The Health and Human Services Commission in February 2009 asked the individuals working on the new Medicaid orthodontic benefit policy to review whether or not a board certified orthodontist should review each and every prior authorization request for orthodontic treatment. … Read More
The TMHP document reported about in our last story that was recently appended to a court filing by Xerox shows that staff from the Health and Human Services Commission and its Office of Inspector General were well aware of the … Read More
A new document has come to light out of the lawsuit the state filed in 2014 against Xerox, its former Medicaid claims administrator, that shows Medicaid dentists were concerned as early as 2007 about Xerox’s prior authorization process and demanded … Read More
This coming Thursday, May 19 from 8:30 am to noon, a town hall meeting on Medicaid managed care is being held at the Edinburg Conference Center at Renaissance, 118 Paseo Del Prado, Edinburg,TX. The meeting has been set up to allow Medicaid providers … Read More
The Houston Chronicle reported this morning that Frianita Wilson, the wife of former Health and Human Services Commission Inspector General Doug Wilson and an HHSC executive in her own right, is now back at work at HHSC after being on administrative … Read More
Charles Smith, a longtime ally of Gov. Greg Abbott, will be the next executive commissioner of the Texas Health and Human Services Commission, the governor announced Tuesday. Smith, the chief deputy executive commissioner at the massive agency, will start his … Read More
Earlier this week, TDMR received an email from a mother who had her sons under Medicaid orthodontic treatment back in 2011 and 2012 and is still very upset at the both the state handling of the matter and the lack … Read More
Dr. Michael Goodwin of Amarillo pleaded guilty to one charge of health care fraud back in 2012 relating to the investigation into allegations of statewide Medicaid orthodontic billing fraud. Goodwin is the only dentist out of that morass to so … Read More
Health and Human Services Commission Inspector General Stuart Bowen Jr. announced in his quarterly report a new initiative to help combat Medicaid fraud and also help Medicaid providers. This is the IG Integrity Initiative. It was formally rolled out on … Read More
This morning Health and Human Services Commission Inspector General Stuart Bowen Jr. issued his latest quarterly report on OIG activities and results. Bowen has ushered in a new era of transparency and accountability for the agency and these reports provide … Read More
The investigative digging of the Texas media into the operations of state government has once again revealed to the public, otherwise blissfully ignorant, the tremendous apparent hypocrisy of several state officials who view their positions as the divine right of … Read More
Since 2012, there have been a large number of outstanding but here-to-date sealed False Claims Act lawsuits against Texas dentists who billed Medicaid for orthodontic treatment from 2007 to 2011. Some are known and high profile but there are 46 pages … Read More
The Sunset Advisory Commission today released its staff report on their observations and recommendations relating to the State Board of Dental Examiners. Basically, they found it had too many board members who did too little and got mired in business- … Read More
Today the Sixth Court of Appeals issued their decision in the Medicaid payment hold case of Antoine Dental Center of Houston. The court again exonerated the practice from allegations of Medicaid fraud, again terminated the payment hold and, for the … Read More
Gov. Rick Scott of Florida has signed into law changes that bring back DMOs such as MCNA and Dentaquest into Florida’s dental Medicaid program if all goes well. Florida governor signs new bill relating to dental Medicaid Florida HB 819, … Read More
Governor Greg Abbott has named Steve Austin chair of the State Board of Dental Examiners. The governor has also appointed Diane Garza for a term set to expire February 1, 2017, appointed Bryan Henderson, II, Jorge Quirch and Rich Villa … Read More
Four federal lawmakers from New Mexico – Sen. Martin Heinrich, Sen. Tom Udall, Rep. Ben Ray Luján and Rep. Michelle Lujan Grisham – filed a bill last week to guarantee due process rights to Medicaid providers across the country who are … Read More
Well, the answer to that question is about to be answered shortly. TDMR was contacted today by none other than Dr. Paul Dunn, the long-suffering dentist from Levelland who thought his troubles with Medicaid were over when he settled his … Read More
USA Today reported last week that 27 corporations listed in the Standard & Poor’s 500 paid no income tax for 2015 despite having pre-tax profits. The corporate giants include General Motors, Hewlett Packard, United Continental, News Corp, Weyerhauser amongst others. … Read More
The Texas Supreme Court this week issued a ruling allowing a whistleblower suit filed by Michael McMillen, a former Health and Human Services Commission Office of Inspector General attorney, to continue. McMillen contends he was fired in early 2012 for reporting … Read More
