Medicaid Reform News

Last Friday, HHSC sent out the following notice: If you’re interested in Medicaid managed care issues, you might be interested in being a member of the State Medicaid Managed Care Advisory Committee. The Texas Health and Human Services Commission executive … Read More

In the same Xerox/Conduent court filing from July 2018 mentioned in our previous article, there is another exhibit worth mentioning.  It is the complete email chain involving HHSC OIG officials discussing OIG investigator Ray Acuña’s meeting notes on the Xerox/Conduent … Read More

The State Medicaid Managed Care Advisory Committee of HHSC is holding a public meeting in Austin on December 12. Here is the information: December 12, 2018 – 1:00pm Health and Human Services Commission, Brown-Heatly Building, Public Hearing Room 4900 North … Read More

We’ve heard from various dentists that they have questions about controversial issues that have come up over the last several months.  So we assume there are more out there that have the same questions or heard the same rumors. Primarily … Read More

It appears that Texas Office of the Attorney General (OAG) forgot to sue Xerox to recover over $133 million that the federal government determined it was owed because of the state’s lack of oversight over Xerox, its then-Medicaid claims administrator, … Read More

UPDATE:  TDMR has received a copy of the ImmediaDent and Samson Partners press statement from Samson Partners vice-president of marketing Stephen Valenti.  It is at the bottom of our story in full. Indiana-based ImmediaDent and DSO Samson Dental Partners of … Read More

UPDATE: We’ve added below an additional HHSC presentation given to the House Committee on General Investigating & Ethics which gives further details of MCO contract management. This morning HHSC sent out a notice that it was looking for public comments … Read More

The Texas State Board of Dental Examiners will be holding a stakeholders meeting in Austin on November 20.  It will be held at the William P. Hobby Jr. State Office Building, Tower III, Room 100, 333 Guadalupe Street at 1:30 … Read More

Reported in a shocking report released this week, the Office of Inspector General for the U.S. Department of Health found that the Ohio Department of Medicaid made $90.5 million in capitation payments to managed care organizations in the state on … Read More

UPDATE: Christine Mann, the Press Officer at HHSC, has informed us that new RFP is out as of yesterday.  The information is below and is available at http://www.txsmartbuy.com/sp/HHS0002879 Medicaid CHIP Dental Status: Addendum Posted Solicitation ID:   HHS0002879 Response Due Date: 11/30/2018 Response Due Time: 2:00 PM Agency … Read More

Texas Health and Human Services as a government body develops “rules” to implement laws passed by state and federal legislators.   Their website states that “to be good stewards of the public trust, HHS takes into account stakeholder input when rules are … Read More

Back in August, a notice appeared on the TMHP website that Texas Medicaid was going to impose a lifetime limit for restorations and stainless steel crowns on September 1. Lifetime limits The notice said: Effective for dates of service on or … Read More

In the last edition of TDA Today, the Texas Dental Association goes to bat for dental Medicaid providers on two issues. First, the publication reported that the TDA’s Council on Public Health and Access to Care met with HHSC (HHSC, … Read More

The Statesman published an article this morning about the scathing testimony heard by the House Committee on Human Services, chaired by Rep. Richard Peña Raymond, at a special hearing held yesterday in Edinburg. Wanted public and provider feedback on managed … Read More

You just found out about this? So did we. Just learned of it TDMR learned of it about 10 days ago when a provider gave us a copy of a letter they received from DentaQuest dated July 27 but received … Read More

By Marissa Evans, The Texas Tribune Aug. 23, 2018 Courtney Phillips is the new executive commissioner for the Texas Health and Human Services Commission, Gov. Greg Abbott announced Thursday. Phillips is currently the chief executive officer for the Nebraska Department … Read More

TDMR recently reached out to Rep. Richard Peña Raymond, chair of the House Human Services Committee to get his views on the current scene and the future of dental Medicaid in Texas. Supporter of dental Medicaid Raymond has been a major force … Read More

Medicaid dental providers apparently want an online forum to securely discuss mutual problems with Texas Medicaid and DMOs.  Some 92% of those taking our survey answered a resounding “yes” to having such a forum. Comments Here are some of the … Read More

Since our recent stories about the new dental RFP for Medicaid and DentaQuest’s capitation payment move, TDMR has received several emails from dental providers about their concerns over the RFP choices and provider lack of power against such large companies. … Read More

We have closed our revised 2018 Dental Management Organization annual survey and are today giving you the results.  Our survey sample is not that large, unfortunately.  At the end of the day, only 39 providers entered the survey as we … Read More

An industry insider has told TDMR that he thinks six dental management companies will vie for the Texas Medicaid dental contract RFP that closes in September. He named the two current contractors, MCNA and DentaQuest, and included Liberty Dental and … Read More

Rendering of new HHS Building It is finally here, not with a bang but with a sigh.  It’s been out over a week and not a whisper about it until today despite the fantastic anticipation by dental Medicaid providers over … Read More

The new audit is yet another scandal at an agency plagued by contracting woes. Six of the commission’s leaders have left in the last several months. BY EMMA PLATOFF Republished from the Texas Tribune A new state audit has found that … Read More

TDMR has received an email from a group calling itself “Texas Dentists for Fairness.” Per their email, they are a group of owners of individual clinics from around the state  Other than that we don’t know anything about them.  They … Read More

The U.S. Department of Health and Human Services Office of the Inspector General issued a report yesterday that found that managed care organizations are not doing enough to identify Medicaid waste, fraud and abuse.  HHS-OIG undertook the review because it … Read More

TDMR has confirmed rumors that a number of Texas dental providers have been approached by DentaQuest to change their payment method from managed fee-for-service to capitation. Capitation to “share the financial risk” with providers A capitation payment is a fixed amount … Read More

By Marissa Evans June 27, 2018 Linda Badawo says she doesn’t know if managed care works or not — but it hasn’t worked for her family. Sitting with her son D’ashon beside her in his wheelchair, Badawo told legislators during … Read More

UPDATE:  Conduent Share Price Drops 13% Over The Last Few Days – The stock market has apparently reacted harshly to the recent Seeking Alpha analysis on the underappreciation of the $2 billion Texas Medicaid fraud lawsuit against Xerox/Conduent.  The stock price … Read More

The Supreme Court of Texas today rejected an attempt by Xerox/Conduent to point the finger at Texas dentists when it goes to court in an attempt to defend itself from at least $2 billion in damages and penalties stemming from its failed Medicaid orthodontic prior authorization … Read More

In case anyone missed it, Charles Smith, the Executive Commissioner of Texas Health and Human Services retired at the end of May. The continuing saga of poor contracting practices at the state agency enraged legislators and Gov. Abbott.  As the … Read More

Tracy Ryans pulls out client applications containing private information that was mistakenly sent to her from the Texas Health and Human Services Commission, on April 24, 2018. Pu Ying Huang for The Texas Tribune. By Marissa Evans, The Texas Tribune … Read More

UPDATE: April 20:  NEW SURVEY IS OPEN After reviewing the responses from the previous version of the survey, we closed it because there was a large amount of doubt about the veracity of some of the answers provided.  The largest … Read More

Heather Griffith Peterson has resigned from her job as chief operating officer for the Texas Health and Human Services Commission. Texas Health and Human Services Yoiks, here we are again.By Marissa Evans, The Texas Tribune April 18, 2018 The state … Read More