Texas Dentists for Medicaid Reform - Fighting for Due Process Rights for Medicaid Providers

Who Lobbied for UnitedHealthcare, MCNA and DentaQuest

October 31, 2019

For the sake of public disclosure, TDMR is providing the lists of lobbyists registered with the Texas Ethics Commission who lobbied in 2019 on behalf of the three dental insurance companies that were recently announced as the awardees of the contracts for dental services for Texas Medicaid. The reports are in PDF format and are downloadable.. The dollar amount each expects to be paid for the year is in the last column on the right under "Amount." The "LT" designation means "less than." "PROSPECT" means prospective - how much they expect to earn for the year. If you want to … [Read More...]

OIG Update & Quarterly Report – Dental Fraud Highlighted

October 25, 2019

TDMR received an email newsletter this week from HHS-OIG. They promoted their quarterly report and also a special downloadable publication for dentists on illegal dental solicitation. We have these below for you to download. Here some other items of interest from the email. OIG releases second part of audit series The OIG is conducting a series … [Read More...]

Who is UnitedHealthcare?

October 24, 2019

Part of UnitedHealthcare complex in Minnetonka, MN We thought Medicaid dentists might like to know something about UnitedHealthcare, the company that is going to be awarded the third DMO contract for Texas Medicaid, based on the recent announcement by Texas Health and Human Services. We had hoped to have the company supply us with information … [Read More...]

HHS Finally Announces DMO Contract Awardees

October 15, 2019

Texas Health and Human Services has finally made an announcement about the award of DMO contracts for Texas Medicaid. The announcement was posted on the HHS website yesterday and the big winners are MCNA, DentaQuest and newcomer United Healthcare Insurance Company. HHS states: "HHSC intends to award three dental managed care contracts to DentaQuest … [Read More...]

OAG Opposes Disqualifying Late Relators in Xerox/Conduent Case

October 3, 2019

The story of Texas vs. Xerox/Conduent appears to be never-ending. Relators to get money? There is still the issue of qui tam relators and whether or not they are going to get a cut of the Xerox/Conduent settlement. We thought that the OAG (Office of the Attorney General) had already answered no. But, wait for it, that now may not be the … [Read More...]

UPDATE: Texas HHS: Announcement Made – Still No DMOs Chosen for New Medicaid Contract

September 27, 2019

UPDATE: As of October 15, HHS announced the three companies to be awarded this contract. UPDATE: September 27: We checked today. No awards yet. A blinking notice has been placed on the right-hand column of our website showing the contract status as of the last time we checked which will be at least once a week. We'll let you know … [Read More...]

Dental Compliance 101: Keeping Patient Information Confidential

September 17, 2019

By Samona France, Compliance Protection Specialist - Medicaid dentists have a hard job! Low hours and below-market reimbursement rates, coupled with layers of bureaucracy and vague guidelines for marketing to/treating/retaining Medicaid eligible patients can crush the dreams and finances of well-meaning dentists and their practices. But complying … [Read More...]

Why States Aren’t Really Interested in Reducing Medicaid Fraud

September 4, 2019

The following is an article from Jeff Leston of Castlestone LLC . Castlestone provides fraud prevention solutions to governments and others. ------------- Since the passage of the Affordable Care Act, Medicaid expansion has been literally force-fed to states. Federal monies dished out Some, like California, Illinois, and Louisiana, took second … [Read More...]