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 has just published its report for 2020 on Medicaid fraud uncovered and reported by MCOs in Texas. The report shows that DentaQuest and MCNA found only $234,098 and $127,264 in Medicaid fraud, respectively for 2020. According to the … Read More
Bill filing has started for the upcoming legislative session at the Texas Capitol. One of the early filings is HB 648, a bill introduced by House Rep. Richard Peña Raymond of Laredo to modify the mandate of the HHSC Office … Read More
Remember back in 2012 when the media and the state were outraged by dentists giving out gift cards or other small inducements to have Medicaid children get under care? In case you don’t, here are links to some media articles … Read More
We are pleased to make public the results of our Texas Medicaid Dental Maintenance Organization Annual Survey 2020. This year 90 dentists took the opportunity to give us their views on the performance of MCNA and DentaQuest. Last year we … 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
June 24, 2019 – 1:00pm Health and Human Services Commission, Robert D. Moreton Building, Room M-1001,100 W 49th StreetAustin, TX 78756 Webcasting Available 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 and select … Read More
California made capitation payments after beneficiaries’ deaths. Of the 184 capitation payments in our random sample, 6 payments were correct. For the remaining 178 payments, California made unallowable payments totaling $433,948 ($302,755 Federal share). Despite California’s efforts to identify and … Read More
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 order Roll … Read More
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 … Read More
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 … 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
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 … Read More
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
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 … Read More
The Statesman published an article this morning about the scathing testimony heard by the House Committee on Human Services, chaired by Rep. Richard Peña Raymond, at a special hearing held yesterday in Edinburg. Wanted public and provider feedback on managed … Read More
You just found out about this? So did we. Just learned of it TDMR learned of it about 10 days ago when a provider gave us a copy of a letter they received from DentaQuest dated July 27 but received … Read More
Medicaid dental providers apparently want an online forum to securely discuss mutual problems with Texas Medicaid and DMOs. Some 92% of those taking our survey answered a resounding “yes” to having such a forum. Comments Here are some of the … Read More
Since our recent stories about the new dental RFP for Medicaid and DentaQuest’s capitation payment move, TDMR has received several emails from dental providers about their concerns over the RFP choices and provider lack of power against such large companies. … 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
An industry insider has told TDMR that he thinks six dental management companies will vie for the Texas Medicaid dental contract RFP that closes in September. He named the two current contractors, MCNA and DentaQuest, and included Liberty Dental and … Read More
Rendering of new HHS Building It is finally here, not with a bang but with a sigh. It’s been out over a week and not a whisper about it until today despite the fantastic anticipation by dental Medicaid providers over … Read More
The U.S. Department of Health and Human Services Office of the Inspector General issued a report yesterday that found that managed care organizations are not doing enough to identify Medicaid waste, fraud and abuse. HHS-OIG undertook the review because it … Read More
By Marissa Evans June 27, 2018 Linda Badawo says she doesn’t know if managed care works or not — but it hasn’t worked for her family. Sitting with her son D’ashon beside her in his wheelchair, Badawo told legislators during … Read More
