Dentaquest headquarters in Boston, MA We received a copy of this release from DentaQuest's Boston PR firm this morning. It appears DentQuest did continue to work with a large provider in Texas to come up with an alternative payment model. The details below are sketchy. DentaQuest Enters into First-of-its-Kind Value-Based Contract in Texas Alternative Payment … [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...]
UPDATE: Indiana Dental Practice & DSO Shell Out $5.1 Million Over Medicaid False Claims Allegations
UPDATE: TDMR has received a copy of the ImmediaDent and Samson Partners press statement from Samson Partners vice-president of marketing Stephen Valenti. It is at the bottom of our story in full. Indiana-based ImmediaDent and DSO Samson Dental Partners of Kansas have agreed to pay the federal government and Indiana some $5.139 million to resolve false claims allegations of … [Read more...]
Medicaid Managed Care Companies in Ohio Received $90 Million in Payments for Dead People
Reported in a shocking report released this week, the Office of Inspector General for the U.S. Department of Health found that the Ohio Department of Medicaid made $90.5 million in capitation payments to managed care organizations in the state on behalf of deceased beneficiaries. Over 81,000 payment made over two years The audit covered a two-year period from July 1, … [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...]
TDA Weighs in on DMO RFP and Capitation
In the last edition of TDA Today, the Texas Dental Association goes to bat for dental Medicaid providers on two issues. First, the publication reported that the TDA's Council on Public Health and Access to Care met with HHSC (HHSC, HHS; tomato, tomahto) reps from the Quality Oversight, Finance and the Medicaid/CHIP Services Department. They discussed the state requirement … [Read more...]
Comments about Dental Medicaid: Rep. Richard Peña Raymond
TDMR recently reached out to Rep. Richard Peña Raymond, chair of the House Human Services Committee to get his views on the current scene and the future of dental Medicaid in Texas. Supporter of dental Medicaid Raymond has been a major force for dental Medicaid providers. It was before his committee at public hearings in 2012 that dentists affected by the great Texas … [Read more...]
Texas Medicaid Dental Provider Forum NOW OPEN
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 comments left by those answering the survey. "IT CAN BE VERY DIFFICULT AT TIMES, THEY CHANGE THE CRITERIA SO FREQUENTLY." "The … [Read more...]