Jeff Leston, the founder of Castlestone LLC, has provided TDMR with his take on how to improve government healthcare plans such as Texas Medicaid to reduce waste, fraud and abuse. Castlestone is a company created to use the infrastructure of … Read More
UPDATE, March 2: Survey is now closed. Last fall through to this January, TDMR received a deluge of unsolicited complaints regarding problems with Medicaid dental managed care organizations. Lots of complaints and education actions taken We have published no less … Read More
For the last several years, TDMR has provided contact information on its website for reporting Medicaid fraud, waste and abuse to both state and federal healthcare authorities. From the links provided on practically every page of our website, anyone could go … Read More
TDMR received a notice yesterday from the Health and Human Services Inspector General office that Inspector General Stuart Bowen will be hosting, along with Sen. Chuy Hinojosa, a “Rio Grande Valley Medicaid Integrity Symposium.” The event is to take place … Read More
House Bill 1420 was introduced into the legislation session yesterday by House Representative Mando Martinez. The bill is captioned as “Relating to the imposition of a late payment penalty against Medicaid managed care organizations that fail to timely pay certain … Read More
The following is a statement received from MB2 Dental Solutions, the Dallas-area dental service organization, that recently settled with federal and state authorities for a whopping $8.45 million over allegations of Medicaid fraud. A company representative told us that they … Read More
In August of last year, the Sunset Advisory Commission requested a review by a blue ribbon panel of dental experts into dental anesthesia-related deaths in Texas as part of its review process of the State Board of Dental Examiners. On … Read More
TDMR has learned from a staffer in the office of Sen. Juan “Chuy” Hinojosa that they have been informed by Health and Human Services that managed care organizations, including MCNA, do not have any right under any Texas or federal … Read More
Did you know that HHS, formerly HHSC, has a Managed Care Inquiries and Complaints mailbox? It does. It also has a person to field those inquiries and complaints. That person is Dr. Marguerite Laccabue, MPH, DDS, Dental Director of the Office of … Read More
At the same stakeholders meeting last February that representatives from MCNA and Dentaquest provided briefings, the then-dental director for the Health and Human Services Inspector General, Dr. Linda Altenhoff, presented on rules and regulations regarding solicitation by dental providers. Altenhoff … Read More
In February of last year, Texas Health and Human Services Dental Director Marguerite Laccabue held a dental stakeholders meeting in Austin. It doesn’t appear from the HHSC online video of the proceedings that it was well-attended or promoted as the … Read More
TDMR has obtained a copy of a January 4 letter from State Sen. Juan “Chuy” Hinojosa to Charles Smith, the Executive Commissioner of Texas Health and Human Services asking Smith to review MCO “credible allegations of fraud” payment holds. While … Read More
TDMR received the following email from a Texas dentist. He has given permission for us to publish it and we are doing so anonymously to hopefully prevent any further retribution against himself and his practice. I am writing this email … Read More
Tuesday, TDMR republished a press release issued by the Department of Justice, U.S. Attorney’s Office, Northern District of Texas that Carrollton-based MB2 Dental Solutions and 21 pediatric dental practices affiliated with MB2 had agreed to an $8.45 million settlement to resolve … Read More
Last Thursday, Texas Health and Human Services held its Biannual Managed Care Stakeholder Meeting in Austin. The meeting was primarily hosted by Jami Snyder, the Associate Commissioner for the Medicaid & CHIP Services Department of HHS. During the open discussion … Read More
2016 ended very badly for Texas Medicaid. It was a very poor Christmas for many. There were a number of important divisive events that occurred which we decided not to comment on during the holiday season. We didn’t want to spread … Read More
Back in December, TDMR asked dentists to take an online survey to ascertain their views on Texas Medicaid dental managed care. We now have these results which are provided below and can be downloaded. Limitation of survey results Before we … Read More
TDMR has been notified that Texas Health and Human Services is holding its biannual meeting on managed care next Thursday in Austin. It is open to the public and is taking public comment on several items. If you can’t make … Read More
Sen. Lois Kolkhorst asked a pertinent question to Inspector General Stuart Bowen this past September, “Are you auditing MCOs for fraud?” The question came in the context of a hearing being held by the Senate Committee on Health and Human … Read More
The Office of Audit Services of the HHS-OIG released a report today that they found Florida’s Agency for Health Care Administration was paying state MCOs their capitation rate for deceased Medicaid beneficiaries. They estimated that “these overpayments amount to approximately 2 … Read More
