Texas Dentists for Medicaid Reform

Texas Medicaid Dental Provider Forum NOW OPEN

August 9, 2018

Medicaid dental providers apparently want an online forum to securely discuss mutual problems with Texas Medicaid and DMOs. Some 92% of those taking our survey answered a resounding "yes" to having such a forum. Comments Here are some of the comments left by those answering the survey. "IT CAN BE VERY DIFFICULT AT TIMES, THEY CHANGE THE CRITERIA SO FREQUENTLY." "The reimbursements for orthodontic procedures is pathetic." We need to create a situation that allows providers a voice...at this point, DMO's are beginning to dictate treatment, define clinical parameters and ignore the provider's … [Read More...]

Dentists Comment About DMO Problems & Request for Proposals

August 6, 2018

Since our recent stories about the new dental RFP for Medicaid and DentaQuest's capitation payment move, TDMR has received several emails from dental providers about their concerns over the RFP choices and provider lack of power against such large companies. Comments from dental providers Number of DMOs - "We need 3-4 DMOs so dentists can … [Read More...]

TDMR DMO Survey 2018 Results: MCNA Improves, DentaQuest Has More Problems, Dentists Frustrated

July 26, 2018

We have closed our revised 2018 Dental Management Organization annual survey and are today giving you the results. Our survey sample is not that large, unfortunately. At the end of the day, only 39 providers entered the survey as we decided to ask for actual names and provider numbers to prevent possible false responses. Consequently, it is more … [Read More...]

Six DMOs Likely to Vie for Texas Medicaid Dental RFP But Newcomers May Not Get a Contract

July 23, 2018

An industry insider has told TDMR that he thinks six dental management companies will vie for the Texas Medicaid dental contract RFP that closes in September. He named the two current contractors, MCNA and DentaQuest, and included Liberty Dental and Delta Dental out of California, Avesis, and Scion Dental now Skygen as insurers he felt would … [Read More...]

RFP Released Last Week for Dental Services for Texas Children’s Medicaid and CHIP

July 18, 2018

Rendering of new HHS Building It is finally here, not with a bang but with a sigh. It's been out over a week and not a whisper about it until today despite the fantastic anticipation by dental Medicaid providers over the last number of months, if not years. But with the recent foofaraw and resignations over HHS contracts again, maybe that is … [Read More...]

State Audit Finds Billion-dollar Errors in Texas Health and Human Services’s Contracting Process

July 18, 2018

The new audit is yet another scandal at an agency plagued by contracting woes. Six of the commission's leaders have left in the last several months. BY EMMA PLATOFF Republished from the Texas Tribune A new state audit has found that Texas’ health agency may have awarded more than $3.4 billion in contracts erroneously — another scandal at an … [Read More...]

Dental Providers Riled Up About DentaQuest Capitation Payment Plan

July 16, 2018

TDMR has received an email from a group calling itself "Texas Dentists for Fairness." Per their email, they are a group of owners of individual clinics from around the state Other than that we don't know anything about them. They are tremendously concerned by DentaQuest's "private conversations with some of the largest DSO servicing Medicaid in … [Read More...]

New HHS-OIG Report Criticizes MCO Identification of Medicaid Fraud and Abuse

July 12, 2018

The U.S. Department of Health and Human Services Office of the Inspector General issued a report yesterday that found that managed care organizations are not doing enough to identify Medicaid waste, fraud and abuse. HHS-OIG undertook the review because it and "others have ongoing concerns about program integrity in Medicaid managed … [Read More...]

DentaQuest Now Promoting Capitation Payments Instead of Fee-for-Service to Some Providers

July 9, 2018

TDMR has confirmed rumors that a number of Texas dental providers have been approached by DentaQuest to change their payment method from managed fee-for-service to capitation. Capitation to "share the financial risk" with providers A capitation payment is a fixed amount of money per patient … [Read More...]

House Committees Hear Concerns on Medicaid Managed Care Program for Medically Vulnerable Texans

June 28, 2018

By Marissa Evans June 27, 2018 Linda Badawo says she doesn’t know if managed care works or not — but it hasn’t worked for her family. Sitting with her son D'ashon beside her in his wheelchair, Badawo told legislators during a joint hearing of the House General Investigating & Ethics … [Read More...]

Analyst Predicts Xerox/Conduent to Pay $500 Million to Texas to Settle Medicaid Fraud Lawsuit – Share Price Drops

June 26, 2018

UPDATE: Conduent Share Price Drops 13% Over The Last Few Days - The stock market has apparently reacted harshly to the recent Seeking Alpha analysis on the underappreciation of the $2 billion Texas Medicaid fraud lawsuit against Xerox/Conduent. The stock price of the company is now sitting at … [Read More...]

Xerox Can’t Blame Dentists in State Fraud Case Rules Texas Supreme Court

June 22, 2018

The Supreme Court of Texas today rejected an attempt by Xerox/Conduent to point the finger at Texas dentists when it goes to court in an attempt to defend itself from at least $2 billion in damages and penalties stemming from its failed Medicaid orthodontic prior authorization process from 2004 … [Read More...]

Charles Smith Retires, Cecile Young Takes Over As Another HHS Executive Commissioner Hit By Contracting Woes

June 13, 2018

In case anyone missed it, Charles Smith, the Executive Commissioner of Texas Health and Human Services retired at the end of May. The continuing saga of poor contracting practices at the state agency enraged legislators and Gov. Abbott. As the Texas Tribune reported: "In recent weeks and months, … [Read More...]

A Texas health commission employee was fired. Then she received the private information of more than 100 clients.

April 26, 2018

Tracy Ryans pulls out client applications containing private information that was mistakenly sent to her from the Texas Health and Human Services Commission, on April 24, 2018. Pu Ying Huang for The Texas Tribune. By Marissa Evans, The Texas Tribune April 25, 2018 Tracy Ryans got mail — straight … [Read More...]

Texas Medicaid Dental Maintenance Organization Annual Survey 2018

April 20, 2018

UPDATE: April 20: NEW SURVEY IS OPEN After reviewing the responses from the previous version of the survey, we closed it because there was a large amount of doubt about the veracity of some of the answers provided. The largest indicator was that 46% of those claiming they were Medicaid dentists … [Read More...]

Texas Health Official Resigns Amid Contracting Errors

April 18, 2018

Heather Griffith Peterson has resigned from her job as chief operating officer for the Texas Health and Human Services Commission. Texas Health and Human Services Yoiks, here we are again.By Marissa Evans, The Texas Tribune April 18, 2018 The state official who oversees information technology … [Read More...]

State auditor finds more contracting errors made by health agencies

April 17, 2018

Charles Smith of the Texas Department of Health and Human Services testifies Wednesday, Nov. 1, 2017, to the House Committees on Human Services and Public Health at the Capitol. Bob Daemmrich for the Texas Tribune. Texas HHS still hasn't learned its lesson about contracting, from before Jack … [Read More...]

Dentists Comment About DMO Problems & Request for Proposals

TDMR DMO Survey 2018 Results: MCNA Improves, DentaQuest Has More Problems, Dentists Frustrated

Six DMOs Likely to Vie for Texas Medicaid Dental RFP But Newcomers May Not Get a Contract

RFP Released Last Week for Dental Services for Texas Children’s Medicaid and CHIP

State Audit Finds Billion-dollar Errors in Texas Health and Human Services’s Contracting Process

Latest TDMR Research and Articles

Texas Medicaid Dental Provider Forum NOW OPEN

Dentists Comment About DMO Problems & Request for Proposals

TDMR DMO Survey 2018 Results: MCNA Improves, DentaQuest Has More Problems, Dentists Frustrated

Six DMOs Likely to Vie for Texas Medicaid Dental RFP But Newcomers May Not Get a Contract

RFP Released Last Week for Dental Services for Texas Children’s Medicaid and CHIP

State Audit Finds Billion-dollar Errors in Texas Health and Human Services’s Contracting Process

Dental Providers Riled Up About DentaQuest Capitation Payment Plan

New HHS-OIG Report Criticizes MCO Identification of Medicaid Fraud and Abuse

DentaQuest Now Promoting Capitation Payments Instead of Fee-for-Service to Some Providers

House Committees Hear Concerns on Medicaid Managed Care Program for Medically Vulnerable Texans

Analyst Predicts Xerox/Conduent to Pay $500 Million to Texas to Settle Medicaid Fraud Lawsuit – Share Price Drops

Xerox Can’t Blame Dentists in State Fraud Case Rules Texas Supreme Court

Charles Smith Retires, Cecile Young Takes Over As Another HHS Executive Commissioner Hit By Contracting Woes

A Texas health commission employee was fired. Then she received the private information of more than 100 clients.

Texas Medicaid Dental Maintenance Organization Annual Survey 2018

Texas Health Official Resigns Amid Contracting Errors

State auditor finds more contracting errors made by health agencies

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