A purchasing director of Child Protective Services has been placed on administrative leave as officials launch an investigation into a pending contract involving a nonprofit where the director’s husband works, the American-Statesman has learned.It’s the second time Frianita Wilson has … Read More
Several legal media outlets reported yesterday that former Texas Medicaid claims administrator Xerox has brought an appeal before the Texas Supreme Court because the company says the state is “wrongfully blocking the company from designating the dentists who treated patients in the alleged … Read More
Jeff Leston, the founder of Castlestone LLC, has provided TDMR with his take on how to improve government healthcare plans such as Texas Medicaid to reduce waste, fraud and abuse. Castlestone is a company created to use the infrastructure of … Read More
TDMR has learned from a staffer in the office of Sen. Juan “Chuy” Hinojosa that they have been informed by Health and Human Services that managed care organizations, including MCNA, do not have any right under any Texas or federal … Read More
Did you know that HHS, formerly HHSC, has a Managed Care Inquiries and Complaints mailbox? It does. It also has a person to field those inquiries and complaints. That person is Dr. Marguerite Laccabue, MPH, DDS, Dental Director of the Office of … Read More
At the same stakeholders meeting last February that representatives from MCNA and Dentaquest provided briefings, the then-dental director for the Health and Human Services Inspector General, Dr. Linda Altenhoff, presented on rules and regulations regarding solicitation by dental providers. Altenhoff … Read More
In February of last year, Texas Health and Human Services Dental Director Marguerite Laccabue held a dental stakeholders meeting in Austin. It doesn’t appear from the HHSC online video of the proceedings that it was well-attended or promoted as the … Read More
TDMR has obtained a copy of a January 4 letter from State Sen. Juan “Chuy” Hinojosa to Charles Smith, the Executive Commissioner of Texas Health and Human Services asking Smith to review MCO “credible allegations of fraud” payment holds. While … Read More
TDMR received the following email from a Texas dentist. He has given permission for us to publish it and we are doing so anonymously to hopefully prevent any further retribution against himself and his practice. I am writing this email … Read More
Last Thursday, Texas Health and Human Services held its Biannual Managed Care Stakeholder Meeting in Austin. The meeting was primarily hosted by Jami Snyder, the Associate Commissioner for the Medicaid & CHIP Services Department of HHS. During the open discussion … Read More
2016 ended very badly for Texas Medicaid. It was a very poor Christmas for many. There were a number of important divisive events that occurred which we decided not to comment on during the holiday season. We didn’t want to spread … Read More
Back in December, TDMR asked dentists to take an online survey to ascertain their views on Texas Medicaid dental managed care. We now have these results which are provided below and can be downloaded. Limitation of survey results Before we … Read More
CVS Pharmacy, accused by the state of Texas of defrauding Medicaid of $30.5 million, is suing the state Health and Human Services Commission, claiming state officials approved the billing practices at the heart of the fraud case, court records show. … Read More
TDMR has been notified that Texas Health and Human Services is holding its biannual meeting on managed care next Thursday in Austin. It is open to the public and is taking public comment on several items. If you can’t make … Read More
After more than a year of delays, Texas is officially kicking Planned Parenthood out of the state’s Medicaid program. In a move that could affect thousands of low-income women, state health officials on Tuesday delivered a final legal notice to … Read More
Just before the Thanksgiving holiday, TDMR received a flurry of emails and phone calls regarding our story about a dentist who was having payments recouped by MCNA for treatments the company had previously approved. He was being forced to travel … Read More
When President-elect Donald Trump tweeted Sunday — without evidence — that “millions” of people voted illegally in the race for the White House, he invited a wrath of condemnation for again stoking doubts about the U.S. election system. But in … Read More
Our story on MCNA secretly recouping payments from a dentist who had an MCNA pre-approved treatment plan for a young Medicaid-eligible cancer patient touched a raw nerve with a number of dentists from around the state. The story received a … Read More
In response to TDMR’s latest story on payment holds placed on Medicaid dentists by MCNA, TDMR received an emotional missive from a Medicaid dentist about his negative experience with MCNA. He gave permission to publish his comments. The legislative session … Read More
There is a rumor circulating that the Texas Health and Human Services Commission is putting together a new request for proposals (RFP) for dental managed care organizations for Texas Medicaid. While this may or may not be the case as … Read More
Last November, former Texas Medicaid director Billy Millwee, now a private consultant, appeared before the Little Hoover Commission in Sacramento, California. The LHC is an independent state oversight agency that was created in 1962 with the mission to investigate California … Read More
HHSC ensures that policies are medically appropriate, patient-centered, transparent and based on the best available evidence. The agency’s medical and dental policies outline the types of procedures and treatments for which HHSC will pay for specific conditions. Medical practitioners, program … Read More
Dr. Linda Altenhoff is no longer with the Inspector General’s office as Chief Dental Officer. In August, she moved over to MCNA and is now Associate Dental Director for MCNA Texas and works out of San Antonio. Named IG Chief Dental … Read More
The Texas Tribune this morning published an article that indicates the fate of Texas Health and Human Services Inspector General Stuart Bowen is uncertain at this time. Planned Parenthood investigation tied to fund-raising effort The context of the story was … Read More
Feeding on outrage sparked by the release of controversial undercover videos of Planned Parenthood officials, Gov. Greg Abbott vowed one year ago to cut off $3.1 million in Medicaid funding that the organization’s Texas affiliates receive to provide family planning … Read More
Drugmaker Mylan will pay $465 million to settle allegations that it overbilled Medicaid for its life-saving EpiPen, ending one of the controversies over the soaring price of the emergency allergy injection.The settlement with the Department of Justice follows news that … Read More
It all started with a battle over information: In one corner was the Texas Health and Human Services Commission. In the other were Texas lawmakers. The commission holds the details of the state’s Medicaid contracts with large pharmaceutical companies, which show … Read More
Nearly 300 East Texas children with disabilities who are part of the state’s Early Childhood Intervention program have no one to provide them with medically necessary therapies after the region’s lone provider closed its doors this week in response to hefty budget cuts … Read More
We received an email from a dentist with some very useful advice regarding denied treatment by dental MCOs (managed care organization). He specifically mentions MCNA. I just wanted to pass on the name of a resource that I recently found … Read More
A significant cut to the amount of money Texas pays therapists who treat children with disabilities was finally cleared to take effect — more than one year after state lawmakers originally ordered it — when the Texas Supreme Court on … Read More
AUSTIN –The $1.3 billion shortfall in Medicaid funding going into the next budget cycle can’t all be attributed to what Republicans typically call “out-of-control growth.” Source: Lawmakers tackle looming $1.3 billion shortfall in Medicaid – Houston Chronicle
On September 1, the first phase of the consolidation of the Texas Health and Human Services system became operational. SB 200, the Health and Human Services Commission sunset bill passed last legislative session called for transferring the Department of Assistive and … Read More
As HHS submits its Legislative Appropriations Requests for the next biennium, we are proud to share them with the people of Texas, whom we serve. The HHS system’s budget proposals reflect better integrated operations, a commitment to serving Texans in … Read More
A federal judge faulted the state Medicaid program in a strongly worded order, ruling the program had improperly denied 2,000 out-of-network emergency claims submitted by a nonprofit health care provider that treated indigent children.U.S. District Judge Keith Ellison ruled last week that the state … Read More
HOUSTON (CN) — Texas’s Medicaid reimbursement policy violates federal rules and should be put on hold because it leaves some health care providers “holding the bag,” a federal judge ruled. The Texas Children’s Health Plan denied about 2,000 claims that … Read More
Former Gov. Rick Perry may be taking a break from campaigning to bust a move on the dance floor, following reports from an entertainment website that the politician may be joining the next season of “Dancing With the Stars.” As … Read More
The Department of Health and Human Services Office of Inspector General audit released earlier this week found Texas had miscalculated payments for the Medicaid Supplemental Physician Payments program and owed the federal government some $57.9 million for the period 2004 … Read More
The audit section of the Department of Health and Human Services Office of Inspector General issued a report earlier this month that Texas now owed the federal government some $57.9 million because the state Health and Human Services Commission did … Read More
The weekend can’t come fast enough for the Texas Health and Human Services Commission. On Wednesday, federal officials asked the state’s largest agency to return $57,884,268, the federal share of $95,359,841 in supplemental payments to doctors made improperly from 2004 to … Read More
This week the Health and Human Services Commission Inspector General released his June 2016 quarterly report on the activities of his agency. Besides announcing the creation of a Pediatric Dentistry Action Team, the report also discloses that more Medicaid dentists … Read More
