“Solicitation by Medicaid Providers” Briefing by Dental Director, Inspector General

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 is now with MCNA, leaving IG last August.

Misled orthodontic stakeholders in 2009

She is also the individual that told a similar orthodontic stakeholders meeting in 2009 that all prior authorization requests for Medicaid orthodontic treatment were being reviewed by a board certified orthodontist when in fact TMHP was using low-paid, high school graduates to do the reviews.

Providing public service to make information public 

Again, as a public service, TDMR is dragging this video (20-minutes long) and accompanying slides out of the dustbin of the HHS video archives so that providers can get the information and help them with their practices.  It is sad that we have to do this.

Dr. Linda Altenhoff, then-dental director, IG – “Solicitation by Medicaid Providers”

Altenhoff presentation Feb 26 2016

 

One Response

  • The moral of this story. competition is not the same as competent.

    MCO\’ s and disloyal provider are on the same side of the road. and competing for gaining the( tax payers moneys) patient as a prize ( milking the cow).

    Since 1994 , I was a Medicaid provider years before the MCO and the incremental in the Medicaid procedures payments. I never had heard the word fraud at that time as a dentist provider. Medicaid was very please on having me as provider sending me gratitude messages often. I was a happy dentist providing services to the needed low income kids .

    Medicaid well deserve incremental of the underpayments for the procedures took place and the # of Medicaid providers increased( need a hand to milk a cow?) . Suddenly must of the Medicaid patient needed braces. It is when Medicaid budget got affected having to pay more for the same procedures.Then regulation and the word fraud appeared in the HHCS atmosphere followed by the term medical necessity. Seems the payment need to be cut again to adjust the budget.

    The MCO\’s. come to the picture ( Opportunity to MILK THE COW) trying to make their Hippocratic way as saviors and fraud experts with requested of poor verifiable documentation and protocols within the audits, defamation , harassment to dentist providers and all sort of improvisations on the implementation of the contacted agreements sign. The competition between the MCOs took place.

    HHCS do not want to do anything with the contracted relation between MCO\’s and providers but sure want to go after the providers whom are no following Medicaid rules ( good excuse, more teeth for MCOs) and want MCOs to take the provider right of practice with their implemented contact agreements to cut the payments.

    Now the providers victims stay victims and we have to deal with it .

    HHCS did laundry and are coming out with a new face (a butcher clean apron).

    MCO\’s manage no to be account for their wrong recoups and kicked out the good providers whom complain standing before the providers rights , the profession and the patients. The MCOs are taking advantage of the providers sign contract agreements which might be in breach of contact until some decide to legally demand .

    The HHCS is taking time to implement the new regulations and giving time to the MCOS do their own laundry and to put the mess together with what they have not comply under the agreement.

    Seems we providers really need \”one\” private legal representation for all us.

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