In March TDMR reported on the federal HHS-OIG report about the 2021 cumulative activities of state Medicaid Fraud Control Units around the country.  As there were no state breakdowns, we filed an access to information request with the Office of … Read More

This was posted on the Texas HHS-OIG website yesterday.  Thought we would republish.. ————————— Ensuring Texas Medicaid dollars are spent for their intended purpose requires the OIG to work with health care professionals to prevent fraud, waste and abuse. Accurate … Read More

The list of complaints about DentaQuest from Medicaid providers keeps growing. It seems that new Canadian ownership hasn’t changed any business practices so far, but we hear they like their money too. While some problems have been reported about MCNA … Read More

The following article was supplied by Texas HHS-OIG. Keeping accurate and complete patient records is part of providing quality patient care. Good record keeping can also help protect a practice against allegations of wrongdoing. The patient record is a legal … Read More

TDMR received an email notification today that Texas HHS is looking for a Dental Policy Analyst to assist in advanced complex dental and medical benefits policy analysis, development and consultation. No necessary dental requirements The odd about the advertisement for … Read More

The Department of Health and Human Services Office of Inspector General recently released its 2021 Medicaid Fraud Control Units (MFCU) Fiscal Year 2021 Annual Report. Investigates criminal fraud Medicaid Fraud Control Units have the job of investigating criminal fraud by … Read More

Just received this notification today. NOTICE OF STAKEHOLDER MEETING March 11, 2022 The Texas State Board of Dental Examiners will host a Stakeholder Meeting  Friday, March 11, 2022 at 1:00 PM The meeting will be in person and broadcast via Zoom … Read More

The Houston Chronicle broke a bombshell story today (paywall unfortunately). This ortho story still has legs. OAG assisted company they were suing to defraud insurer The Chronicle reported that the Office of the Attorney General had secretly made last-minute modifications … Read More

TDMR has done a review of the Texas Medicaid dental maintenance organization contract available publicly on the Texas HHS website and found a requirement that all medical necessity determinations be based on “valid and reliable clinical evidence or a consensus … Read More

We found an article recently published on the OIG website that we thought should be republished here. Providers encouraged to self-report errors More providers are participating in the OIG self-audit process so they can determine if they need to self-disclose … Read More

The 2021 annual report published by Texas HHS-OIG on fraud and abuse recoveries by MCOs and DMOs again shows a minimal amount of Medicaid fraud being found and recovered considering the state’s whooping multi-billion dollar healthcare budget.  For 2020/2021, the … Read More

It has been reported in two Florida business publications this week that children of the late MCNA founder Dr. Jeffrey Feingold have sold the company’s headquarters in Ft. Lauderdale to a Florida capital firm. According to The Real Deal, a … Read More

TDMR published a letter from a dentist a month ago who expressed their outrage about DMO self-made rules that restrict and inhibit treatment of young Medicaid-eligible children to their detriment. Now that the holiday season is well out of the … Read More

It is remarkable that in a state that cherishes free enterprise, it is okay for dental maintenance organizations to offer money and other inducements to encourage parents with Medicaid-eligible children to use their company yet it is a crime for … Read More

After our article last month on rate and coverage drops in Webb county for Medicaid waiver patients when DentaQuest took over the program, it didn’t take too long for us to be contacted about similar concerns within CHIP and children’s … Read More