Latest TDMR Stories
ADA Survey Highlights Challenges in Dental Staff Recruitment
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
Texas Medicaid Eligibility System Prone to Errors?
The Texas Tribune published a major story yesterday about the problems Texas and other states are having with Medicaid eligibility systems developed by global consulting firm Deloitte. The Kaiser Family Foundation researched and wrote the story. A few sentences summarize … Read More
Texas Supreme Court Concludes No Evidence of Fraud and Reverses Summary Judgment Against Dr. Richard Malouf
In what can only be described as a bombshell decision, the Texas Supreme Court has sided with Dr. Richard Malouf and his legal team. The Court not only reversed the $16 million summary judgment against Dr. Malouf but granted his … Read More
Feds Threaten to Withhold Medicaid Funds Over Slow Eligibility Approvals
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
Benecare Replaces DentaQuest As Massachusetts Third-Party Payer
A few weeks ago, it was announced that Benecare Dental Plans has taken over the contract as a third-party payer for the Medicaid program in Massachusetts under MassHealth. DentaQuest lost the contract, which it had held for at least a … Read More
DMO Premium Rates for Medicaid Dental Dropped from $36.53 in 2011 to $25.73 Proposed in 2024
According to our review of the annual third-party actuarial reports produced for Texas HHS Provider Finance, the Medicaid dental premium rate for dental maintenance organizations has dropped significantly since 2011. The proposed per-member, per-month capitation rate paid to the DMOs … Read More
Arkansas Going Back to Fee-For-Service Medicaid Dental, Ending Managed Care
In a surprising move, the Arkansas Department of Human Services (DHS) announced this week that it is ending its Medicaid managed care dental program and transitioning back to a fee-for-service model starting November 1, 2024. This move from contracting with … Read More
National Conference of State Legislatures Recognizes Low Reimbursement Rates Affect Dental Provider Participation
The National Conference of State Legislatures (NCSL) has published an online article that promotes the need for oral health for all citizens and highlights the strides some states have taken to improve access to dental care, including Medicaid. The article … Read More
Texas HHS Provider Finance Dental Fee Review Later This Year
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
Massachusetts Dental Society Requested Immediate 10% Fee Increase to Address Medicaid Access to Care Issues in the State
According to a press release and an article on the American Alliance for Dental Insurance Quality website, this past February, the Massachusetts Dental Society (MDS) and nine other dental organizations sent identical letters to the MassHealth Dental Program, requesting that … Read More
Texas Medicaid Ortho Spending: From $250 Million in 2011 to $786,900 in 2022
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
Colorado Dental Association Taskforce Secures Significant Fee Increase for Medicaid Dental Providers
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
High Volume Dental Providers Are the Backbone of Texas Medicaid Dental Services
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
Walmart Health Centers Closing Nationwide Including Newly Opened and Proposed Locations in Texas
Holy Healthcare, Batman, Walmart just announced it is getting out of the healthcare provider business by closing its 51 Walmart Health centers around the country, including three brand new locations opened only a few weeks ago in Pearland, Sugar Land … Read More
State’s premature release of bid proposal info touches off new battle over $116 billion in Medicaid contracts
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
Sizeable Fee Increases for THSteps Medical Services Were Approved 2022/23, None for Dental Services
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