Texas Dentists for Medicaid Reform

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 Texas...regarding DentaQuests desire to move to a CAPITATION model" and that they will be left powerless and in the dark by any such plan. Their concerns are eloquently outlined in the email which is reprinted in full below and we would appreciate … [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 per unit of time paid in advance to a healthcare … [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 Committee and a subcommittee of House Appropriations on … [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 $17.69, June 28, a 13% drop from its 52-week high on … [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 to 2012. Wanted to make dentists financially … [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, the commission has endured scandal over how … [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 from the Texas Health and Human Services … [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...]

DMO Request for Proposals Coming?

March 22, 2018

TDMR has been asked several times recently if we have any knowledge of an upcoming RFP (request for proposals) for dental management organizations. There have been rumors flying around for well over a year now that Texas Health and Human Services would be putting out such an RFP at some … [Read More...]

The United States Dental Association Is Forming!

February 22, 2018

TDMR has been asked to inform its readers that a new association of dentists is in the process of being formed. The new association is to be called the United States Dental Association. Among the founding members of the new organization are Drs. Juan Villarreal and Robert Anderton. Dr. … [Read More...]

Texas Dentists Misled by Xerox/TMHP on Orthodontic Prior Authorizations: Deposition

February 7, 2018

Yes, we know it is 2018. Sorry. But the truth about the late great Texas Medicaid orthodontic debacle (2007 to 2011) has been not fully been made public yet. So here is some more truth for those who were involved in this horrendous boondoggle. There is more to come. Dentists voiced concerns … [Read More...]

Bye-bye Xerox, Hello Fuji

February 2, 2018

Two days ago, the iconic and troubled American corporation Xerox was sold to Japan's Fujifilm for $6.3 billion dollars, ending its solo history in this country. Losing money, under pressure The new company will be known as Fuji Xerox and, per Reuters, "become a subsidiary of Fujifilm, with … [Read More...]

“Truth Decay” One Year Later

January 29, 2018

In January of last year, Dr. Juan Villarreal's long-awaited book "Truth Decay: How Government Corruption Caused a Political Scandal Victimizing Texas Dentists and How It Could Happen to You!" was released on Amazon.com. "Truth Decay" details Dr. Villarreal's personal struggles and victories … [Read More...]

Legislation Aimed at the Root Causes of Medicare and Medicaid Fraud

January 18, 2018

Recently the Health and Human Services Office of Inspector General issued a report A-17-17-52000- U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES MET MANY REQUIREMENTS OF THE IMPROPER PAYMENTS INFORMATION ACT OF 2002 BUT DID NOT FULLY COMPLY FOR FISCAL YEAR 2016. In the report, OIG recommends that … [Read More...]

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

Latest TDMR Research and Articles

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

DMO Request for Proposals Coming?

The United States Dental Association Is Forming!

Texas Dentists Misled by Xerox/TMHP on Orthodontic Prior Authorizations: Deposition

Bye-bye Xerox, Hello Fuji

“Truth Decay” One Year Later

Legislation Aimed at the Root Causes of Medicare and Medicaid Fraud

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