Latest TDMR Stories
Texas Beware: Louisiana Punishes DentaQuest $11 Million for Medicaid Contract Violations
In July, the Louisiana Legislative Auditor’s office published a scathing audit review of DentaQuest’s performance as one of the two dental maintenance organizations with Louisiana Medicaid. It fined the company for its poor performance. FYI, Louisiana calls them dental benefit … Read More
Judge Rules Thousands Illegally Booted off Tennessee Medicaid by Deloitte System Similar to Texas
This week, a federal judge in Tennessee found that an algorithmic system similar to the one in Texas and designed by the same company illegally denied Medicaid benefits to thousands of Medicaid-eligible individuals. The TennCare Connect system, developed by Deloitte, … Read More
ACS/Xerox/Conduent Can’t Escape Damages Lawsuit Brought by Texas Dentists Over Improper Ortho Prior Authorizations
Justice for Medicaid dentists and orthodontists, whose lives, reputations, and practices were ruined in the great Texas Ortho Debacle, appears to be coming—slowly, but surely. Legal losses continue to mount for Conduent State Healthcare LLC, spun off from Xerox in … Read More
“Something Needs to Change! This is Unacceptable!! Especially for Such a “Great” State like Texas!”
More comments have poured in as a result of our last article containing remarks from dentists about the state of their Medicaid practices. Medicaid dentists are having difficulty grappling with the crushing weight of rising costs and woefully inadequate Medicaid … Read More
“Sometimes I Contemplate Closing and Hanging up My Hat”
TDMR’s recent article on the financial challenges facing Medicaid dental practices in Texas has struck a chord with a number of providers who left comments. We don’t often receive a spate of comments after an article, but this one certainly … Read More
With Costs Up by as Much as 98% Since 2010, Can Medicaid Dental Practices in Texas Survive?
The Texas Medicaid dental landscape faces a dire financial paradox. While costs for essential supplies, staffing, and real estate have surged dramatically, Medicaid reimbursement rates have stagnated below 2007 levels. Dental supply costs have increased by up to 98%, staffing … Read More
ADA Survey Highlights Challenges in Dental Staff Recruitment
The American Dental Association’s Health Policy Institute (ADA HPI) recently published its “Economic Outlook and Emerging Issues in Dentistry” report for the second quarter of 2024. This comprehensive survey offers valuable insights into the current economic conditions, staffing challenges, and … Read More
Texas Medicaid Eligibility System Prone to Errors?
The Texas Tribune published a major story yesterday about the problems Texas and other states are having with Medicaid eligibility systems developed by global consulting firm Deloitte. The Kaiser Family Foundation researched and wrote the story. A few sentences summarize … Read More
Texas Supreme Court Concludes No Evidence of Fraud and Reverses Summary Judgment Against Dr. Richard Malouf
In what can only be described as a bombshell decision, the Texas Supreme Court has sided with Dr. Richard Malouf and his legal team. The Court not only reversed the $16 million summary judgment against Dr. Malouf but granted his … Read More
Feds Threaten to Withhold Medicaid Funds Over Slow Eligibility Approvals
This week, several media outlets, including KXAN, have reported on U.S. Rep. Lloyd Doggett‘s release of correspondence from the Centers for Medicaid and CHIP Services (CMS) to Texas regarding significant delays and backlogs in processing Medicaid program eligibility. These delays … Read More
Benecare Replaces DentaQuest As Massachusetts Third-Party Payer
A few weeks ago, it was announced that Benecare Dental Plans has taken over the contract as a third-party payer for the Medicaid program in Massachusetts under MassHealth. DentaQuest lost the contract, which it had held for at least a … Read More
DMO Premium Rates for Medicaid Dental Dropped from $36.53 in 2011 to $25.73 Proposed in 2024
According to our review of the annual third-party actuarial reports produced for Texas HHS Provider Finance, the Medicaid dental premium rate for dental maintenance organizations has dropped significantly since 2011. The proposed per-member, per-month capitation rate paid to the DMOs … Read More
Arkansas Going Back to Fee-For-Service Medicaid Dental, Ending Managed Care
In a surprising move, the Arkansas Department of Human Services (DHS) announced this week that it is ending its Medicaid managed care dental program and transitioning back to a fee-for-service model starting November 1, 2024. This move from contracting with … Read More
National Conference of State Legislatures Recognizes Low Reimbursement Rates Affect Dental Provider Participation
The National Conference of State Legislatures (NCSL) has published an online article that promotes the need for oral health for all citizens and highlights the strides some states have taken to improve access to dental care, including Medicaid. The article … Read More
Texas HHS Provider Finance Dental Fee Review Later This Year
TDMR has learned that Texas Health and Human Services Provider Finance will conduct its biennial review of the Medicaid dental fee schedule later this year. The review will be presented at a rate hearing in November, with a proposed implementation … Read More
Massachusetts Dental Society Requested Immediate 10% Fee Increase to Address Medicaid Access to Care Issues in the State
According to a press release and an article on the American Alliance for Dental Insurance Quality website, this past February, the Massachusetts Dental Society (MDS) and nine other dental organizations sent identical letters to the MassHealth Dental Program, requesting that … Read More