The Supreme Court of Texas today rejected an attempt by Xerox/Conduent to point the finger at Texas dentists when it goes to court in an attempt to defend itself from at least $2 billion in damages and penalties stemming from its failed Medicaid orthodontic prior authorization process from 2004 to 2012. Wanted to make dentists financially responsible for damages The … [Read more...]
The United States Dental Association Is Forming!
TDMR has been asked to inform its readers that a new association of dentists is in the process of being formed. The new association is to be called the United States Dental Association. Among the founding members of the new organization are Drs. Juan Villarreal and Robert Anderton. Dr. Villarreal is the founder of TDMR, author of "Truth Decay" and owner of Harlingen Family … [Read more...]
“Truth Decay” One Year Later
In January of last year, Dr. Juan Villarreal's long-awaited book "Truth Decay: How Government Corruption Caused a Political Scandal Victimizing Texas Dentists and How It Could Happen to You!" was released on Amazon.com. "Truth Decay" details Dr. Villarreal's personal struggles and victories overcoming allegations of Medicaid fraud by the Texas Office of Inspector General … [Read more...]
‘PUSH! PUSH!’ How a bungled private contract cost Texans $130 million
A dozen years ago, Texas health care administrators hired a company to help determine when taxpayers should cover the cost of dental care for the state’s poorer residents, particularly children. The company, later acquired by the giant corporation Xerox, deployed a team of medical specialists to review the tens of thousands of requests for dental and orthodontic care that … [Read more...]
Interview with the Author of “Truth Decay,” Dr. Juan D. Villarreal
The following is an interview done with Dr. Juan D. Villarreal, author of "Truth Decay: How Government Corruption Caused a Political Scandal Victimizing Texas Dentists and How It Could Happen to You!," published by TDMR. The book has now been available for two months on Amazon. If you haven't obtained your copy, please pick up either the paperback or the Kindle … [Read more...]
No Law Allows MCOs To Place “Credible Allegations of Fraud” Payment Holds Against Providers
TDMR has learned from a staffer in the office of Sen. Juan "Chuy" Hinojosa that they have been informed by Health and Human Services that managed care organizations, including MCNA, do not have any right under any Texas or federal law to place a "credible allegations of fraud" payment hold on Medicaid providers - only the HHS Inspector General can do that. Meetings with … [Read more...]
Another Dentist’s Plea for Help with MCNA
TDMR received the following email from a Texas dentist. He has given permission for us to publish it and we are doing so anonymously to hopefully prevent any further retribution against himself and his practice. I am writing this email to whoever might be able to help my patients. I am an oral surgeon in ... and I have been treating Medicaid patients, both children and … [Read more...]
Texas officially kicking Planned Parenthood out of Medicaid
After more than a year of delays, Texas is officially kicking Planned Parenthood out of the state’s Medicaid program. In a move that could affect thousands of low-income women, state health officials on Tuesday delivered a final legal notice to defund the organization from the Medicaid program through which it provides family planning and women’s health services to the poor. … [Read more...]
Testimony Shock: Texas MCOs Recover Only $2 Million in Alleged Fraud from $20 Billion Budget in 2015
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 recovered $2 million in alleged fraudulent payments in 2015 out of a $20 billion budget. Sen. Schwertner … [Read more...]
Dentist’s Outrage Over MCNA Secret Recoupments on Child’s Pre-Approved Treatments
In response to TDMR's latest story on payment holds placed on Medicaid dentists by MCNA, TDMR received an emotional missive from a Medicaid dentist about his negative experience with MCNA. He gave permission to publish his comments. The legislative session is starting and we will do our best to inform legislators about such issues. If you have a similar experience, … [Read more...]