AUSTIN, Texas (AP) — Some $350 million in cuts to a Texas Medicaid program providing therapy for disabled children have taken effect.The reductions sparked outcry after being approved by the GOP-controlled Legislature last year.They reduce revenue for some Texas therapy … Read More
On Dec. 7, 2016, just in time for the holiday season, the Office of Inspector General (OIG) released a policy statement regarding the nominal value of gifts that healthcare providers may give to Medicare and Medicaid beneficiaries. In short, the … Read More
There have been rumors flying by the last few weeks that Inspector General Stuart Bowen wants to make it easier to place “credible allegation of fraud” (CAF) payment holds against Medicaid providers. We had no idea that this was difficult … Read More
There may be help on the way for tens of thousands of disabled Texas children on the verge of losing much needed therapy to budget cuts.State House Speaker Joe Straus told the Texas Tribune lawmakers will work to make sure … Read More
December 1, 2016 — The number of U.S. children receiving dental care significantly increased from 2000 to 2014, according to a new study in Pediatrics. Even more positively, the researchers found a steep narrowing of coverage disparities in race/ethnicity and … 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
DALLAS (AP) – Prosecutors say a Texas woman who operated a home health care company has pleaded guilty in a case linked to more than $40 million in fraudulent services. Myrna S. Parcon pleaded guilty Tuesday in Dallas to conspiracy … Read More
Pfizer (PFE -0.6%) takes exception to the release of Medicaid rebate data to state lawmakers by the Texas Health and Human Services Commission. The agency, which initially said no, acquiesced after the Texas Attorney General determined that the release would … Read More
UPDATE: We now have a copy of the letter from Delta Dental to Texas dentists regarding joining their “Texas Medicaid network.” (see below) TDMR received an interesting email after our recent story on dental managed care and the possibility of … Read More
The Audit division of the Health and Human Services Office of Inspector General released a report at the end of October (although TDMR just received the email notification about it today) about an audit they conducted on the practice of … Read More
Last year, the Texas legislature approved a $350 million cut in Medicaid reimbursement rates to early childhood intervention therapists and providers. The cuts, made to help balance a billion dollars in property tax relief, affect the most vulnerable Texas children … Read More
Even as the share of children in Texas without health insurance continues to decline, the state still has nearly twice the national average, according to a new study. A Georgetown University Center for Children and Families report released Thursday found that Texas … 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
Overinflated promises being made for expansion of Texas’ Medicaid program remind us of two time-proven adages: “If it looks too good to be true, it probably is,” and “There ain’t no such thing as a free lunch.” Recent newspaper articles … Read More
States are beginning to turn to hospitals to cover the cost of Medicaid expansion once the federal match begins to drop next year.The Affordable Care Act provides 100% federal financing for those made newly eligible for Medicaid under the law. … 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
When it comes to a patient’s health, the old phrase, “The doctor knows best,” still rings true, especially for medications. When the Texas Legislature meets in January, there will be plenty of budget and policy battles waged. The battles fought over one of … Read More
In August, TDMR conducted its annual online survey of Medicaid providers. This time, however, the focus of the survey was expanded from only dentists to all Medicaid providers to see how the two compare. Completed surveys were filled out by … 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
Although mandatory pediatric dental insurance was included in U.S. healthcare reform, coverage is a stark departure from the benefits envisioned by the Patient Protection and Affordable Care Act and those required under Medicaid, according to a new report. Coverage isn’t … Read More
Dr. Richard Lange, the president of Texas Tech, told ABC-7 in an exclusive sit-down interview that the university has hired one of the dental school’s first faculty members: Dr. Richard Black, a local dentist with an extensive resume of serving … 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
One takeaway after several weeks of listening to people with their thumb on the pulse of health care policy issues in Texas is Medicaid expansion might well be dead on arrival before the 2017 legislative session begins in Austin.A number … 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
After almost 16 years working for the Texas Medical Board, Mari Robinson announced Wednesday that she is stepping down as executive director in mid-October to accept a new position as the director of telehealth at The University of Texas Medical … Read More
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
Jessica Stefonik is grinning. She’s got a bounce in her step. Her cheeks are a little puffy and her speech is a bit thick.”It feels weird right now, but I’ll get used to it,” she says.What she’s trying to get … Read More
Millions of Americans endure pain and shame because they can’t afford dental care. The issue is particularly pronounced in rural areas, as emphasized by a recent report by National Public Radio. People in rural areas are not only more likely … Read More
The chairman of the Texas Senate Health and Human Services Committee and other high-ranking Republicans on Tuesday expressed little interest in expanding publicly funded insurance coverage to low-income Texans, suggesting the issue is unlikely to gain traction when the state … Read More
A key domestic policy directive presidential aspirant Donald Trump made to Congress as a way to reform the healthcare system is to “block-grant Medicaid to the states.”The health insurance program for poor Americans, which is funded by a matching formula of state … Read More
Hospitals in the Dallas-Fort Worth region were overpaid by $27 million in federal funds to provide health care for the uninsured, according to a new order from the Obama administration, which is threatening to take the money back. Federal health … Read More
At a Managed Medicaid Town Hall meeting in May, state Sen. Juan “Chuy” Hinojosa, D-McAllen, heard numerous concerns about Medicaid reimbursement (payment) schedules and the large losses that McAllen area hospitals are experiencing when these institutions care for Medicaid patients. … Read More
GOP presidential nominee Donald Trump strongly praised Rick Perry when asked at an Austin fundraiser on Tuesday about the possibility of the former governor challenging U.S. Sen. Ted Cruz in a Republican primary. “I’ve been hearing a lot about that … Read More
The latest quarterly report issued by IG last week reminds Medicaid providers that CMS has a deadline of September 25 for re-enrollment of all Medicaid providers (deadline originally March). All providers who enrolled prior to January 1, 2013, must … 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
In his recent quarterly report, Health and Human Services Commission Inspector General Stuart Bowen announced the kickoff off his initiative to increase awareness and cooperation on fraud, waste and abuse between Medicaid stakeholders. The IG Integrity Initiative (IGII) is described as … 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
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
