Texas Dentists for Medicaid Reform

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Latest TDMR Research and Articles

HHS Finally Announces DMO Contract Awardees

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 USA Insurance Company, Inc., MCNA Insurance Company, and United Healthcare Insurance Company for an initial contract period of three years. The award notices will be posted on the Electronic State Business Daily (ESBD) when the contracts are … [Read More...]

OAG Opposes Disqualifying Late Relators in Xerox/Conduent Case

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: Still No DMOs Chosen for New Medicaid Contract

UPDATE, August 30: The tentative start date for this contract is September 2, three days away.  The RFP number didn't come up when we searched for it on the Electronic State Business Daily (ESBD) website this morning. So we phoned Texas HHS Contracting to find out what was up.  We were told the state online contracting system won't show … [Read More...]

Dental Compliance 101: Keeping Patient Information Confidential

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

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...]

Xerox/Conduent Relators to Get Zip, Nada, Nothing; State Now Says

Back in February, the Texas Office of Attorney General and Xerox/Conduent settled the state's longstanding lawsuit against the company for $235.9 million. The original lawsuit under the Texas Medicaid Fraud Prevention Act alleged that Xerox/Conduent had committed Medicaid fraud for its lax orthodontic prior authorization process which used … [Read More...]

Texas HHS OIG August 2019 Update

This came in from OIG. ----------------------------------------------------------- Welcome to the August 2019 edition of OIG Update. This monthly newsletter from the Texas Health and Human Services Office of Inspector General (OIG) provides an update about some of the agency's recent efforts in detecting, preventing and deterring fraud, waste … [Read More...]

HHS Looking To Save $350 Million On Medicaid

HHS sent out this notice today. The 86th Legislature included a cost containment rider in the FY 2020-21 General Appropriations Act directing the Health and Human Services Commission to achieve $350 million in savings by focusing efforts on "increasing fraud, waste, and abuse prevention and detection; seeking to maximize federal flexibility … [Read More...]