This past week a number of Medicaid dentists filed suit against ACS, Affiliated Computer Systems, the state’s Medicaid claims administrator better known as TMHP or the Texas Medicaid and Health Partnership. The dentists allege that ACS was negligent in their … Read More
Antoine Dental Center of Houston, Harlingen Family Dentistry of Harlingen, M&M Orthodontics of San Antonio and Dr. Paul Dunn of Levelland filed suit this past Monday against ACS, Affiliated Computer Services, the state’s private contractor which handles claims administration for … Read More
More than 40 health and community groups launched a campaign Wednesday to raise awareness of the coverage gap created when Texas officials declined to expand Medicaid as part of the Affordable Care Act. Advocating that poor Texans should have greater … Read More
February 6, 2014 — Thousands of applications for orthodontic approvals under Medicaid were delayed after Texas employed a single dentist to review them. The understaffing led to dentists, not the private company reviewing the applications, being accused of fraud for … Read More
DALLAS (AP) U.S. Health and Human Services Secretary Kathleen Sebelius says Texas is losing $18 million a day in federal funding by not expanding Medicaid under the federal health-care overhaul. Sebelius spoke Friday at Paul Quinn College in south Dallas. … Read More
Due to its reluctance to expand Medicaid under the Affordable Care Act, Texas may see more than 3,000 deaths due to a lack of insurance, according to a new Health Affairs study. The study looked at the uninsured rates for … Read More
January 30, 2014 — South Carolina health officials and dental providers are hopeful that state lawmakers will reinstate dental Medicaid coverage for low-income adults, saying the move will save emergency room (ER) costs and help people with painful oral infections … Read More
SAN ANTONIO — The facts are pretty basic: About 1 million Texans — 115,000 in Bexar County — could be eligible for insurance coverage under the Affordable Care Act, but won’t be able to get it. Because they live in … Read More
A long time dental Medicaid provider recently sent to TDMR an old article that was written in the March/April 2005 edition of the Texas Medicaid Bulletin. It is interesting because both the Texas Medicaid and Health Partnership (TMHP) and the … Read More
Yesterday the Dallas Morning News reported that a North Dallas psychotherapist plead guilty to a five-year health care fraud scheme and agreed to surrender his license to practice psychology. The US Attorneys Office press release states that Michael Ellis Wolf, … Read More
The Far North Dallas psychologist said he treated a single postal worker seven days a week, up to eight hours a day. A federal billing contractor responded by paying the therapist more than $1 million, court records say. Now Michael … Read More
The Texas Department of Insurance on Tuesday issued state regulations for health care “navigators,” the workers who assist people seeking health insurance in the federal marketplace created by the Affordable Care Act. The rules take into account some of the … Read More
January 17, 2014 — Idaho is considering restoring adult dental coverage in its Medicaid program after emergency room costs more than doubled following budget cuts and the elimination of nonemergency dental coverage. After the program was cut in 2011, dental-related … Read More
Comments on the story: “Don’t be so quick to dismiss Medicaid business” on the Dr. Bicuspid website.
At the beginning of December, 2013, the Health and Human Services Commission published online its budgetary figures for 2014. Included in the document are the 2012 and 2013 expenditures and metrics for the Office of the Inspector General and its … Read More
Texas is again sinking to the bottom of the barrel on a national health care measure. The state ranks 38th in the nation – down from 29th five years ago – for failing to support emergency patients. That’s according to the latest report card … Read More
AUSTIN — Hospital officials, Democratic lawmakers and advocates for the poor complained Monday that the state’s proposed rule on health insurance “navigators” could cripple efforts to educate Texans about their coverage options.At a final hearing and in written comments submitted … Read More
January 3, 2014 — Since I began my first dental client consultancy for a corporate dental practice in Arizona (about two years before the publication of my article, “The emergence of the dental practice management company,” in the September 2009 … Read More
On January 1, the Affordable Care Act changed the rules states use to determine whether people can get most types of Medicaid or Children’s Health Insurance Program (CHIP) coverage. Here’s a list of some of the more significant changes: Medicaid … Read More
TDMR believes that personal attacks on individuals are unwarranted and attempts to steer a high road in dealing with Medicaid issues. But TDMR also believes that the conduct of public officials, especially those in the employ of the Texas government … Read More
TDMR is pleased to present the first in a series of articles on health care compliance penned by TDMR President Greg Ewing. Greg is a health care lawyer with over fifteen years of experience in transactional health law; health information technology; … Read More
December 20, 2013 — Almost half a million Coloradans are expected to gain dental benefits under Medicaid by 2016, but they’ll have a hard time finding a dentist to treat them, according to a study by the Colorado Health Institute. … Read More
December 19, 2013 — United Health Foundation’s 2013 America’s Health Rankings report has ranked U.S. states according to their health and includes visits to the dentist in its data. The healthiest states have a higher concentration of dentists, and their … Read More
For Martha Blaine, the 10 Affordable Care Act “navigators” who meet clients daily on behalf of the Community Council of Greater Dallas blend in with the rest of her staff. “They are all employees,” said Blaine, the organization’s executive director. … Read More
Washington, DC – A Houston doctor has been arrested on charges related to her alleged participation in a $158 million Medicare fraud scheme involving false claims for mental health treatment.Acting Assistant Attorney General Mythili Raman of the Justice Department’s Criminal … Read More
Back on October 15th, 2012, now more than a year ago, Texas Deputy Attorney General for Civil Litigation John Scott testified before the House Committee on Public Health in the Capitol. TDMR has just reviewed the archived video from the … Read More
Before the Thanksgiving long weekend, TDMR received a copy of the August 2012 audit conducted by the HHSC Office of the Inspector General on the Texas Medicaid and Healthcare Partnership. As far as we know this is the first time … Read More
On April 1, Texas’ most powerful elected officials gathered at the state Capitol to rail against Medicaid. In a packed press conference room with protesters shouting outside the door, Republican Gov. Rick Perry, Lt. Gov. David Dewhurst, and U.S. Sens. … Read More
A year after Texas was slated to increase Medicaid payments to primary care physicians under the Affordable Care Act, the state has received federal approval to implement the change. Although the ACA required states to increase payments to primary care … Read More
In fast-growing Texas, which is home to one in 11 of the nation’s children, child poverty has continued to rise despite an improving economy, according to a new report from the Center for Public Policy Priorities, a liberal think tank. … Read More
AUSTIN — Insurance companies, brokers and consumer advocates say a highly publicized national wave of health plan cancellations largely bypassed Texas. There are several complex reasons, but one of the biggest is this: Following the example of Arkansas and other … Read More
The Texas Sunset Commission is evaluating the state Health and Human Services Commission this coming year under its mandate to periodically review Texas state agencies for their operation and need to exist. About the Commission The Texas Legislature created the … Read More
Critics of the Affordable Care Act have lambasted President Obama’s signature legislation as it struggles with technical glitches and as thousands of people nationally report the cancellation of their existing health insurance plans. But a report released Thursday by Families … Read More
November 19, 2013 — A New York judge on November 18 ordered a new trial in the Small Smiles case after ruling that a lawyer for the insurance company stalked the jury during the trial. The judge found that the … Read More
BROWNSVILLE, Texas –– Texas spent $400 million on speech therapy for children under Medicaid last year, up 30 percent from three years ago. Speech therapists along a 76-mile stretch of Texas Highway 83, from Brownsville to Mission, collect more money … Read More
WASHINGTON — Bowing to pressure, President Barack Obama on Thursday announced changes to his health care law to give insurance companies the option to keep offering consumers plans that would otherwise be canceled. Obama to allow sale of plans canceled … Read More
After a 40-year career, Dr. Paul Dunn is now on the verge of bankruptcy because he helped Medicaid children. In 2012, HHSC-OIG placed Dunn’s practice in Levelland under a 100% “credible allegation of fraud” payment hold for his orthodontic Medicaid … Read More
Greg Abbott outlines many policy proposals including passing law to prevent state agencies from working with the Affordable Care Act. Abbott Unveils Proposals for Privacy, Ethics and DNA | The Texas Tribune.
In Dallas to raise cash for Senate candidates, President Barack Obama took a side trip Wednesday to pressure Gov. Rick Perry to expand Medicaid and thank volunteers working to help uninsured Texans. He called it a “no-brainer” that Texas could … Read More
WASHINGTON — With 6.4 million uninsured residents, Texas is a major target for anyone eager to put a dent in the number of Americans without health coverage. It’s also a bastion of resistance to Obamacare. The governor won’t set up … Read More
