There have been rumors flying by the last few weeks that Inspector General Stuart Bowen wants to make it easier to place “credible allegation of fraud” (CAF) payment holds against Medicaid providers. We had no idea that this was difficult … Read More
Just before the Thanksgiving holiday, TDMR received a flurry of emails and phone calls regarding our story about a dentist who was having payments recouped by MCNA for treatments the company had previously approved. He was being forced to travel … Read More
Our story on MCNA secretly recouping payments from a dentist who had an MCNA pre-approved treatment plan for a young Medicaid-eligible cancer patient touched a raw nerve with a number of dentists from around the state. The story received a … Read More
In response to TDMR’s latest story on payment holds placed on Medicaid dentists by MCNA, TDMR received an emotional missive from a Medicaid dentist about his negative experience with MCNA. He gave permission to publish his comments. The legislative session … Read More
UPDATE: We now have a copy of the letter from Delta Dental to Texas dentists regarding joining their “Texas Medicaid network.” (see below) TDMR received an interesting email after our recent story on dental managed care and the possibility of … Read More
The Audit division of the Health and Human Services Office of Inspector General released a report at the end of October (although TDMR just received the email notification about it today) about an audit they conducted on the practice of … Read More
A source informed TDMR in late October that they estimated the number of dentists in Texas on payment holds placed by Medicaid dental maintenance organization MCNA to be around 200. Spate of payment holds TDMR reported back in August about … Read More
There is a rumor circulating that the Texas Health and Human Services Commission is putting together a new request for proposals (RFP) for dental managed care organizations for Texas Medicaid. While this may or may not be the case as … Read More
Last November, former Texas Medicaid director Billy Millwee, now a private consultant, appeared before the Little Hoover Commission in Sacramento, California. The LHC is an independent state oversight agency that was created in 1962 with the mission to investigate California … Read More
Dr. Linda Altenhoff is no longer with the Inspector General’s office as Chief Dental Officer. In August, she moved over to MCNA and is now Associate Dental Director for MCNA Texas and works out of San Antonio. Named IG Chief Dental … Read More
The Sunset Advisory Commission has made public its decisions regarding its sunset review of the State Board of Dental Examiners based on its staff report and hearings held. These have been available since August on the Commission website and … Read More
The Texas Tribune this morning published an article that indicates the fate of Texas Health and Human Services Inspector General Stuart Bowen is uncertain at this time. Planned Parenthood investigation tied to fund-raising effort The context of the story was … Read More
TDMR has been making changes over the past few months. Updated website and content You might have noticed that the look of our website has been updated. It is easier to view on smartphones and tablets as well as being a … Read More
In August, TDMR conducted its annual online survey of Medicaid providers. This time, however, the focus of the survey was expanded from only dentists to all Medicaid providers to see how the two compare. Completed surveys were filled out by … Read More
We received an email from a dentist with some very useful advice regarding denied treatment by dental MCOs (managed care organization). He specifically mentions MCNA. I just wanted to pass on the name of a resource that I recently found … Read More
On September 1, the first phase of the consolidation of the Texas Health and Human Services system became operational. SB 200, the Health and Human Services Commission sunset bill passed last legislative session called for transferring the Department of Assistive and … Read More
Today, we received an email notification from the Health and Human Services Commission that as long as Medicaid provider re-enrollment applications have been received by the Texas Medicaid and Healthcare Partnership on or before September 24, those providers will not face … Read More
The Department of Health and Human Services Office of Inspector General audit released earlier this week found Texas had miscalculated payments for the Medicaid Supplemental Physician Payments program and owed the federal government some $57.9 million for the period 2004 … Read More
The audit section of the Department of Health and Human Services Office of Inspector General issued a report earlier this month that Texas now owed the federal government some $57.9 million because the state Health and Human Services Commission did … Read More
The latest quarterly report issued by IG last week reminds Medicaid providers that CMS has a deadline of September 25 for re-enrollment of all Medicaid providers (deadline originally March). All providers who enrolled prior to January 1, 2013, must … Read More
