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 money defending himself against unproven allegations of Medicaid fraud for giving under-privileged Texas children orthodontic treatment approved by Xerox and the state, contacted us after reading the article to express his disbelief.
He wondered how villains such as Jack Stick and Doug Wilson, former high HHSC executives, could lose their jobs and the person that was best in a position to know about the flawed Xerox ortho prior authorization process was now a VP for a Texas DMO.
He recalled that it was Dr. Altenhoff's statements which gave dental stakeholders the misleading impression back in 2009 that a "board certified orthodontist" was reviewing the prior authorization requests after dentists demanded to know who was approving them. In reality, high school graduates and a janitor among other untrained individuals acting as Xerox/Conduent "dental specialists" were rubber stamping the requests and dentists were misled.
This dentist who still has to practice to make ends meet said it was ironic that not only was Altenhoff a VP at MCNA but that she was a VP of program compliance. Surely, an oxymoron if he had ever heard one.
Dentists sought to file complaint with TSBDE
We have to agree.
Altenhoff has little respect. A couple of years ago there was a movement by several aggrieved dentists seriously damaged by the ortho mess to file a complaint against Altenhoff with the State Board of Dental Examiners for unprofessional conduct for her misleading statements. However, upon review, the TSBDE complaint process relates to dentists practicing dentistry, not dentists operating in government.
Dithers and dissembles on a simple question
Concerns about Altenhoff's program compliance competence is not a joke. We found a short segment of a deposition she gave several years ago as the dental director of OIG.
She is asked if the state is responsible for enforcing the standards of medical necessity for Medicaid orthodontic treatment. Her unwillingness to answer with a simple "yes" leads into almost seven minutes of dithering and dissembling. In the end, she only admits that the state is responsible for enforcing the state's contractor to do so because she is given a copy of the federal audit which says so.
A perfect bureaucrat. Take as little responsibility as possible.
Spreading the sunshine
It has been said that the best disinfectant is sunshine. Jack Stick and Doug Wilson were high enough and visible enough that their destructive acts were eventually seen for what they were and they no longer had jobs.
A player behind the scenes such as Altenoff wasn't that noticeable. But now that she has made out like a bandit and steps into the spotlight as a private sector VP, the sunshine follows.
If anyone at HHSC was responsible for the ortho mess, in our opinion, Dr. Linda Altenhoff was a major factor.
More to come
This article is the just first in a series relating to "who knew what when" between Xerox/Conduent and the state on this orthodontic mess that will be rolling into its 8th year in early 2019.
Quite a few dentists out there will be cheering when they read this article and also wondering why Altenhoff is a VP at MCNA.