Members Sought for State Medicaid Managed Care Advisory Committee
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
“I Guess No One Really Cares” – HHSC OIG Director of Medicaid Integrity
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
Public Meeting in Austin on Managed Care December 12
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
Questions Linger about Capitation and DMO RFP
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
Did Texas OAG Forget to Sue Xerox For $133 Million Owed the Feds for Medicaid Orthodontic Prior Authorization Debacle?
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: Indiana Dental Practice & DSO Shell Out $5.1 Million Over Medicaid False Claims Allegations
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: HHSC Proposes to Reduce Monies an MCO Obtains from Fraud Recovery to 50% from 100%
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
State Board of Dental Examiners Stakeholders Meeting November 20
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
Medicaid Managed Care Companies in Ohio Received $90 Million in Payments for Dead People
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: New RFP Out – Say What? Dental RFP Canceled by HHSC Over Proposal Problems
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
HHS Looking for Feedback on Proposed Rules
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
Lifetime Limitation for Restorations and Stainless Steel Crowns
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
TDA Weighs in on DMO RFP and Capitation
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