One of the main items of interest to Medicaid dentists from the latest quarterly report from the Health and Human Services Commission Inspector General Stuart Bowen is that a “Pediatric Dentistry Action Team” has been created within his agency. The … Read More
If you remember the heyday of HHSC/TMHP/Xerox program spending on orthodontia back in 2011 that begat allegations of Medicaid fraud, it was at a sky-high $249 million. In 2015, it was $13.6 million. So it is little wonder that the number … Read More
In case you might be wondering how much Texas now spends on dental care for Medicaid children, we now have an answer for you. TDMR filed an open record request earlier this year to get the spending figures for 2014 and … Read More
Over the past two weeks, it has been a major story that Attorney General Ken Paxton took a $100,000 donation for his personal legal fees from a friend whose company was accused of Medicaid fraud. The company just settled the … Read More
reported this morning on a new contracting scandal involving current Medicaid claims administrator Accenture and the Office of Attorney General. Outrage of use of “emergency leave” for fired staff You might remember back in May, the OAG was found to … Read More
AUSTIN — A top lawyer at the attorney general’s office was fired last year when she raised concerns that her bosses were breaking federal rules as they scrambled to salvage a foundering technology deal that has cost taxpayers hundreds of millions of dollars. After Martha … Read More
Dr. Juan D. Villarreal of Harlingen Family Dentistry and founder of Texas Dentists for Medicaid Reform has completed the writing of a book about his personal experience with Texas Medicaid and its attempt to falsely accuse Texas dentists of healthcare … Read More
The Texas Supreme Court on Friday delivered a temporary, last-minute victory to families of children with disabilities who want to stop sweeping budget cuts to a state-funded children’s therapy program. State lawmakers last year approved $350 million in budget cuts … Read More
In a last-ditch effort to stave off $350 million in cuts to a state Medicaid program that provides therapy to disabled children, federal and state lawmakers are asking the federal government to intervene.Families that have sued the state to stop … Read More
Heather Griffith Peterson and Kara Crawford have joined the HHS executive leadership team. They both began June 1. “We are putting together a strong leadership team that will continue to move the Texas Health and Human Services system forward,” Health … Read More
Child Protective Services officials have killed an idea to give some of its top employee big raises. “No salary increases for regional directors will even be considered until clear improvement is seen at CPS,” said Patrick Crimmins, spokesman for the … Read More
AUSTIN — Texas state health officials once again are delaying a massive data project that has struggled to get off of the ground for more than a decade. The state Health and Human Services Commission informed lawmakers Tuesday it was pausing … Read More
Back on May 19, Sen. Chuy Hinojosa and Rep. Richard Peña Raymond hosted a town hall meeting for providers on Medicaid managed care in Edinburg at the Edinburg Conference Center at Renaissance. It has taken a while but here are … Read More
Recently, TDMR filed an open records request with the Texas Health and Human Services Commission to find out how many individual Texas dentists are currently participating in Medicaid and how those participation numbers have changed since the Frew settlement in … Read More
Like many parents of children with autism, Braulio De La Cruz sought an expensive therapy called applied behavioral analysis — or ABA – when his son Noah Leonardo was diagnosed last year. Noah, now 3 years old, qualifies for Medicaid … Read More
You might remember the case of Austin dentist, Dr. Rachel Trueblood. $16 million overpayment demand settled for $39,000 Back in 2014, Dr. Trueblood had been accused of Medicaid fraud, placed on “credible allegations of fraud” payment hold which closed her … Read More
AUSTIN – Gary Jessee will lead the newly created Medical and Social Services division of the Health and Human Services system, HHS Executive Commissioner Charles Smith announced today. Jessee, who is currently the state Medicaid director, will become deputy executive … Read More
The policy revision to the Medicaid orthodontic benefit process contemplated by representatives of the Texas Medicaid and Healthcare Partnership and the Health and Human Services Commission in 2009 was sweeping. Per the final draft of the confidential policy revision attached … Read More
The Health and Human Services Commission in February 2009 asked the individuals working on the new Medicaid orthodontic benefit policy to review whether or not a board certified orthodontist should review each and every prior authorization request for orthodontic treatment. … Read More
AUSTIN — The Texas Medicaid program, under pressure from lawmakers, is again proposing significant cuts in pay for therapists who treat more than a quarter-million disabled children and elderly Texans. On Friday, the Texas Association for Home Care & Hospice … Read More
The TMHP document reported about in our last story that was recently appended to a court filing by Xerox shows that staff from the Health and Human Services Commission and its Office of Inspector General were well aware of the … Read More
A new document has come to light out of the lawsuit the state filed in 2014 against Xerox, its former Medicaid claims administrator, that shows Medicaid dentists were concerned as early as 2007 about Xerox’s prior authorization process and demanded … Read More
HOUSTON – A 20-count federal indictment has been unsealed following the arrest of the owner of KMD Healthcare Services Inc., and his brother on charges they engaged in a conspiracy involving fraudulent Medicare and Medicaid billing for ambulance services, announced … Read More
A 36-year-old woman from Lubbock, Texas, Paula McNeal, who pleaded guilty in January 2016 to one count of health care fraud, was sentenced today by Senior U.S. District Judge Sam R. Cummings to 18 months in federal prison and ordered … Read More
This coming Thursday, May 19 from 8:30 am to noon, a town hall meeting on Medicaid managed care is being held at the Edinburg Conference Center at Renaissance, 118 Paseo Del Prado, Edinburg,TX. The meeting has been set up to allow Medicaid providers … Read More
Chief Deputy Executive Commissioner Charles Smith announced Heather Griffith Peterson and Kara Crawford are joining the Health and Human Services’ executive leadership team. “We are putting together a strong leadership team that will continue to move the Texas Health and … Read More
The Houston Chronicle reported this morning that Frianita Wilson, the wife of former Health and Human Services Commission Inspector General Doug Wilson and an HHSC executive in her own right, is now back at work at HHSC after being on administrative … Read More
AUSTIN — A Texas state official put on paid leave amid last year’s contracting scandal has been reinstated after 15 months in which she received nearly $150,000 in salary without having to work. The official, Frianita Wilson, a longtime procurement … Read More
Charles Smith, a longtime ally of Gov. Greg Abbott, will be the next executive commissioner of the Texas Health and Human Services Commission, the governor announced Tuesday. Smith, the chief deputy executive commissioner at the massive agency, will start his … Read More
Earlier this week, TDMR received an email from a mother who had her sons under Medicaid orthodontic treatment back in 2011 and 2012 and is still very upset at the both the state handling of the matter and the lack … Read More
The Health and Human Service Commission Inspector General’s office has replaced a controversial Medicaid fraud data analytics program with a statistical software package that cost the agency nothing. The 21CT contracting scandal cost the state $20 million and took out … Read More
AUSTIN — Chris Traylor will retire as head of the Texas Health and Human Services Commission at the end of next month, legislative officials with knowledge of his decision said late Thursday. Traylor, who canceled retirement plans last spring to … Read More
This morning Health and Human Services Commission Inspector General Stuart Bowen Jr. issued his latest quarterly report on OIG activities and results. Bowen has ushered in a new era of transparency and accountability for the agency and these reports provide … Read More
A Texas appeals court delivered a big loss on Thursday to a group of home health agencies and parents of children with disabilities who sued the state over payment cuts to in-home therapy providers. The Texas 3rd Court of Appeals ruled … Read More
State health officials confirmed Tuesday they have asked the Obama administration to keep a 15-month lifeline of federal Medicaid money flowing into Texas to help hospitals treat uninsured patients. That money would offer temporary relief to health care providers who face losing the funds — … Read More
The investigative digging of the Texas media into the operations of state government has once again revealed to the public, otherwise blissfully ignorant, the tremendous apparent hypocrisy of several state officials who view their positions as the divine right of … Read More
A recent court ruling in favor of a Texas orthodontics provider adds to the state’s longstanding inability to prove claims that dental providers overbilled Medicaid tens of millions of dollars, according to the Austin American-Statesman. In the latest case, an … Read More
State Medicaid regulators pursuing orthodontists who they claim bilked Texas out of tens of millions of dollars suffered another decisive setback Thursday, when an appeals court ruled investigators hadn’t proven any fraud had occurred in one of the state’s largest … Read More
Today the Sixth Court of Appeals issued their decision in the Medicaid payment hold case of Antoine Dental Center of Houston. The court again exonerated the practice from allegations of Medicaid fraud, again terminated the payment hold and, for the … Read More
Two people are facing federal charges in connection with defrauding and scheming to defraud through false billing via their local medical equipment companies. But the two cases, however similar, are not linked to each other, according to a news release … Read More
