February 25, 2019 - 1:00pmHealth and Human Services Commission, Brown-Heatly Building, Public Hearing Room4900 North Lamar Blvd.Austin, TX 78751 This meeting will be webcast. To access the webcast, go to https://hhs.texas.gov/about-hhs/communications-events/live-archived-meetings the day and time of the meeting. Call to orderRoll callAdoption of December 12, 2018, draft … [Read more...]
Gold Coast Health Plan Selects Conduent for Medicaid Managed Care Administration
FLORHAM PARK, N.J., Jan. 31, 2019 /PRNewswire/ -- Conduent Incorporated (NYSE: CNDT), a digital interactions company, was awarded a $100 million, seven-year contract extension to provide third-party administration services for Gold Coast Health Plan (GCHP), a Ventura County, Calif.-based Medi-Cal plan. Conduent will deploy an end-to-end plan administration platform, … [Read more...]
Dental Managed Care Issues Receive Legislative Attention with Meeting at the Capitol
Back on November 21, House Human Services Committee Chairman Richard Peña Raymond held a meeting with a select group of dental providers regarding dental managed care issues. Providers requested meeting The meeting was initially requested by South Texas Dental but was expanded to include other dental groups and the Texas Dental Association which were invited through Raymond's … [Read more...]
DentaQuest New Standard of Care Review for Restorations Begins February 1
Dentaquest headquarters in Boston, MA We want to remind Medicaid dentists that DentaQuest is starting a new protocol on February 1 for reviewing restorations done on the same tooth within 36 months. This includes prior authorization along with other criteria detailed below in a copy of the letter sent out to dentists in December. Codes that are affected are D2140, D2150, … [Read more...]
Public Meeting in Austin on Managed Care December 12
The State Medicaid Managed Care Advisory Committee of HHSC is holding a public meeting in Austin on December 12. Here is the information: December 12, 2018 - 1:00pm Health and Human Services Commission, Brown-Heatly Building, Public Hearing Room 4900 North Lamar Blvd. Austin, TX 78751 This meeting will be webcast. To access the webcast, go … [Read more...]
Questions Linger about Capitation and DMO RFP
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 they are concerned about DMOs moving to a capitation plan as DentaQuest was seeking to do and what is currently happening with the RFP. So … [Read more...]
HHSC reviews state Medicaid and CHIP programs
The Texas Health and Human Services Commission (HHCS) recently published its “Rider Report 61,” a review of Medicaid and Children’s Health Insurance Program (CHIP) managed care contracts commissioned by the legislature. The report aims to be a comprehensive assessment of the structure and function of Medicaid Managed Care system in Texas the integrity of which is particularly … [Read more...]
UPDATE: New RFP Out – Say What? Dental RFP Canceled by HHSC Over Proposal Problems
UPDATE: Christine Mann, the Press Officer at HHSC, has informed us that new RFP is out as of yesterday. The information is below and is available at http://www.txsmartbuy.com/sp/HHS0002879 Medicaid CHIP Dental Status: Addendum Posted Solicitation ID: HHS0002879 Response Due Date: 11/30/2018 Response Due Time: 2:00 PM Agency … [Read more...]
Lifetime Limitation for Restorations and Stainless Steel Crowns
Back in August, a notice appeared on the TMHP website that Texas Medicaid was going to impose a lifetime limit for restorations and stainless steel crowns on September 1. Lifetime limits The notice said: Effective for dates of service on or after September 1, 2018, lifetime limitations for restorations and stainless steel crowns will change for Texas Health Steps. The … [Read more...]
Dentist Quits MCNA in Disgust Over $33,000 Recoup Demand
From time to time, TDMR receives correspondence from dentists expressing their frustration and anger with one or both of the current DMOs managing Texas Medicaid. Last week, we received an email from a dental provider about a recoupment demand made by MCNA. Apparently, it took the company three years to review the documents he had sent them per their initial request. He … [Read more...]