texas health and human services commission

The Sunshine State now joins the growing list of states that have recently increased dental Medicaid rates. Florida’s commitment to “live healthy” for its citizens On October 1, several health care bills came into effect in Flordia called the ‘Live … Read More

TDMR is pleased to announce that we received confirmation today from Texas Health and Human Services that, as of yesterday, DentaQuest is no longer paying a one-surface fee for non-interproximal two-surface fillings and will be reprocessing previously denied claims. Win … Read More

In July, the Louisiana Legislative Auditor’s office published a scathing audit review of DentaQuest’s performance as one of the two dental maintenance organizations with Louisiana Medicaid. It fined the company for its poor performance.  FYI, Louisiana calls them dental benefit … Read More

This week, a federal judge in Tennessee found that an algorithmic system similar to the one in Texas and designed by the same company illegally denied Medicaid benefits to thousands of Medicaid-eligible individuals. The TennCare Connect system, developed by Deloitte, … Read More

Justice for Medicaid dentists and orthodontists, whose lives, reputations, and practices were ruined in the great Texas Ortho Debacle, appears to be coming—slowly, but surely. Legal losses continue to mount for Conduent State Healthcare LLC, spun off from Xerox in … Read More

More comments have poured in as a result of our last article containing remarks from dentists about the state of their Medicaid practices.  Medicaid dentists are having difficulty grappling with the crushing weight of rising costs and woefully inadequate Medicaid … Read More

TDMR’s recent article on the financial challenges facing Medicaid dental practices in Texas has struck a chord with a number of providers who left comments.  We don’t often receive a spate of comments after an article, but this one certainly … Read More

The American Dental Association’s Health Policy Institute (ADA HPI) recently published its “Economic Outlook and Emerging Issues in Dentistry” report for the second quarter of 2024. This comprehensive survey offers valuable insights into the current economic conditions, staffing challenges, and … Read More

This week, several media outlets, including KXAN, have reported on U.S. Rep. Lloyd Doggett‘s release of correspondence from the Centers for Medicaid and CHIP Services (CMS) to Texas regarding significant delays and backlogs in processing Medicaid program eligibility. These delays … Read More

TDMR has learned that Texas Health and Human Services Provider Finance will conduct its biennial review of the Medicaid dental fee schedule later this year. The review will be presented at a rate hearing in November, with a proposed implementation … Read More

This past week, TDMR came across the State Of Texas Medicaid Managed Care Dental Rate Setting reports on the Texas HHS Provider Finance web portal. These are the third-party actuarial reports compiled for Texas HHS to recommend the per-member, per-month … Read More

The Colorado Dental Association (CDA) announced at the end of April that Gov. Polis had signed the 2024/25 state budget, which includes $78 million in “meaningful reimbursement rate increases for Medicaid dental providers.” The increased fees schedule goes into effect … Read More

TDMR recently received the 2023 statistics of active and enrolled Medicaid dentists from a freedom of information request to Texas Health and Human Services.  These statistics come from the THSteps Active and Enrolled Dental Provider Participation Report (downloadable PDF below), … Read More

BY KAREN BROOKS HARPER, Texas Tribune APRIL 26, 2024 “State’s premature release of bid proposal info touches off new battle over $116 billion in Medicaid contracts” was first published by The Texas Tribune, a nonprofit, nonpartisan media organization that informs … Read More

TDMR has compared the fee schedules for TMHP THSteps Medical services from 2019 and 2024 to determine if doctors are being hampered by the same reluctance from Texas HHS to increase fees that have plagued Medicaid dentists over the last … Read More

REPUBLISHED FROM THE TEXAS TRIBUNE By Karen Brooks Harper, The Texas Tribune April 18, 2024 “Proposed changes to state Medicaid plans could shake up health coverage for 1.8 million low-income Texans” was first published by The Texas Tribune, a nonprofit, … Read More

TDMR received notification of a new report from Texas HHS on the End of Continuous Medicaid Coverage in Texas. The upshot for children who were under Medicaid coverage during the public health emergency (PHE) is that, at present, some 999,524 … Read More

Over the last several months, TDMR has been receiving anecdotal comments from Medicaid dental providers that they have found themselves truly between a rock and a hard place at this time. Although we have reported on a number of negative … Read More

Arizona, through its Arizona Health Care Cost Containment System (AHCCCS). the state’s Medicaid agency, has instituted a value-based healthcare initiative with its Differential Adjusted Payment (DAP) program, which has been running for several years. Value-based healthcare initiative Value-based healthcare focuses … Read More

Back in March, TDMR published an article on the number of active THSteps Enrolled Dental Providers obtained from an open records request filed with Texas Health and Human Services. Records since 1996 Texas HHS has been compiling these figures since … Read More

Looking for a fee increase for Medicaid services? Here is another opportunity to make your voice heard. We received this email notification for Texas HHS this week. The Texas Health and Human Services Commission is working on its Legislative Appropriations … Read More

Two weeks ago, TDMR reached out to Texas HHS to find out if a new dental director had been hired for the Medicaid CHIP program to take the place of Dr. Margaret Laccabue. And, yes, that has occurred.  We were … Read More

NOTE: DentaQuest had contacted us and the fees used for comparison initially were their commercial fees, not the Medicaid fee schedule available to providers and not publicly available online.  We did not receive the correct fees from DentaQuest.  However, we … Read More

It was announced yesterday that Emily Zalkovsky will replace Stephanie Stevens on July 1 as Medicaid and CHIP Director for Texas HHS.  Ms. Zalkovsky has been deputy director since September 2020.  There is no mention of why Ms. Stephens is … Read More

TDMR has learned that Dr. Margaret Laccabue is no longer the Dental Director, Office of the Medical Director, Medicaid and CHIP Services for Texas HHS.  We have it on good authority that she was released from employment with HHS, but … Read More

UPDATE:  The Texas HHS Open Records Office sent TDMR a further document that contains only the active number of dentists in the Texas Medicaid program from 1996 to 2022.  The previous document used contained both active and inactive combined.  This … Read More

You just can’t make this stuff up. HHS just contracted with Conduent again Texas just rehired Conduent, the company it had fired in 2014 as its lead Medicaid contractor and then accused of $1.2 billion in Medicaid fraud which it … Read More

What happens if a company gets sued for $2 billion by the State of Texas for Medicaid fraud as its former Medicaid claims administrator, then tries to pay the settlement by committing insurance fraud? Texas gives them a new contract!  … Read More

TDMR received an email from a provider that a new problem had developed in credentialing a dentist that adds even more time to the process. No TPI in welcome letter Apparently, TMHP is no longer including the TPI (Texas Provider … Read More

This seems like a silly question because surely the agency that pays billions of dollars to DMOs and MCOs and keeps the Medicaid show on the road in Texas should know something—and perhaps should know everything– about the credentialing of their Medicaid dentists in Texas. You wouldn’t be … Read More

The American Dental Association’s Health Policy Institute last month published the results of an ongoing survey it has been conducting since January 2022, quizzing some 3,000 participating private practice dentists each month to measure the impact of COVID-19 and other … Read More

Texas Health and Human Services Office of the Inspector General came out with its last quarterly report for fiscal year 2022 this month. OIG provider settlements One of the key takeaways from the report is that 16% of the 147 … Read More

TDMR received this letter highlighting the difficulty Medicaid dental providers are having in today’s current economic climate and the need for the legislature this session to take corrective action. We publish it in hopes that it will reach open and … Read More

Texas Health and Human Services is looking for a dental policy analyst for its HHSC Medical and Dental Benefits Program.  As they say, “If you enjoy researching, writing policy and remaining current with dental practices, and are interested in being … Read More

State Medicaid Director Stephanie Stephens, in a speech given on September 27 at the 2022 North Texas State of Reform Health Policy Conference, stated that an HHS priority for the upcoming legislative budget is Medicaid provider rates. Provider fees a … Read More

TDMR received an email from Texas Health and Human Services this week requesting everyone’s help to come up with ideas to save some dough.  Apparently, the Texas Legislature directed HHS to figure out how to save $350 million for the … Read More

Thanks to the excessive prices for oil products due to the attempted embargo of Russian oil to punish the country for its war on Ukraine, the Texas state budget will benefit to the tune of some $27 billion, according to … Read More

The Texas Exclusions Database simplifies applicant screening for Medicaid providers, offering the ability to better protect their patients with real-time verification of potential employees before they are hired. Texas Health and Human Services (HHS) Office of Inspector General (OIG) protects … Read More

After our article about the need for a review of Medicaid dental fees was published in May, we received a number of comments from dentists about how the lack of a fee increase is impeding service to their clients and … Read More

Everyone remembers the Frew case back in 2004 when the Supreme Court forced Texas to provide basic healthcare services including dental care for Medicaid-eligible children. Reason for fee increase in 2007 For those that don’t remember, let’s recap. Linda Frew, … Read More