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 … Read More
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 … Read More
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 … Read More
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 … Read More
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 … Read More
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 … Read More
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 … Read More
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 … Read More
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 … Read More
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
