In the same Xerox/Conduent court filing from July 2018 mentioned in our previous article, there is another exhibit worth mentioning. It is the complete email chain involving HHSC OIG officials discussing OIG investigator Ray Acuña's meeting notes on the Xerox/Conduent ortho prior authorization (PA) process. Stopped requiring molds for PA Some of the correspondence … [Read more...]
Court Document Shows Altenhoff and HHSC Knew Xerox Dental “Clerks” Worked at Home and Rubber Stamped Ortho PAs in June 2008
In a court document filed in July 2018 by Xerox/Conduent, an exhibit containing HHSC OIG email correspondence and notes from June 2008 proves that Dr. Linda Altenhoff, the state dental director, knew all about the faulty Xerox/Conduent ortho prior authorization (PA) process which carried on another three years and cost the state hundreds of millions of dollars. Altenhoff, as … [Read more...]
Capitation? DentaQuest and Brident Dental Agree on Alternative Payment Method
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...]
Dr. Linda Altenhoff: Making Out Like a Bandit at MCNA
In September when TDMR learned that the new Medicaid Dental Services RFP had gone out, we also learned and reported that Dr. Linda Altenhoff, former dental director for the Department of State Health Services and dental director for Texas OIG had become a Vice President of MCNA, one of the current Texas DMOs. HHSC bosses lost jobs A dentist in his 70s who lost his retirement … [Read more...]
State cancels health contracts with anti-abortion Heidi Group
An anti-abortion group that continuously failed to provide reproductive health services to the number of patients it told the state it could is getting its contracts terminated — and is facing an investigation by Texas' health agency over questionable billing. Texas Health and Human Services Commission officials said in an email Friday that “it has become clear that the Heidi … [Read more...]
UPDATE: HHSC Proposes to Reduce Monies an MCO Obtains from Fraud Recovery to 50% from 100%
UPDATE: We've added below an additional HHSC presentation given to the House Committee on General Investigating & Ethics which gives further details of MCO contract management. This morning HHSC sent out a notice that it was looking for public comments on several proposed rule changes relating to MCO fraud investigations of providers and fund recoveries. Draft rules on … [Read more...]
State cancels health contracts with anti-abortion Heidi Group
An anti-abortion group that continuously failed to provide reproductive health services to the number of patients it told the state it could is getting its contracts terminated — and is facing an investigation by Texas' health agency over questionable billing. Texas Health and Human Services Commission officials said in an email Friday that “it has become clear that the … [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...]