Texas Medicaid continues to restrict dentists from using some of the most widely accepted crown materials when treating patients’ permanent molars. This outdated policy must change. Following consultation with dental professionals, TDMR urges the Texas Health and Human Services Commission … Read More
Twelve years after Texas Medicaid dentists sued ACS/Xerox/Conduent over its handling of orthodontic prior authorizations, the Texas Supreme Court has ruled that the company had no legal right to bring its latest appeal. The Court vacated the 2024 opinion of … Read More
The Texas Health and Human Services Commission has opened bidding for new statewide Medicaid and CHIP dental contracts and asked prospective contractors to explain how they will improve access to care and reduce administrative burdens for participating dentists. Released October … Read More
New providers seeking to participate in Texas Medicaid face months of delays in getting clearance from the Texas Health and Human Services Office of Inspector General, according to a source familiar with the applications. Apparently, some providers have been trying … Read More
DentaQuest’s Canadian parent company, Sun Life Financial, wants better financial results from its U.S. dental business, according to an August earnings call. Texas dentists are under pressure from DentaQuest audits seeking tens of thousands of dollars in repayments over alleged … Read More
Twelve years after dentists filed suit over ACS/Xerox/Conduent’s handling of the Texas Medicaid orthodontic prior authorization scandal, they are still waiting for their damages claims to reach trial. Two dentists in related cases against the company have already died while … Read More
Vanessa Melendez had been going back and forth with the state over her family’s Medicaid and food assistance applications for months when the Houston mom learned she was pregnant with her third child. She submitted a new application for Medicaid … Read More
A proposed class action settlement has been reached with Managed Care of North America (MCNA), MCNA Insurance Company and Healthplex over a massive 2023 data breach that affected approximately 8.9 million people. As reported by TDMR at the time, the … Read More
Texas children have the highest reported rate of oral health problems in the country, according to data from the 2024 National Survey of Children’s Health. The survey found that 21% of Texas children ages 1 to 17 experienced one or … Read More
A new report from the American Dental Association’s Health Policy Institute suggests that while dentists are becoming more optimistic about the economy, the financial pressures facing dental practices have not eased. The State of the U.S. Dental Economy – Q2 … Read More
DentistryIQ recently published an important article examining how two Texas Medicaid fraud lawsuits are shining a spotlight on compliance risks facing pediatric dental practices. The title of the article is Is Pediatrics the Most Heavily Scrutinized Specialty in Dentistry? Ouch! The … Read More
The Texas Supreme Court has issued a significant decision that could reshape how Medicaid fraud cases are pursued in Texas, ruling that the State cannot simply point to an alleged regulatory violation. Instead, it must also prove that the alleged … Read More
HHSC has announced “that Stephanie Stephens will be the new Chief Medicaid and CHIP Officer, also known as Texas State Medicaid director, effective Aug. 15. Stephens will succeed Emily Zalkovsky and lead Medicaid and CHIP Services through the Sunset review … Read More
Delta Dental is again eyeing Texas Medicaid. TDMR has received recent reports from several Texas dentists indicating that Delta Dental is reaching out to recruit providers as part of a planned expansion into the Texas Medicaid market. According to information … Read More
Concerns are being raised about DentaQuest’s audit practices in the Texas Medicaid dental program, with some providers and attorneys questioning whether the process is fair, transparent, and functioning as intended. Austin administrative attorney Jason Ray, who represents healthcare providers in … Read More
Brident Dental & Orthodontics appears to be reducing its presence in Texas. TDMR has received several independent reports indicating that Brident locations in Texas are being offered to prospective buyers. One source familiar with the process described seeing a substantial … Read More
OIG recently published the following article on its website. Providers should know that AI is on the job at OIG now. New tech tools increase OIG productivity Teams within the OIG Data Operations Division recently launched new efficiency-focused tools … Read More
The Centers for Medicare & Medicaid Services has proposed a new rule to limit certain Medicaid payment arrangements used by states. According to CMS, the proposal is intended to “rein in misused Medicaid dollars” and place new limits on state-directed … Read More
We are republishing this article from the OIG website that was written for and published by Texas Dental Association (TDA). As the Texas Health and Human Services Office of Inspector General (OIG) works to prevent fraud, waste and abuse in … Read More
The ADA’s latest State of the U.S. Dental Economy (Q1 2026) has been released and paints an interesting picture. According to the report, on the surface, things look stable. Dentist confidence is holding, and consumer spending on dental care continues … Read More
