A Medicaid dental provider with multiple offices in the state contacted TDMR this past week, voicing serious concerns about recent restrictions imposed on their practice by Canadian-owned DMO DentaQuest regarding the use of substitute dentists. Violation of Texas Administrative Code … Read More
While DentaQuest limits its Medicaid network in Texas and threatens to boot over 100 providers from its network in urban areas, yesterday, its Canadian parent company, Sun Life Financial Inc., crowed about its share price reaching an all-time high, boosted … Read More
California has problems. We all know about them. Now, they’ve added DentaQuest as another one for their Medicaid (Medi-Cal) program to the apparent detriment of state dental providers, considering the company’s situation in Texas, Louisiana and other states. This past … Read More
TDMR has received a missive from a concerned dentist, which we are publishing. It sums up the frustration and intense concern about DentaQuest’s recent actions in limiting its network, including a threat to remove over 100 urban providers. This prodigious … Read More
Our story on foreign-owned DentaQuest’s limitations on dental care access for Medicaid children in Texas has sparked outrage among dental providers, leading to an outpouring of angry comments. Many practitioners shared their frustrations and experiences, highlighting how the restrictive policies … Read More
TDMR is pleased to announce that we received confirmation today from Texas Health and Human Services that, as of yesterday, DentaQuest is no longer paying a one-surface fee for non-interproximal two-surface fillings and will be reprocessing previously denied claims. Win … Read More
It’s a bad week for DentaQuest. Yesterday, according to an article in the online publication The Center Square, Louisiana legislators ripped into DentaQuest at a hearing of the House Joint Budget Committee as the Louisiana Department of Health had recommended … Read More
Remember we wrote that Texas should beware of DentaQuest and its corporate behavior, which cost the company $11 million in fines in Louisiana for Medicaid contract violations, which was recently cited in a report by the Louisiana Legislative Auditor’s office. … Read More
In July, the Louisiana Legislative Auditor’s office published a scathing audit review of DentaQuest’s performance as one of the two dental maintenance organizations with Louisiana Medicaid. It fined the company for its poor performance. FYI, Louisiana calls them dental benefit … Read More
A few weeks ago, it was announced that Benecare Dental Plans has taken over the contract as a third-party payer for the Medicaid program in Massachusetts under MassHealth. DentaQuest lost the contract, which it had held for at least a … 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
Almost three hundred seniors and patients with disabilities were stranded mid-treatment plan in Laredo thanks to a change in dental insurance providers in July of this year. Since 2017, Dr. Amin Abdul of the Asclepius Dental Center of Laredo has … Read More
We received an email from a dentist a few weeks ago who was having trouble with a particular DMO. In the process of trying to assist them, we reached out to Texas HHS in an attempt to find a state-level … Read More
Our 2021 survey of Texas dental maintenance organizations is complete and the results have been compiled. Survey says: long-term providers MCNA and DentaQuest have improved their performance in the minds of Medicaid dentists from previous years while newcomer United Healthcare … Read More
SURVEY IS CLOSED As we come out of the pandemic and into a hopefully normal July 4 weekend, TDMR is issuing our annual survey to find out how dental maintenance organizations have been performing for Medicaid dentists over the last … Read More
Texas HHS-OIG published on their website June 24 an audit they completed on DentaQuest back on January 9. The audit found that DentaQuest had $1.53 million in “unallowable, unsupported, and overstated expenses on its Administrative Expenses FSR [Financial Statistical Report]” … Read More
Texas Health and Human Services recently awarded DentaQuest a contract to continue providing dental managed care to enrollees in Texas Medicaid and CHIP programs. DentaQuest has been a partner to the State of Texas since 2012, providing Medicaid and CHIP … Read More
We’ve heard from various dentists that they have questions about controversial issues that have come up over the last several months. So we assume there are more out there that have the same questions or heard the same rumors. Primarily … Read More
We have closed our revised 2018 Dental Management Organization annual survey and are today giving you the results. Our survey sample is not that large, unfortunately. At the end of the day, only 39 providers entered the survey as we … Read More
TDMR has confirmed rumors that a number of Texas dental providers have been approached by DentaQuest to change their payment method from managed fee-for-service to capitation. Capitation to “share the financial risk” with providers A capitation payment is a fixed amount … Read More
TDMR has been asked several times recently if we have any knowledge of an upcoming RFP (request for proposals) for dental management organizations. There have been rumors flying around for well over a year now that Texas Health and Human Services … Read More
HOUSTON, Nov. 28, 2017 /PRNewswire/ — DentaQuest, the leading purpose-driven oral health company and the largest Medicaid dental benefits administrator in the nation, has donated $10,000 to the Memorial Hermann School-Based Health Centers’ mobile dental program. This donation marks the … Read More
DentaQuest, the leading oral health company in the United States and the largest in the Medicaid space, wired one million dollars today to the Rebuild Texas Fund launched by The Michael & Susan Dell Foundation. With this donation, DentaQuest joins … Read More
Procurement Director Edward Armstrong must have a feeling of deja vu.Disclosure provisions in the state’s competitive bidding process have landed him in the hot seat again, this time as a defendant in a lawsuit filed last week by DSM USA … Read More
A Boston company has asked a judge to overturn an Arkansas official’s decision that resulted in the firm losing a bid for a multimillion-dollar contract to manage dental benefits for Medicaid recipients. In a lawsuit filed Monday in Pulaski County … Read More
Below are the results of our TDMR Medicaid Dental Maintenance Organization Followup Survey. 84 dentists responded to the survey which is not quite comparable to the 105 who took the first survey back in December 2016. Cautions on the results … Read More
UPDATE, March 2: Survey is now closed. Last fall through to this January, TDMR received a deluge of unsolicited complaints regarding problems with Medicaid dental managed care organizations. Lots of complaints and education actions taken We have published no less … Read More
In February of last year, Texas Health and Human Services Dental Director Marguerite Laccabue held a dental stakeholders meeting in Austin. It doesn’t appear from the HHSC online video of the proceedings that it was well-attended or promoted as the … Read More
Back in December, TDMR asked dentists to take an online survey to ascertain their views on Texas Medicaid dental managed care. We now have these results which are provided below and can be downloaded. Limitation of survey results Before we … Read More
In testimony before the Senate Committee on Health and Human Services in September, Inspector General Stuart Bowen shocked committee chairman Sen. Charles Schwertner with the revelation that the 22 MCOs (managed care organizations) operating in Texas had only found and … 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
ATLANTA–(BUSINESS WIRE)–Amerigroup Community Care, a Georgia statewide provider of Medicaid managed care services, has partnered with DentaQuest to launch Dental Home services to its members. The Patient-Centered Dental Home model connects each member to a personal dentist who leads a … 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
UPDATE: MCNA has responded to our recent request for a contact for provider complaints and provided information about their complaint process. See information below. Managed Care Organizations (MCOs) received significant mention in the report issued by the Health and Human … Read More
No, that wasn’t $200 million. It wasn’t $50 million. It wasn’t even $500,000 or $250,000. The amount of dental fraud found and recovered by Texas dental management organizations in 2015 was only $243,982.84 per the “HHSC OIG Annual Report on … Read More
