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 … Read More
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 … Read More
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 … Read More
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, … Read More
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 … Read More
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 … Read More
UPDATED: The federal government has come through with temporary funding for Texas. It won’t be a bad Christmas after all. There hasn’t been much big news regarding Texas Medicaid recently, but here is a doozy. The Dallas Morning News reminded … Read More
UPDATE: After conferring with colleagues, this is not the major reimbursement changes that were discussed earlier this year but an annual update of codes with minor changes. Hope you are having a nice Friday afternoon, the Friday before the Christmas … Read More
UPDATE: Arguments in this case were heard by the Supreme Court on Wednesday, December 6. The 39-minute video of the oral arguments is here. The court’s decision is not expected until spring of next year. As a heads up for dentists … Read More
TDMR is releasing the results of its 2017 Medicaid Provider survey today. Not much has changed Not much has apparently changed for Medicaid providers from 2016. per the 337 individuals who answered our anonymous, 6 question survey in October and … Read More
By TDMR President Gregory Ewing On September 7, 2017, Equifax, one of the nation’s three credit-reporting companies reported that it had discovered a cybersecurity breach that compromised the personal information of as many as 143 million Americans, roughly half of … Read More
Insurance coverage for more than 390,000 Texas children and pregnant women is in jeopardy after Congress failed to renew authorization for a federal program. Congressional authorization for the Children’s Health Insurance Program, which provides low-cost health insurance for children from … Read More
According to a story in today’s Texas Tribune, a large number of experienced executive staff of Texas Health and Human Services have exited the mega-agency due to conflicts with current Executive Commissioner Charles Smith. So far, these include, according to the … Read More
Today, the Texas Supreme Court agreed to hear oral arguments from orthodontic providers regarding the dentists’ counterclaims in the pending State vs. dentists vs. TMHP/Xerox cases. The general facts of the underlying dispute about orthodontic prior authorization have been well-covered … Read More
UPDATE: September 1, HHS announced this morning that it has put on hold the proposed rate changes per legislative sources. Original story: August 1, 2017 TDMR has received a copy of an email from the Texas Academy of Pediatric Dentistry … Read More
On August 9, the House Committee on Human Services held a public hearing. Part of the agenda was to hear testimony relating to the proposed dental Medicaid reimbursement rate cuts for many necessary codes that have been called “devastating” by … Read More
From the Texas Dental Association: ATTENTION TDA MEMBER MEDICAID DENTISTS: CALL TO ACTION Texas Health and Human Services (HHS) is moving forward with a devastating proposal that will significantly cut certain Medicaid dental reimbursement rates. The proposed cuts include dental codes that … Read More
From the Texas Dental Association: As a part of ongoing efforts to prevent potentially devastating “rebalancing” of Medicaid dental fees, the Texas Dental Association (TDA) will meet with Health and Human Services officials in the coming weeks to discuss each … Read More
TDMR has received a statement from the Texas Dental Association about its position on the proposed upcoming cuts to dental reimbursement rates for Medicaid providers. Statement from TDA President Dr. Joey Cazares The Texas Dental Association (TDA) already voiced strong … Read More
The Statesman published a landmark article this morning by reporter Eric Dexheimer regarding the great Texas orthodontic debacle. Story finally pieced together Thanks to the state’s fraud suit against Xerox, its former Medicaid claims administrator summarily terminated back in early … Read More
A dentist recently contacted TDMR with a problem that his practice, a group practice, has come across with the new requirements for placing Medicaid children under general anesthesia. Difficulty with multiple dentists doing treatment He wrote: The new general anesthesia … Read More
In a blast from the past, former Health and Human Services Inspector General Doug Wilson and his wife are in the news again. Resigned on Friday Frianita Wilson resigned last Friday from Child Protective Services after her husband’s former agency … Read More
Back in October 2015, TDMR filed an open records request with the Office of the Attorney General seeking to find out how much legal manpower had been used to pursue questionable Medicaid cases against Texas dentists involved in the multi-million dollar … Read More
On Tuesday, May 2, Dr. Juan D. Villarreal D.D.S. was honored by the U.S. Small Business Administration Lower Rio Grande Valley District at a luncheon celebrating Small Business Week. He was presented with the SBA’s 2017 Entrepreneurial Success Award at … Read More
From Texas Health and Human Services: The 14-day comment period for the Texas Health Steps Dental Therapeutic Services policy ended March 28, 2017. HHSC solicited and received comments on proposed revisions to the policy from various stakeholders. A summary of comments … Read More
The Texas Monthly has reported that Health and Human Services Inspector General Stuart W. Bowen Jr. resigned last night. He was asked to resign by Gov. Greg Abbott because he had hidden the fact that he was also employed by … Read More
The Inspector General wants your feedback on our website, https://oig.hhsc.texas.gov/. Please take our quick, 7 question survey and let us know how you use our site, what you like about it, and what we can improve on. Click on the link … Read More
The Texas Senate confirmed Charles Smith’s appointment on April 19 as the Health Human Services executive commissioner for a two-year term at the head of the state’s largest agency. Smith, a Childress native, oversees an agency of 53,000 employees that … Read More
Last week, the Texas Association of Health Plans (TAHP) announced that it was working with the Texas Medical Association (TMA) to speed up credentialing for Medicaid providers by selecting Aperture, LLC, as the statewide Credentialing Verification Organization (CVO). Here is … Read More
The following is an interview done with Dr. Juan D. Villarreal, author of “Truth Decay: How Government Corruption Caused a Political Scandal Victimizing Texas Dentists and How It Could Happen to You!,” published by TDMR. The book has now been available … Read More
Texas HHS placed on their website last week two new policies relating to Medicaid dentistry on which they would like stakeholder comments. Dental anesthesia The first is a draft policy relates to dental anesthesia which: Requires prior authorization for general anesthesia in conjunction … Read More
Below are the results of our TDMR Medicaid Dental Maintenance Organization Followup Survey. 84 dentists responded to the survey which is not quite comparable to the 105 who took the first survey back in December 2016. Cautions on the results … Read More
TDMR recently had the opportunity to interview the current president of the Texas Dental Association, Dr. Rita M. Cammarata. Dr. Cammaratta, despite her extremely busy schedule, graciously consented to answer several questions that we posed to her via email. Her … Read More
Yesterday, the Sunset Advisory Commission introduced both a House and Senate bill to adopt their proposed changes to legislation affecting the State Board of Dental Examiners. HB 2990 was introduced as authored by Sunset member state Rep. Cindy Burkett while … Read More
Another bill affecting Medicaid providers of all stripes was introduced yesterday by state Rep. Sergio Muñoz Jr. from District 35 in the Rio Grande Valley. Rep Muñoz, Jr. is a second term representative who was a member of the Government … Read More
HB 2558, am act relating to capitation payments under a contract with a health maintenance organization for the provision of dental care services, has been introduced into this legislative session this week by State Rep. Dr. Tom Oliverson out of … Read More
Several legal media outlets reported yesterday that former Texas Medicaid claims administrator Xerox has brought an appeal before the Texas Supreme Court because the company says the state is “wrongfully blocking the company from designating the dentists who treated patients in the alleged … Read More
Jeff Leston, the founder of Castlestone LLC, has provided TDMR with his take on how to improve government healthcare plans such as Texas Medicaid to reduce waste, fraud and abuse. Castlestone is a company created to use the infrastructure of … Read More
UPDATE, March 2: Survey is now closed. Last fall through to this January, TDMR received a deluge of unsolicited complaints regarding problems with Medicaid dental managed care organizations. Lots of complaints and education actions taken We have published no less … Read More
For the last several years, TDMR has provided contact information on its website for reporting Medicaid fraud, waste and abuse to both state and federal healthcare authorities. From the links provided on practically every page of our website, anyone could go … Read More
