case of Austin dentist, Dr. Rachel Trueblood. $16 million overpayment demand settled for $39,000 Back in 2014, Dr. Trueblood had been accused of Medicaid fraud, placed on "credible allegations of fraud" payment hold which closed her dental clinics in Austin and was being demanded to pay back to the then-Health and Human Services Commission Office of … [Read more...]

Medicaid-Provider Dentist to Head Texas Dental Association Next Year

McAllen dentist Dr. Jose “Joey” Cazares has been elected by members of the Texas Dental Association’s House of Delegates to be the 2016-2017 President-Elect of the Association, and will automatically ascend to the Presidency in 2017-2018.  Dr. Cazares will be the first president of the TDA to be elected from the Rio Grande Valley District Dental Society. Dr. Cazares is … [Read more...]

HLD Scoring Sheet Would Have Been Eliminated by 2009 Medicaid Orthodontic Benefit Policy Revision

The policy revision to the Medicaid orthodontic benefit process contemplated by representatives of the Texas Medicaid and Healthcare Partnership and the Health and Human Services Commission in 2009 was sweeping.  Per the final draft of the confidential policy revision attached as an exhibit to a court filing by Xerox last month, it would have eliminated and replaced billing … [Read more...]

TMHP/Xerox: Board Certified Orthodontist Review of Medicaid Ortho Prior Authorizations Too Costly

The Health and Human Services Commission in February 2009 asked the individuals working on the new Medicaid orthodontic benefit policy to review whether or not a board certified orthodontist should review each and every prior authorization request for orthodontic treatment. In fact, it was recognized as one of the major issues.  Per the document in the recent court filing by … [Read more...]

Document Shows State Knew Details of Xerox Medicaid Orthodontic Prior Authorization Process in 2009

The TMHP document reported about in our last story that was recently appended to a court filing by Xerox shows that staff from the Health and Human Services Commission and its Office of Inspector General were well aware of the details of Xerox's orthodontic prior authorization process. They knew because TMHP/Xerox did answer the five questions asked by Medicaid dentists about … [Read more...]

Medicaid Dentists Demanded to Know Who Was Reviewing Orthodontic Prior Authorizations in 2007

A new document has come to light out of the lawsuit the state filed in 2014 against Xerox, its former Medicaid claims administrator, that shows Medicaid dentists were concerned as early as 2007 about Xerox's prior authorization process and demanded to know how it worked. In fact, it appears from the document that a policy review of the whole Medicaid orthodontic program was … [Read more...]


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