State Medicaid Director Stephanie Stephens, in a speech given on September 27 at the 2022 North Texas State of Reform Health Policy Conference, stated that an HHS priority for the upcoming legislative budget is Medicaid provider rates. Provider fees a … Read More
The American Dental Association recently held a webinar in which members of a key study about Medicaid dental practitioners provided details of their findings. Estimate drops by 11% The main takeaway is that the ADA has now readjusted downward from … Read More
TDMR received an email from Texas Health and Human Services this week requesting everyone’s help to come up with ideas to save some dough. Apparently, the Texas Legislature directed HHS to figure out how to save $350 million for the … Read More
OIG recently published the following article on its website which we thought to republish here along with the PDF documents linked to in the article. Texas providers encouraged to self-report overpayments Providers continue to participate in the OIG’s self-report process, … Read More
According to a recent report entitled “Access to Oral Health Workforce Report, Part I” by the Pennsylvania Coalition for Oral Health, the state lost 13.5% of its dentists participating in its Medicaid program between the beginning of 2019 and the … Read More
Ensuring Texas Medicaid dollars are spent for their intended purpose requires the Texas Health and Human Services (HHS) Office of Inspector General (OIG) to work with health care professionals to prevent fraud, waste and abuse. Accurate medical and dental coding … Read More
The recent business headlines about Sun Life, the Canadian insurer that purchased DentaQuest earlier this year, and its Q2 financial results are quite bipolar – either dismal or glowing. Good Q2 or not for DentaQuest purchaser Several publications spotlight the … Read More
The American Dental Association has reported that dental services increased 1.9% in June, the highest single-month rise ever recorded since the Department of Labor started keeping track in 1995. Job Market Increases The increase is attributable in part, according to … Read More
The American Dental Association reports that 14 state legislatures have passed progressive legislation regarding Medicaid dental care this year, partly due to increased budget surpluses in those states. Connecticut, Georgia, Illinois, Maryland, Mississippi, Missouri, Nebraska, South Dakota, Tennessee, Vermont, and … Read More
Thanks to the excessive prices for oil products due to the attempted embargo of Russian oil to punish the country for its war on Ukraine, the Texas state budget will benefit to the tune of some $27 billion, according to … Read More
The Texas Exclusions Database simplifies applicant screening for Medicaid providers, offering the ability to better protect their patients with real-time verification of potential employees before they are hired. Texas Health and Human Services (HHS) Office of Inspector General (OIG) protects … Read More
After our article about the need for a review of Medicaid dental fees was published in May, we received a number of comments from dentists about how the lack of a fee increase is impeding service to their clients and … Read More
TDMR has learned that a number of Medicaid dentists around the state have been receiving informal letters from the Office of Inspector General about their billings. Avoid formal process Apparently, OIG is looking to resolve billing situations informally rather than … Read More
PRESS RELEASE BY Sun Life Financial Inc. Jun 01, 2022, 08:27 ET BOSTON and WELLESLEY, Mass., TORONTO, June 1, 2022 /PRNewswire/ – Sun Life Financial Inc. (TSX: SLF) (NYSE: SLF), through its U.S. business, announced today the completion of its acquisition of DentaQuest, the second-largest dental benefits provider … Read More
It is with some irony that a company that has been found guilty of insurance fraud by a jury in Delaware (and apparently colluding with the Texas Office of the Attorney General to do so) is still a major player in … Read More
Everyone remembers the Frew case back in 2004 when the Supreme Court forced Texas to provide basic healthcare services including dental care for Medicaid-eligible children. Reason for fee increase in 2007 For those that don’t remember, let’s recap. Linda Frew, … Read More
In March TDMR reported on the federal HHS-OIG report about the 2021 cumulative activities of state Medicaid Fraud Control Units around the country. As there were no state breakdowns, we filed an access to information request with the Office of … Read More
This was posted on the Texas HHS-OIG website yesterday. Thought we would republish.. ————————— Ensuring Texas Medicaid dollars are spent for their intended purpose requires the OIG to work with health care professionals to prevent fraud, waste and abuse. Accurate … Read More
The list of complaints about DentaQuest from Medicaid providers keeps growing. It seems that new Canadian ownership hasn’t changed any business practices so far, but we hear they like their money too. While some problems have been reported about MCNA … Read More
The following article was supplied by Texas HHS-OIG. Keeping accurate and complete patient records is part of providing quality patient care. Good record keeping can also help protect a practice against allegations of wrongdoing. The patient record is a legal … Read More
