After our last article about possible termination from a DMO’s network for filing a complaint with HHS before all company complaint procedures have been exhausted, we picked up online copies of the Medicaid Provider manuals for DentaQuest, MCNA and UnitedHealthcare … Read More
Dr. Janice Reardon, Chief Dental Officer of the Office of Inspector General, has been honored with the Lifetime Membership Award by the Texas Dental Association. The award recognizes her 30 years of continuous membership in the TDA. A graduate of … Read More
After we published our article last week about the HHS complaint line and its email address, we received a few emails from dentists. Several were excited about the possibility of complaining to HHS about their DMO troubles, but one had … Read More
We received an email from a dentist a few weeks ago who was having trouble with a particular DMO. In the process of trying to assist them, we reached out to Texas HHS in an attempt to find a state-level … Read More
Our 2021 survey of Texas dental maintenance organizations is complete and the results have been compiled. Survey says: long-term providers MCNA and DentaQuest have improved their performance in the minds of Medicaid dentists from previous years while newcomer United Healthcare … Read More
The U.S. Department of Health and Human Services Office of the Inspector General just published an audit report this week that Texas paid out incorrectly $922,557 in CHIP payments to Medicaid managed care organizations. Now a million dollars in the … Read More
Medicaid fraud or fraud of any type is serious business, and something TDMR decries. Those low enough to use their position as healthcare professionals to bilk federal and state governments for personal gain that cheats the taxpayer and young underprivileged … Read More
SURVEY IS CLOSED As we come out of the pandemic and into a hopefully normal July 4 weekend, TDMR is issuing our annual survey to find out how dental maintenance organizations have been performing for Medicaid dentists over the last … Read More
On Tuesday, Texas HHS OIG sent out its June email newsletter. Out of the three articles promoted, one is again about dental Medicaid issues. This time the article is about common billing errors committed by Medicaid dentists, an article that … Read More
This past week the Attorney General of Texas sent out a press release that deemed agency personnel who had complained about potential conflicts of interest by the AG himself were “rogue political appointees” rather than whistleblowers because they had only … Read More
AUSTIN — Texas has the highest number and percentage of uninsured children in the country. According to the United States Census, the child uninsured rate in Texas rose from 9.8% in 2016 to 12.7%, over double the national average, in … Read More
Some stories never die. Here we are a decade later still talking about “Crooked Teeth” and the outcome of all those stories that ran on WFAA alleging hundreds of millions of dollars of Medicaid fraud committed by Texas orthodontists and dentists. … Read More
A recent open records request to the Texas Office of the Attorney General reveals that the state has paid out so far $457,416.67 to qui tam relator Joshua Lafountain. No knowledge or evidence of wrongdoing TDMR reported, starting last May, … Read More
By Ross Ramsey, The Texas Tribune – When this legislative session comes to an end on Memorial Day, Texas will still have more uninsured residents than any other state, and a higher percentage of uninsured residents, too. The Texas Legislature … Read More
The testimony in favor of changes to the Texas Medicaid Fraud Prevention Act by Austin administrative attorney Jason Ray is important for Medicaid providers to read. He testified on April 14 supporting the committee substitute version of bill HB3802 regarding … Read More
On April 14, the House Committee on Judiciary & Civil Jurisprudence held a public hearing and a few days later voted on CSHB 3082, a bill brought forward by House Representative Matt Krause. The purpose of HB 3082 is to … Read More
April 23: Texas House votes down budget amendment aimed at giving health coverage to more uninsured Texans: The Texas Legislature has declined to pass any broad expansion of state and federal health care coverage for uninsured Texans since the Affordable … Read More
We thought we would publish this on our website from the latest TSBDE newsletter received today. The PREP Act was changed back on March 11. Becoming a COVID-19 Vaccine Provider The latest amendment to the PREP Act expands qualified persons … Read More
Almost a decade ago, on May 13, 2011, Byron Harris, famed WFAA investigative reporter, started a large freight train roaring down the track with his first story of a series, “Texas taxpayers pay big for straight teeth.” False narrative destroyed … Read More
This article is reprinted from the OIG Monthly Newsletter received today. The majority of Texas Medicaid dental providers take pride in their work and deliver excellent care to their patients. Those who try to cheat the system and fail to … Read More
