Texas Dentists for Medicaid Reform - Fighting for Due Process Rights for Medicaid Providers

OIG Presentation on Dental Solicitation

January 23, 2020

Back in June of 2019, a representative of HHSC-OIG did a presentation on dental solicitation of Medicaid patients to several dental associations. This was mentioned in their Quarterly Report - 4th Quarter report we reported on last October. However, we did not provide a copy of this presentation or provide details about it since OIG also published a pamphlet on the subject at the behest of the Texas Dental Association which we did provide. Looking at it recently, we thought it might be good to provide this presentation for Medicaid dentists as well. This is what OIG said about … [Read More...]

OIG Now Opens Provider Investigations into Dentists and Doctors at 3x the Rate of Complaints

January 15, 2020

The recently released HHSC-OIG Quarterly Report for the 1st Quarter of 2020 shows that the rate of provider investigations opened into dentists and doctors is roughly three times the rate of the number of complaints received by the agency. The rate for dentists is slightly higher than that of doctors. This is roughly double the rate of … [Read More...]

UPDATE: In Memoriam

January 2, 2020

UPDATE: This past Saturday over 500 family, friends and individuals from the community came to pay their respects to Dr. Villarreal at Camp Perry in Rio Hondo. His many achievements and contributions are commemorated in an article published by the Valley Morning Star. As many in the south Texas dental community already know, Dr. … [Read More...]

Texas HHS 2020 Inaugural Business Plan Available

December 12, 2019

HHS Executive Director Courtney Phillips Texas HHS has published a business plan for 2020 outlining its goals. This came out a few months ago but we just became aware of it. The plan is contained in a 64-page PDF document which is available below. There is no mention of dental services but the document is a useful window into HHS and … [Read More...]

UPDATED with Survey- Medicaid Dentists: Lack of Use of D1352 Is Causing Audits and Recoupments

December 2, 2019

MEDICAID DENTISTS: Please take our confidential and anonymous five-question survey about D1352. It is basically a simple Yes-No questionnaire. It takes less than a minute. SURVEY IS NOW CLOSED. Back in late 2011, the ADA added several new codes to the CDT (Current Dental Terminology) manual. One of these codes was D1352 which is defined as a … [Read More...]

Texas HHS-OIG Fraud and Abuse Prevention Advisory on Dental Services

November 21, 2019

Last month, TDMR reported on the Texas Health and Human Services Office of Inspector General Quarterly Report for the fourth quarter of 2019. A highlighted topic in the report was the Illegal solicitation of patients by dental providers. Didn't know about advisory We just discovered that OIG issued a Fraud and Abuse Prevention Advisory back … [Read More...]

Texas HHS-OIG Audit Finds MCNA billed Medicaid $766,000 in unsupported consulting expenses and more

November 18, 2019

A recent audit done by Texas Health and Human Services Office of Inspector General found that dental maintenance organization MCNA had paid out $766,000 in consulting expenses that are unallowable under their Medicaid contract. The expenses were reported in their 2017 Administrative Expenses financial statistical report that MCNA had filed … [Read More...]

Who Lobbied for UnitedHealthcare, MCNA and DentaQuest

October 31, 2019

For the sake of public disclosure, TDMR is providing the lists of lobbyists registered with the Texas Ethics Commission who lobbied in 2019 on behalf of the three dental insurance companies that were recently announced as the awardees of the contracts for dental services for Texas Medicaid. The reports are in PDF format and are downloadable.. … [Read More...]