In the same Xerox/Conduent court filing from July 2018 mentioned in our previous article, there is another exhibit worth mentioning. It is the complete email chain involving HHSC OIG officials discussing OIG investigator Ray Acuña's meeting notes on the Xerox/Conduent ortho prior authorization (PA) process. Stopped requiring molds for PA Some of the correspondence … [Read more...]
Court Document Shows Altenhoff and HHSC Knew Xerox Dental “Clerks” Worked at Home and Rubber Stamped Ortho PAs in June 2008
In a court document filed in July 2018 by Xerox/Conduent, an exhibit containing HHSC OIG email correspondence and notes from June 2008 proves that Dr. Linda Altenhoff, the state dental director, knew all about the faulty Xerox/Conduent ortho prior authorization (PA) process which carried on another three years and cost the state hundreds of millions of dollars. Altenhoff, as … [Read more...]
Capitation? DentaQuest and Brident Dental Agree on Alternative Payment Method
Dentaquest headquarters in Boston, MA We received a copy of this release from DentaQuest's Boston PR firm this morning. It appears DentQuest did continue to work with a large provider in Texas to come up with an alternative payment model. The details below are sketchy. DentaQuest Enters into First-of-its-Kind Value-Based Contract in Texas Alternative Payment … [Read more...]
Public Meeting in Austin on Managed Care December 12
The State Medicaid Managed Care Advisory Committee of HHSC is holding a public meeting in Austin on December 12. Here is the information: December 12, 2018 - 1:00pm Health and Human Services Commission, Brown-Heatly Building, Public Hearing Room 4900 North Lamar Blvd. Austin, TX 78751 This meeting will be webcast. To access the webcast, go … [Read more...]
Dr. Linda Altenhoff: Making Out Like a Bandit at MCNA
In September when TDMR learned that the new Medicaid Dental Services RFP had gone out, we also learned and reported that Dr. Linda Altenhoff, former dental director for the Department of State Health Services and dental director for Texas OIG had become a Vice President of MCNA, one of the current Texas DMOs. HHSC bosses lost jobs A dentist in his 70s who lost his retirement … [Read more...]
Questions Linger about Capitation and DMO RFP
We've heard from various dentists that they have questions about controversial issues that have come up over the last several months. So we assume there are more out there that have the same questions or heard the same rumors. Primarily they are concerned about DMOs moving to a capitation plan as DentaQuest was seeking to do and what is currently happening with the RFP. So … [Read more...]
Did Texas OAG Forget to Sue Xerox For $133 Million Owed the Feds for Medicaid Orthodontic Prior Authorization Debacle?
It appears that Texas Office of the Attorney General (OAG) forgot to sue Xerox to recover over $133 million that the federal government determined it was owed because of the state’s lack of oversight over Xerox, its then-Medicaid claims administrator, which mishandled the state’s orthodontic prior authorization process from 2008-2011. Revealed in recent court filing by … [Read more...]
UPDATE: Indiana Dental Practice & DSO Shell Out $5.1 Million Over Medicaid False Claims Allegations
UPDATE: TDMR has received a copy of the ImmediaDent and Samson Partners press statement from Samson Partners vice-president of marketing Stephen Valenti. It is at the bottom of our story in full. Indiana-based ImmediaDent and DSO Samson Dental Partners of Kansas have agreed to pay the federal government and Indiana some $5.139 million to resolve false claims allegations of … [Read more...]
UPDATE: HHSC Proposes to Reduce Monies an MCO Obtains from Fraud Recovery to 50% from 100%
UPDATE: We've added below an additional HHSC presentation given to the House Committee on General Investigating & Ethics which gives further details of MCO contract management. This morning HHSC sent out a notice that it was looking for public comments on several proposed rule changes relating to MCO fraud investigations of providers and fund recoveries. Draft rules on … [Read more...]
State Board of Dental Examiners Stakeholders Meeting November 20
The Texas State Board of Dental Examiners will be holding a stakeholders meeting in Austin on November 20. It will be held at the William P. Hobby Jr. State Office Building, Tower III, Room 100, 333 Guadalupe Street at 1:30 pm. Its purpose is to allow stakeholder input to the Dental Practice Committee which will be considering the following: Teledentistry, specifically … [Read more...]