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
We knew there were serious problems with Texas Health and Human Services Commission handling of billions of dollars in contracts for health care and social services, but new audits show this mess of a system is even worse than we … Read More
AUSTIN — Texas’ sprawling bureaucracy for regulating health care and providing social services is vulnerable to a “perception of impropriety” because it routinely lets individual contracting personnel open bids on their own, without any witnesses, a new internal audit says. … Read More
Only one word comes to mind looking at photos that Texas Department of State Health Services employees took of gray, green and brown-hued mold dotting their office furniture: Ew. As of July 10, as many as 127 state workers have … 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
A new state audit has found that Texas’ health agency may have awarded more than $3.4 billion in contracts erroneously — another scandal at an agency that has lost six of its top leaders over the last several months in … 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
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
AUSTIN — Gov. Greg Abbott says he is alarmed by contracting mistakes at the Texas Health and Human Services Commission and is sending a top aide, former state Sen. Tommy Williams, to correct the problems. Abbott said through a spokesman … Read More
Charles Smith of the Texas Department of Health and Human Services testifies Wednesday, Nov. 1, 2017, to the House Committees on Human Services and Public Health at the Capitol. Bob Daemmrich for the Texas Tribune. Texas HHS still hasn’t learned … Read More
TDMR has been asked several times recently if we have any knowledge of an upcoming RFP (request for proposals) for dental management organizations. There have been rumors flying around for well over a year now that Texas Health and Human Services … Read More
LONG BEACH, Calif.–(BUSINESS WIRE)–Molina Healthcare, Inc. (NYSE: MOH) today announced that its Texas subsidiaries, Molina Healthcare of Texas, Inc. and Molina Healthcare of Texas Insurance Company, have been awarded contracts by the Texas Health and Human Services Commission (HHSC) for … Read More
TDMR has been asked to inform its readers that a new association of dentists is in the process of being formed. The new association is to be called the United States Dental Association. Among the founding members of the new organization … Read More
Yes, we know it is 2018. Sorry. But the truth about the late great Texas Medicaid orthodontic debacle (2007 to 2011) has been not fully been made public yet. So here is some more truth for those who were involved … Read More
Two days ago, the iconic and troubled American corporation Xerox was sold to Japan’s Fujifilm for $6.3 billion dollars, ending its solo history in this country. Losing money, under pressure The new company will be known as Fuji Xerox and, … Read More
Texas House Speaker Joe Straus is calling on House members to investigate the Texas Health and Human Services Commission after a state audit report revealed mishandling of a contract with a health insurance company. The State Auditor’s Office released a … Read More
In January of last year, Dr. Juan Villarreal’s long-awaited book “Truth Decay: How Government Corruption Caused a Political Scandal Victimizing Texas Dentists and How It Could Happen to You!” was released on Amazon.com. “Truth Decay” details Dr. Villarreal’s personal struggles … Read More
AUSTIN – As lawmakers on Capitol Hill continue to discuss the future of the CHIP program, Texas is set to receive $135 million from the federal government to keep benefits in place thru February. CHIP, which stands for Children’s Health Insurance Program, … Read More
UPDATE: After conferring with colleagues, this is not the major reimbursement changes that were discussed earlier this year but an annual update of codes with minor changes. Hope you are having a nice Friday afternoon, the Friday before the Christmas … Read More
UPDATE: Arguments in this case were heard by the Supreme Court on Wednesday, December 6. The 39-minute video of the oral arguments is here. The court’s decision is not expected until spring of next year. As a heads up for dentists … Read More
TDMR is releasing the results of its 2017 Medicaid Provider survey today. Not much has changed Not much has apparently changed for Medicaid providers from 2016. per the 337 individuals who answered our anonymous, 6 question survey in October and … Read More
AUSTIN — Under Gov. Greg Abbott, more and more top officials at Texas’ social services superagency command big salaries. Not counting staff physicians, the Health and Human Services Commission has 11 administrators making $200,000 a year or more. A decade ago, … Read More
Pfizer (PFE) lost a round in the larger fight over pharmaceutical pricing when a federal judge ruled that Texas lawmakers should be able to obtain state Medicaid rebate data about its medicines. The drug maker last year filed a lawsuit … Read More
According to a story in today’s Texas Tribune, a large number of experienced executive staff of Texas Health and Human Services have exited the mega-agency due to conflicts with current Executive Commissioner Charles Smith. So far, these include, according to the … Read More
Today, the Texas Supreme Court agreed to hear oral arguments from orthodontic providers regarding the dentists’ counterclaims in the pending State vs. dentists vs. TMHP/Xerox cases. The general facts of the underlying dispute about orthodontic prior authorization have been well-covered … Read More
UPDATE: September 1, HHS announced this morning that it has put on hold the proposed rate changes per legislative sources. Original story: August 1, 2017 TDMR has received a copy of an email from the Texas Academy of Pediatric Dentistry … Read More
On August 9, the House Committee on Human Services held a public hearing. Part of the agenda was to hear testimony relating to the proposed dental Medicaid reimbursement rate cuts for many necessary codes that have been called “devastating” by … Read More
From the Texas Dental Association: ATTENTION TDA MEMBER MEDICAID DENTISTS: CALL TO ACTION Texas Health and Human Services (HHS) is moving forward with a devastating proposal that will significantly cut certain Medicaid dental reimbursement rates. The proposed cuts include dental codes that … Read More
From the Texas Dental Association: As a part of ongoing efforts to prevent potentially devastating “rebalancing” of Medicaid dental fees, the Texas Dental Association (TDA) will meet with Health and Human Services officials in the coming weeks to discuss each … Read More
Several ambulance services from across Texas are working to stave off a potential 10 percent cut to their Medicaid reimbursements. The Texas Health and Human Services Commission is planning to cut the amounts ambulance services can bill the government for … Read More
The Statesman published a landmark article this morning by reporter Eric Dexheimer regarding the great Texas orthodontic debacle. Story finally pieced together Thanks to the state’s fraud suit against Xerox, its former Medicaid claims administrator summarily terminated back in early … Read More
A dozen years ago, Texas health care administrators hired a company to help determine when taxpayers should cover the cost of dental care for the state’s poorer residents, particularly children. The company, later acquired by the giant corporation Xerox, deployed … Read More
The Inspector General wants your feedback on our website, https://oig.hhsc.texas.gov/. Please take our quick, 7 question survey and let us know how you use our site, what you like about it, and what we can improve on. Click on the link … Read More
The Texas Senate confirmed Charles Smith’s appointment on April 19 as the Health Human Services executive commissioner for a two-year term at the head of the state’s largest agency. Smith, a Childress native, oversees an agency of 53,000 employees that … Read More
The Texas Health and Human Services Commission did not always claim Federal Medicaid reimbursement for managed care payments in compliance with Federal requirements. Of the 3,170 beneficiary matches in our review, 3,045 were assigned more than 1 Medicaid identification number. … Read More
McALLEN — Five Valley residents have been charged with Medicare fraud and the payment of illegal kickbacks. According to the charging documents, each of the five individuals engaged in conspiracies to refer Medicare beneficiaries to a home health agency … Read More
Texas HHS placed on their website last week two new policies relating to Medicaid dentistry on which they would like stakeholder comments. Dental anesthesia The first is a draft policy relates to dental anesthesia which: Requires prior authorization for general anesthesia in conjunction … Read More
