Back in August, a notice appeared on the TMHP website that Texas Medicaid was going to impose a lifetime limit for restorations and stainless steel crowns on September 1. Lifetime limits The notice said: Effective for dates of service on or after September 1, 2018, lifetime limitations for restorations and stainless steel crowns will change for Texas Health Steps. The … [Read more...]
Dentist Quits MCNA in Disgust Over $33,000 Recoup Demand
From time to time, TDMR receives correspondence from dentists expressing their frustration and anger with one or both of the current DMOs managing Texas Medicaid. Last week, we received an email from a dental provider about a recoupment demand made by MCNA. Apparently, it took the company three years to review the documents he had sent them per their initial request. He … [Read more...]
TDA Weighs in on DMO RFP and Capitation
In the last edition of TDA Today, the Texas Dental Association goes to bat for dental Medicaid providers on two issues. First, the publication reported that the TDA's Council on Public Health and Access to Care met with HHSC (HHSC, HHS; tomato, tomahto) reps from the Quality Oversight, Finance and the Medicaid/CHIP Services Department. They discussed the state requirement … [Read more...]
Valley Providers Heap Scorn on Medicaid Managed Care
The Statesman published an article this morning about the scathing testimony heard by the House Committee on Human Services, chaired by Rep. Richard Peña Raymond, at a special hearing held yesterday in Edinburg. Wanted public and provider feedback on managed care The Committee traveled to the Valley to hear testimony from Medicaid providers and public about "the impact … [Read more...]
Surprise! Medicaid Dental Reimbursement Rates Drop by 2.5% on September 1
You just found out about this? So did we. Just learned of it TDMR learned of it about 10 days ago when a provider gave us a copy of a letter they received from DentaQuest dated July 27 but received in their office August 13. It announced a 2.5% reduction on dental codes from D2140 to D9999 that was approved at a "recent" HHSC rate hearing. What? We knew nothing about … [Read more...]
New Executive Commissioner of Texas Health and Human Services Chosen
By Marissa Evans, The Texas Tribune Aug. 23, 2018 Courtney Phillips is the new executive commissioner for the Texas Health and Human Services Commission, Gov. Greg Abbott announced Thursday. Phillips is currently the chief executive officer for the Nebraska Department of Health and Human Services. She starts her role as commissioner Oct. 19. In a Thursday evening … [Read more...]
Comments about Dental Medicaid: Rep. Richard Peña Raymond
TDMR recently reached out to Rep. Richard Peña Raymond, chair of the House Human Services Committee to get his views on the current scene and the future of dental Medicaid in Texas. Supporter of dental Medicaid Raymond has been a major force for dental Medicaid providers. It was before his committee at public hearings in 2012 that dentists affected by the great Texas … [Read more...]
Texas Medicaid Dental Provider Forum NOW OPEN
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 … [Read more...]
Dentists Comment About DMO Problems & Request for Proposals
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 refuse to accept DMOs that are run … [Read more...]
TDMR DMO Survey 2018 Results: MCNA Improves, DentaQuest Has More Problems, Dentists Frustrated
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 than likely that those … [Read more...]
