For three months, Courissa Hall essentially lived in a Houston rehabilitation hospital providing care for her 4-year-old daughter, who suffered brain damage during a routine appointment at a local dental clinic that specialized in treating Medicaid patients. She’s still processing … Read More
Earlier this week, TDMR received an email from a mother who had her sons under Medicaid orthodontic treatment back in 2011 and 2012 and is still very upset at the both the state handling of the matter and the lack … Read More
Medicaid in Texas and the federal government that continues to expand it are just as voracious and as difficult to pay for as they have ever been.Medicaid expansion ran loose in Texas last week.Somebody had to say it. You certainly … Read More
Health and Human Services Commission Inspector General Stuart Bowen Jr. announced in his quarterly report a new initiative to help combat Medicaid fraud and also help Medicaid providers. This is the IG Integrity Initiative. It was formally rolled out on … Read More
AUSTIN — Attorney General Ken Paxton is still paying a former top staffer more than a month after she left the agency, and aides refuse to answer questions about a special payment arrangement for her and Paxton’s former deputy amid … Read More
AUSTIN — Chris Traylor will retire as head of the Texas Health and Human Services Commission at the end of next month, legislative officials with knowledge of his decision said late Thursday. Traylor, who canceled retirement plans last spring to … Read More
This morning Health and Human Services Commission Inspector General Stuart Bowen Jr. issued his latest quarterly report on OIG activities and results. Bowen has ushered in a new era of transparency and accountability for the agency and these reports provide … Read More
A Texas appeals court delivered a big loss on Thursday to a group of home health agencies and parents of children with disabilities who sued the state over payment cuts to in-home therapy providers. The Texas 3rd Court of Appeals ruled … Read More
Any effort to reform Medicaid financing should take into account evidence that the program already has low payment rates and low spending growth, meaning further reductions could hurt beneficiaries’ access to care, according to an issue brief from the Kaiser … Read More
State health officials confirmed Tuesday they have asked the Obama administration to keep a 15-month lifeline of federal Medicaid money flowing into Texas to help hospitals treat uninsured patients. That money would offer temporary relief to health care providers who face losing the funds — … Read More
Texas Health and Human Services Commission officials say they have no choice but to carry out the will of lawmakers and cut $350 million from the state’s Medicaid program.In September, state District Judge Tim Sulak temporarily blocked implementation of the … Read More
Hefty cuts to a state Medicaid program that pays for poor and disabled Texans to receive in-home therapy won’t endanger patient lives or destroy livelihoods, a state district judge was told Tuesday. Coming from a major health insurer that covers … Read More
When Brianna Dupuie was a year old, a babysitter shook her so hard she had a stroke that paralyzed her right side. Everything Brianna had learned to do — how to walk, crawl and speak — was erased.In the seven … Read More
Here’s an unusual story out of Texas which seems to defy all the conventional wisdom about employment trends and wages. The local press has noticed that nursing homes are having trouble filling the health care jobs at their facilities these … Read More
Today the Sixth Court of Appeals issued their decision in the Medicaid payment hold case of Antoine Dental Center of Houston. The court again exonerated the practice from allegations of Medicaid fraud, again terminated the payment hold and, for the … Read More
March 28, 2016 — Florida Gov. Rick Scott has signed a bill that will study possible changes to the way Medicaid recipients receive dental care in that state. Currently, the state’s Medicaid managed-care system requires HMOs to cover dental services. … Read More
Four federal lawmakers from New Mexico – Sen. Martin Heinrich, Sen. Tom Udall, Rep. Ben Ray Luján and Rep. Michelle Lujan Grisham – filed a bill last week to guarantee due process rights to Medicaid providers across the country who are … Read More
Back in 2012, I delved into a topic of utmost importance and surprising depth: children’s dental health. For years, many dentists chose not to treat Medicaid patients. From an economic point of view, it was really no surprise; providers willing … Read More
Last year, the Medicaid program celebrated its golden anniversary. A lot has changed over the last 50 years. Originally created in 1965 as a joint federal-state program to provide health care coverage for low-income, vulnerable Americans, it is now the … Read More
While Texas lawmakers are studying ways to reduce costs in the state’s Medicaid program for the poor and disabled, health insurance companies are making a business pitch. Health plans could save the state roughly $100 million per year, they say, … Read More
Republican presidential front-runner candidate Donald Trump on Wednesday unveiled proposals for reforming U.S. healthcare that included repealing Obamacare, allowing prescription drugs to be imported, and turning the Medicaid program for the poor into block grants to states. The plan also … Read More
The Texas Supreme Court this week issued a ruling allowing a whistleblower suit filed by Michael McMillen, a former Health and Human Services Commission Office of Inspector General attorney, to continue. McMillen contends he was fired in early 2012 for reporting … Read More
Updated: 3:00 p.m. Wednesday, Feb. 24, 2016 | Posted: 9:08 a.m. Wednesday, Feb. 24, 2016The state’s top criminal court on Wednesday threw out the remaining criminal charge against Rick Perry, sparing the former governor from trial and a potential prison sentence on … Read More
They say you shouldn’t mess with Texas. Those submitting fraudulent claims to the state’s Medicaid program should heed that advice. According to new Medicaid Fraud Control Unit (MFCU) statistics and an interactive map released by the Office of Inspector General, the … Read More
The Texas health commission finally has chosen a company to run a long-delayed massive data project, awarding it to the same firm whose tentative contract was canceled in 2014. The commission disclosed this week that it had decided to award … Read More
UPDATE: The Travis County Public Integrity Unit has forwarded the criminal investigation into the 21 CT matter to another undisclosed investigative unit. Per the Unit’s head, the investigation is starting to move faster and was moved for reason of expertise … Read More
They met on an airplane in the spring of 2011 – the CEO of an Austin technology company and a Texas state official who found themselves seated next to each other and began talking about movies, and then work. Irene … Read More
A Texas Ethics Commission opinion that would have allowed Texas Attorney General Ken Paxton to fund his ongoing legal battle through out-of-state donors failed to pass by one vote Monday.The commission was asked anonymously if an individual working in the attorney … Read More
There have been many changes for Medicaid dental providers over the last few years. The change from fee-for-service to managed care. The upheaval caused by the former Health and Human Services Commission Office of Inspector General and rampant allegations … Read More
WHY WE DID THIS STUDY Medicaid is the primary source of dental coverage for children in low-income families and provides access to dental care for approximately 37 million children. However, access to dental care for children with Medicaid has been … Read More
WICHITA FALLS, TX – (KAUZ) -When it comes to dentists in Texas there is more than 254 areas in the state where dental care is scarce, and according to The Texas Department of State Health Services smaller markets are being … Read More
Research and Statistics If you use assistive technology, such as a screen reader, but are unable to read the information in these reports, please e-mail the webmaster to request an alternate format. CHIP and Medicaid Children’s Health Coverage (XLS) Texas … Read More
Texas has violated the constitutional rights of foster children by exposing them to an unreasonable risk of harm in a system where children “often age out of care more damaged than when they entered,” a federal judge ruled Thursday. “Years … Read More
December 14, 2015 — When it comes to oral health in the U.S., it’s easy to focus on the work that still needs to be done. However, a hefty new ADA Health Policy Institute (HPI) report details a promising trend … Read More
The Texas Health and Human Services Commission sent out an email notification this morning that it is holding a number of public forums about the restructuring of the agency and requesting stakeholder input. We strongly suggest that Medicaid providers take … Read More
A suit to compel the Texas Health and Human Services Commission to release the full list of names of Medicaid providers that have been placed under a “credible allegation of fraud” payment hold since 2010 has been filed in Travis … Read More
November 30, 2015 — If you pay your hygienist a guaranteed salary, it could be hurting your practice. Surprised? Think about it. While you know exactly how much you need to pay your hygienist each month and your hygienist knows … Read More
Health and Human Services (HHS) transformation presents an opportunity to restructure the Texas HHS system to make it more functional, efficient, effective and responsive. As this two-year transformation process unfolds, HHS agencies will be asking for input from stakeholders: the … Read More
As TDMR reported back at the end of September, the new Health and Human Services Commission Inspector General Stuart Bowen had started settling outstanding investigations and cases against Medicaid dentists and providers. Senator Charles Perry was quoted in the media … Read More
Republicans are openly feuding over whether to seek drastic changes to Medicare, Social Security and other entitlement programs, risking a potentially damaging intraparty battle ahead of the 2016 elections. The rift was exemplified this week by the GOP stars of … Read More
