There is a rumor circulating that the Texas Health and Human Services Commission is putting together a new request for proposals (RFP) for dental managed care organizations for Texas Medicaid. While this may or may not be the case as … Read More
Last November, former Texas Medicaid director Billy Millwee, now a private consultant, appeared before the Little Hoover Commission in Sacramento, California. The LHC is an independent state oversight agency that was created in 1962 with the mission to investigate California … Read More
HHSC ensures that policies are medically appropriate, patient-centered, transparent and based on the best available evidence. The agency’s medical and dental policies outline the types of procedures and treatments for which HHSC will pay for specific conditions. Medical practitioners, program … Read More
Dr. Linda Altenhoff is no longer with the Inspector General’s office as Chief Dental Officer. In August, she moved over to MCNA and is now Associate Dental Director for MCNA Texas and works out of San Antonio. Named IG Chief Dental … Read More
The Texas Tribune this morning published an article that indicates the fate of Texas Health and Human Services Inspector General Stuart Bowen is uncertain at this time. Planned Parenthood investigation tied to fund-raising effort The context of the story was … Read More
Feeding on outrage sparked by the release of controversial undercover videos of Planned Parenthood officials, Gov. Greg Abbott vowed one year ago to cut off $3.1 million in Medicaid funding that the organization’s Texas affiliates receive to provide family planning … Read More
Drugmaker Mylan will pay $465 million to settle allegations that it overbilled Medicaid for its life-saving EpiPen, ending one of the controversies over the soaring price of the emergency allergy injection.The settlement with the Department of Justice follows news that … Read More
It all started with a battle over information: In one corner was the Texas Health and Human Services Commission. In the other were Texas lawmakers. The commission holds the details of the state’s Medicaid contracts with large pharmaceutical companies, which show … Read More
Nearly 300 East Texas children with disabilities who are part of the state’s Early Childhood Intervention program have no one to provide them with medically necessary therapies after the region’s lone provider closed its doors this week in response to hefty budget cuts … Read More
We received an email from a dentist with some very useful advice regarding denied treatment by dental MCOs (managed care organization). He specifically mentions MCNA. I just wanted to pass on the name of a resource that I recently found … Read More
A significant cut to the amount of money Texas pays therapists who treat children with disabilities was finally cleared to take effect — more than one year after state lawmakers originally ordered it — when the Texas Supreme Court on … Read More
AUSTIN –The $1.3 billion shortfall in Medicaid funding going into the next budget cycle can’t all be attributed to what Republicans typically call “out-of-control growth.” Source: Lawmakers tackle looming $1.3 billion shortfall in Medicaid – Houston Chronicle
On September 1, the first phase of the consolidation of the Texas Health and Human Services system became operational. SB 200, the Health and Human Services Commission sunset bill passed last legislative session called for transferring the Department of Assistive and … Read More
As HHS submits its Legislative Appropriations Requests for the next biennium, we are proud to share them with the people of Texas, whom we serve. The HHS system’s budget proposals reflect better integrated operations, a commitment to serving Texans in … Read More
A federal judge faulted the state Medicaid program in a strongly worded order, ruling the program had improperly denied 2,000 out-of-network emergency claims submitted by a nonprofit health care provider that treated indigent children.U.S. District Judge Keith Ellison ruled last week that the state … Read More
HOUSTON (CN) — Texas’s Medicaid reimbursement policy violates federal rules and should be put on hold because it leaves some health care providers “holding the bag,” a federal judge ruled. The Texas Children’s Health Plan denied about 2,000 claims that … Read More
Former Gov. Rick Perry may be taking a break from campaigning to bust a move on the dance floor, following reports from an entertainment website that the politician may be joining the next season of “Dancing With the Stars.” As … Read More
The Department of Health and Human Services Office of Inspector General audit released earlier this week found Texas had miscalculated payments for the Medicaid Supplemental Physician Payments program and owed the federal government some $57.9 million for the period 2004 … Read More
The audit section of the Department of Health and Human Services Office of Inspector General issued a report earlier this month that Texas now owed the federal government some $57.9 million because the state Health and Human Services Commission did … Read More
The weekend can’t come fast enough for the Texas Health and Human Services Commission. On Wednesday, federal officials asked the state’s largest agency to return $57,884,268, the federal share of $95,359,841 in supplemental payments to doctors made improperly from 2004 to … Read More
This week the Health and Human Services Commission Inspector General released his June 2016 quarterly report on the activities of his agency. Besides announcing the creation of a Pediatric Dentistry Action Team, the report also discloses that more Medicaid dentists … Read More
One of the main items of interest to Medicaid dentists from the latest quarterly report from the Health and Human Services Commission Inspector General Stuart Bowen is that a “Pediatric Dentistry Action Team” has been created within his agency. The … Read More
If you remember the heyday of HHSC/TMHP/Xerox program spending on orthodontia back in 2011 that begat allegations of Medicaid fraud, it was at a sky-high $249 million. In 2015, it was $13.6 million. So it is little wonder that the number … Read More
In case you might be wondering how much Texas now spends on dental care for Medicaid children, we now have an answer for you. TDMR filed an open record request earlier this year to get the spending figures for 2014 and … Read More
Over the past two weeks, it has been a major story that Attorney General Ken Paxton took a $100,000 donation for his personal legal fees from a friend whose company was accused of Medicaid fraud. The company just settled the … Read More
reported this morning on a new contracting scandal involving current Medicaid claims administrator Accenture and the Office of Attorney General. Outrage of use of “emergency leave” for fired staff You might remember back in May, the OAG was found to … Read More
AUSTIN — A top lawyer at the attorney general’s office was fired last year when she raised concerns that her bosses were breaking federal rules as they scrambled to salvage a foundering technology deal that has cost taxpayers hundreds of millions of dollars. After Martha … Read More
Dr. Juan D. Villarreal of Harlingen Family Dentistry and founder of Texas Dentists for Medicaid Reform has completed the writing of a book about his personal experience with Texas Medicaid and its attempt to falsely accuse Texas dentists of healthcare … Read More
The Texas Supreme Court on Friday delivered a temporary, last-minute victory to families of children with disabilities who want to stop sweeping budget cuts to a state-funded children’s therapy program. State lawmakers last year approved $350 million in budget cuts … Read More
In a last-ditch effort to stave off $350 million in cuts to a state Medicaid program that provides therapy to disabled children, federal and state lawmakers are asking the federal government to intervene.Families that have sued the state to stop … Read More
Heather Griffith Peterson and Kara Crawford have joined the HHS executive leadership team. They both began June 1. “We are putting together a strong leadership team that will continue to move the Texas Health and Human Services system forward,” Health … Read More
Child Protective Services officials have killed an idea to give some of its top employee big raises. “No salary increases for regional directors will even be considered until clear improvement is seen at CPS,” said Patrick Crimmins, spokesman for the … Read More
AUSTIN — Texas state health officials once again are delaying a massive data project that has struggled to get off of the ground for more than a decade. The state Health and Human Services Commission informed lawmakers Tuesday it was pausing … Read More
Back on May 19, Sen. Chuy Hinojosa and Rep. Richard Peña Raymond hosted a town hall meeting for providers on Medicaid managed care in Edinburg at the Edinburg Conference Center at Renaissance. It has taken a while but here are … Read More
Recently, TDMR filed an open records request with the Texas Health and Human Services Commission to find out how many individual Texas dentists are currently participating in Medicaid and how those participation numbers have changed since the Frew settlement in … Read More
Like many parents of children with autism, Braulio De La Cruz sought an expensive therapy called applied behavioral analysis — or ABA – when his son Noah Leonardo was diagnosed last year. Noah, now 3 years old, qualifies for Medicaid … Read More
You might remember the case of Austin dentist, Dr. Rachel Trueblood. $16 million overpayment demand settled for $39,000 Back in 2014, Dr. Trueblood had been accused of Medicaid fraud, placed on “credible allegations of fraud” payment hold which closed her … Read More
AUSTIN – Gary Jessee will lead the newly created Medical and Social Services division of the Health and Human Services system, HHS Executive Commissioner Charles Smith announced today. Jessee, who is currently the state Medicaid director, will become deputy executive … Read More
The policy revision to the Medicaid orthodontic benefit process contemplated by representatives of the Texas Medicaid and Healthcare Partnership and the Health and Human Services Commission in 2009 was sweeping. Per the final draft of the confidential policy revision attached … Read More
The Health and Human Services Commission in February 2009 asked the individuals working on the new Medicaid orthodontic benefit policy to review whether or not a board certified orthodontist should review each and every prior authorization request for orthodontic treatment. … Read More
