In his first State of the State address to the Texas Legislature in early 2015, newly elected Gov. Greg Abbott challenged lawmakers to dedicate their unfolding 140-day session to ethics reform, asserting that “the most important commodity that we have … Read More
Texas could bring home $7 billion annually in federal dollars and cover more than a million uninsured U.S. adults today. Instead, Texans are stuck in the health care “coverage gap” — lacking the uninsured’s access to health insurance because they … Read More
November 6, 2015 — Adults enrolled in Medicaid may be living with unresolved dental problems, according to a new study. Almost half of the adults in the study who visited an emergency department (ED) for dental care did not visit … Read More
Gary Jessee, a 20-year veteran of state service, will be Texas’ new state Medicaid director, Health and Human Services Executive Commissioner Chris Traylor announced Oct. 30. Jessee, who has served three years as the Medicaid/CHIP Division’s chief deputy director for … Read More
The editorial board of the Austin American Statesman has called the decision by Texas “lawmakers and state officials” to investigate Planned Parenthood for Medicaid fraud part of a “witch hunt” that won’t stop until the health care provider “is completely dismantled … Read More
If Planned Parenthood has been billing Texas Medicaid for services it hasn’t been rendering, as Gov. Greg Abbott and state health officials suggested this week, it makes sense to cut off the money and go after the organization for whatever it stole. But … Read More
As Congress stalls in its attempts to defund Planned Parenthood, a handful of states have succeeded in hitting the organization where it hurts. Texas announced Monday it will strip Planned Parenthood of its Medicaid funds after a 3-year video investigation captured … Read More
Advocates of Medicaid expansion in Texas often highlight our state’s record of the largest uninsured population in the nation, according to a recent U.S. Census Bureau report. Though the uninsured rate is falling, advocates say, it would fall even faster … Read More
Texas was within eight days of slashing the amount of money it pays therapists for poor and disabled children when a state district judge last month stepped in and blocked the move. It was the latest round in a high-profile … Read More
Last Friday, the Health and Human Services Commission sent out a notice that it had “updated its Medicaid Medical and Dental Policy web page by posting stakeholder comments and HHSC responses for the THSteps Diagnostic Dental Services policy in development.” … Read More
Following an outcry from dozens of state lawmakers, Texas’ top health agency announced Thursday it will make less drastic cuts than originally planned to a therapy program for children with disabilities, even if that means spending more than lawmakers budgeted for the … Read More
The gap in dental care utilization in the U.S. narrowed between children enrolled in Medicaid and those with private dental benefits from 2005 to 2013, but a large gap remains between adults in those categories, according to a new research … Read More
As reported in the press this week, there has been a tremendous effort on the part of the new Health and Human Services Commission Inspector General Stuart Bowen to settle old, outstanding investigations against Medicaid providers—including dentists. Per the Chronicle, … Read More
A Travis County judge has temporarily blocked the state from reducing funding for a Medicaid-backed therapy program for thousands of Texas kids with special needs, ruling on Tuesday that there was enough reason to believe the Texas Health and Human … Read More
If there is a poster child for dysfunction in Texas government, look no further than the agency Stuart Bowen inherited in January. The Office of Inspector General over the state’s sprawling health agency, charged with investigating Medicaid fraud and waste, … Read More
Costs almost always spiral higher on big government projects because of “deception and mismanagement” by Congress, federal managers and contractors, according to scholars at the Cato Institute. “Cost overruns on large government projects are pervasive,” wrote Chris Edwards and Nicole … Read More
The recent decision by a Travis County District Court judge that again vindicated Antoine Dental Center of Houston on allegations of Medicaid fraud and vacated a three-year “credible allegation of fraud” payment hold has been appealed by the Civil Medicaid … Read More
Medicaid rate cuts for therapy providers, which state lawmakers authorized during the recent legislative session in an effort to control Medicaid spending, have prompted a lawsuit against the state by some providers and patients who question the data the state … Read More
The Texas Health and Human Services Commission made $377 million in Medicaid electronic health record incentive payments to hospitals in 2011 and 2012, but at least $12.5 million of that was made in violation of state and federal regulations, according … Read More
The Health and Human Services Commission (HHSC) is asking for comments on a proposed new advisory committee structure. In response to Sunset legislation approved during the most recent legislative session, HHSC conducted a comprehensive analysis of 132 existing advisory committees. This … Read More
Channel 8’s Byron Harris announced Friday that he’ll retire in October. Ed Bark posted a solid story Monday about the investigative reporter and his 40 years at the TV station. I’d like to go in a slightly different direction. Harris … Read More
Law360, New York (August 27, 2015, 2:12 PM ET) — A Texas federal judge recused himself Wednesday from a False Claims Act suit against a medical center, days after the defendants revealed his cousin could be a key witness. The … Read More
AUSTIN — A lawsuit that sought to block deep cuts in what Medicaid pays for disabled children and poor elderly Texans’ therapies has delayed the rate changes for a month but otherwise forced no change in the state’s plans. On … Read More
August 17, 2015 — California legislators took the first step in resolving oral health disparities by hiring the state’s first dental director, Jayanth Kumar, DDS, MPH. Dr. Kumar, who officially started the position on August 1, will create and implement a … Read More
Yesterday, Travis County District Court Judge Amy Clark Meachum issued her decision in the case of Antoine Dental Centers of Houston, vindicating the practice in its payment hold case. The practice had been accused of “credible allegations of fraud” in … Read More
A district court judge on Wednesday handed state Medicaid regulators another decisive courtroom loss, adding one more notch to the Health and Human Service Commission’s Office of Inspector General’s unenviable losing streak pursuing dentists and orthodontists it claims have bilked … Read More
Home health agencies providing pediatric therapy services, along with the mothers of five children in Travis and Williamson counties, turned to the courts Tuesday to stop Texas officials from imposing program cuts totaling $350 million.Most of those receiving the speech, … Read More
UPDATE, August 11, 2015: We have been informed by a very keen-eyed and interested observer that the definition of “physician” under the Social Security Act includes dentists. So we are not sure why the Texas Health and Human Services Commission … Read More
In January, Stuart Bowen took charge of a state office rocked by accusations of corruption, incompetence and inefficiency. Responsible for ferreting out fraud amid the programs and procedures of the sprawling Health and Human Services Commission, the office of Inspector General … Read More
TDMR has learned that the new Health and Human Services Commission Inspector General Stuart Bowen, Jr. has been taking on and overhauling the agency’s use of statistical sampling and extrapolation. This is the most controversial tool that the agency had … Read More
AUSTIN — Even as they left nearly $18 billion unspent, Texas lawmakers ordered a $350 million cut this year to Medicaid pay for therapists who perform one of health care’s most exacting jobs.In a two-year budget that was flush enough … Read More
Last Wednesday, July 16, lawyers for Antoine Dental Centers of Houston again went to court. Going Travis County District Court This time they appeared before Travis County District Court to appeal the Medicaid payment hold final decision by former Health … Read More
The eight steps you need to take to put together a program for yourself! Many people have asked what the process for establishing an effective compliance program is. At one point, having a compliance program was optional. As a result … Read More
This past Friday at the Leon Valley Conference Center in San Antonio, Star Compliance Services and TDMR held our third healthcare compliance seminar, following our recent successful seminar in Houston and the earlier one held in February at Weslaco. Gregory … Read More
Texas Dentists for Medicaid Reform assisted Star Compliance Services this past Friday to hold a one-day healthcare compliance seminar in Houston at the Norris Conference Center – City Centre. It is the first in a series of seminars that were … Read More
Governor Greg Abbott today announced that Texas Health and Human Services Commission Executive Commissioner Dr. Kyle Janek has expressed his intention to resign, effective July 1, 2015. Governor Abbott simultaneously announced his intention to appoint Chris Traylor as Executive Commissioner … Read More
Texas Health and Human Services Executive Commissioner Kyle Janek, M.D., announced today he is stepping down from his position effective July 1 to make way for new leadership as the agency prepares for major reorganization. “I’ve been honored to lead … Read More
DALLAS — Texas paid $191,410,707 for unallowable orthodontic services from 2008 through 2010, according to a federal investigation to be released on Thursday. And officials say the federal government wants a large portion of it back. The findings are in … Read More
Lawmakers sailed off into the sunset Monday hailing the conservative budget they had passed to fund Texas for the next two years — one that, when it comes to delivering health care to the neediest Texans, likely won’t stay afloat. … Read More
Today, SB 207 with minor changes was approved by both Texas House and Senate conference committees. SB 207 is the bill that contains the Sunset reforms to the Health and Human Services Commission Office of Inspector General. The next step is for … Read More
