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
In his recent quarterly report, Health and Human Services Commission Inspector General Stuart Bowen announced the kickoff off his initiative to increase awareness and cooperation on fraud, waste and abuse between Medicaid stakeholders. The IG Integrity Initiative (IGII) is described as … Read More
This week the Health and Human Services Commission Inspector General released his June 2016 quarterly report on the activities of his agency. Besides announcing the creation of a Pediatric Dentistry Action Team, the report also discloses that more Medicaid dentists … Read More
One of the main items of interest to Medicaid dentists from the latest quarterly report from the Health and Human Services Commission Inspector General Stuart Bowen is that a “Pediatric Dentistry Action Team” has been created within his agency. The … Read More
Today, Health and Human Services Commission Inspector General Stuart Bowen Jr. issued his fourth quarterly report since he took office back in early 2015 replacing former Inspector General Doug Wilson. Please find a copy of the report below. It can … Read More
TDMR has learned that a number of dental providers have reported being placed on payment hold by MCNA for “willful misrepresentation or abuse of claims.” Payment holds placed for mistakes and missing paperwork In these reports, dentists claim that MCNA’s … Read More
If you remember the heyday of HHSC/TMHP/Xerox program spending on orthodontia back in 2011 that begat allegations of Medicaid fraud, it was at a sky-high $249 million. In 2015, it was $13.6 million. So it is little wonder that the number … Read More
In case you might be wondering how much Texas now spends on dental care for Medicaid children, we now have an answer for you. TDMR filed an open record request earlier this year to get the spending figures for 2014 and … Read More
Over the past two weeks, it has been a major story that Attorney General Ken Paxton took a $100,000 donation for his personal legal fees from a friend whose company was accused of Medicaid fraud. The company just settled the … Read More
reported this morning on a new contracting scandal involving current Medicaid claims administrator Accenture and the Office of Attorney General. Outrage of use of “emergency leave” for fired staff You might remember back in May, the OAG was found to … Read More
Back in July 2013, TDMR surveyed Medicaid dentists about their opinions and problems with Medicaid at that time. 139 providers answered up and “provider rights” was the most popular response for the challenges Medicaid providers were facing then. Things have … Read More
Dr. Juan D. Villarreal of Harlingen Family Dentistry and founder of Texas Dentists for Medicaid Reform has completed the writing of a book about his personal experience with Texas Medicaid and its attempt to falsely accuse Texas dentists of healthcare … Read More
Back on May 19, Sen. Chuy Hinojosa and Rep. Richard Peña Raymond hosted a town hall meeting for providers on Medicaid managed care in Edinburg at the Edinburg Conference Center at Renaissance. It has taken a while but here are … Read More
On Thursday, June 23, the Texas Sunset Advisory Commission held its mandated public hearings on state agencies under review this legislative session. Four hours of testimony Over the 12 hours of testimony were given before the Commission on that date … Read More
Recently, TDMR filed an open records request with the Texas Health and Human Services Commission to find out how many individual Texas dentists are currently participating in Medicaid and how those participation numbers have changed since the Frew settlement in … Read More
Those that want to make their views known about the current state of the Texas State Board of Dental Examiners can testify in Austin next week before the Sunset Advisory Commission. The staff report from the Commission is highly critical … Read More
You might remember the case of Austin dentist, Dr. Rachel Trueblood. $16 million overpayment demand settled for $39,000 Back in 2014, Dr. Trueblood had been accused of Medicaid fraud, placed on “credible allegations of fraud” payment hold which closed her … Read More
McAllen dentist Dr. Jose “Joey” Cazares has been elected by members of the Texas Dental Association’s House of Delegates to be the 2016-2017 President-Elect of the Association, and will automatically ascend to the Presidency in 2017-2018. Dr. Cazares will be … Read More
The policy revision to the Medicaid orthodontic benefit process contemplated by representatives of the Texas Medicaid and Healthcare Partnership and the Health and Human Services Commission in 2009 was sweeping. Per the final draft of the confidential policy revision attached … Read More
