Law360, New York (August 27, 2015, 2:12 PM ET) — A Texas federal judge recused himself Wednesday from a False Claims Act suit against a medical center, days after the defendants revealed his cousin could be a key witness. The … Read More
AUSTIN — A lawsuit that sought to block deep cuts in what Medicaid pays for disabled children and poor elderly Texans’ therapies has delayed the rate changes for a month but otherwise forced no change in the state’s plans. On … Read More
August 17, 2015 — California legislators took the first step in resolving oral health disparities by hiring the state’s first dental director, Jayanth Kumar, DDS, MPH. Dr. Kumar, who officially started the position on August 1, will create and implement a … Read More
Yesterday, Travis County District Court Judge Amy Clark Meachum issued her decision in the case of Antoine Dental Centers of Houston, vindicating the practice in its payment hold case. The practice had been accused of “credible allegations of fraud” in … Read More
A district court judge on Wednesday handed state Medicaid regulators another decisive courtroom loss, adding one more notch to the Health and Human Service Commission’s Office of Inspector General’s unenviable losing streak pursuing dentists and orthodontists it claims have bilked … Read More
Home health agencies providing pediatric therapy services, along with the mothers of five children in Travis and Williamson counties, turned to the courts Tuesday to stop Texas officials from imposing program cuts totaling $350 million.Most of those receiving the speech, … Read More
UPDATE, August 11, 2015: We have been informed by a very keen-eyed and interested observer that the definition of “physician” under the Social Security Act includes dentists. So we are not sure why the Texas Health and Human Services Commission … Read More
In January, Stuart Bowen took charge of a state office rocked by accusations of corruption, incompetence and inefficiency. Responsible for ferreting out fraud amid the programs and procedures of the sprawling Health and Human Services Commission, the office of Inspector General … Read More
TDMR has learned that the new Health and Human Services Commission Inspector General Stuart Bowen, Jr. has been taking on and overhauling the agency’s use of statistical sampling and extrapolation. This is the most controversial tool that the agency had … Read More
AUSTIN — Even as they left nearly $18 billion unspent, Texas lawmakers ordered a $350 million cut this year to Medicaid pay for therapists who perform one of health care’s most exacting jobs.In a two-year budget that was flush enough … Read More
Last Wednesday, July 16, lawyers for Antoine Dental Centers of Houston again went to court. Going Travis County District Court This time they appeared before Travis County District Court to appeal the Medicaid payment hold final decision by former Health … Read More
The eight steps you need to take to put together a program for yourself! Many people have asked what the process for establishing an effective compliance program is. At one point, having a compliance program was optional. As a result … Read More
This past Friday at the Leon Valley Conference Center in San Antonio, Star Compliance Services and TDMR held our third healthcare compliance seminar, following our recent successful seminar in Houston and the earlier one held in February at Weslaco. Gregory … Read More
Texas Dentists for Medicaid Reform assisted Star Compliance Services this past Friday to hold a one-day healthcare compliance seminar in Houston at the Norris Conference Center – City Centre. It is the first in a series of seminars that were … Read More
Governor Greg Abbott today announced that Texas Health and Human Services Commission Executive Commissioner Dr. Kyle Janek has expressed his intention to resign, effective July 1, 2015. Governor Abbott simultaneously announced his intention to appoint Chris Traylor as Executive Commissioner … Read More
Texas Health and Human Services Executive Commissioner Kyle Janek, M.D., announced today he is stepping down from his position effective July 1 to make way for new leadership as the agency prepares for major reorganization. “I’ve been honored to lead … Read More
DALLAS — Texas paid $191,410,707 for unallowable orthodontic services from 2008 through 2010, according to a federal investigation to be released on Thursday. And officials say the federal government wants a large portion of it back. The findings are in … Read More
Lawmakers sailed off into the sunset Monday hailing the conservative budget they had passed to fund Texas for the next two years — one that, when it comes to delivering health care to the neediest Texans, likely won’t stay afloat. … Read More
Today, SB 207 with minor changes was approved by both Texas House and Senate conference committees. SB 207 is the bill that contains the Sunset reforms to the Health and Human Services Commission Office of Inspector General. The next step is for … Read More
In March, Attorney General Pam Bondi announced she had nailed someone for Medicaid fraud. The culprit was a 49-year-old home-health worker from dirt-poor Gadsden County, accused of bilking the state out of $13,000. For her crime, Melissa Letica Simmons was … Read More
Medicaid provides health insurance to about 500,000 Iowans. For decades, the government program has been operated by the state, which is not beholden to shareholders. Spending has been held down by reducing fraud, paying lower reimbursements to providers and giving … Read More
Sunday night on this Memorial Day weekend, the Texas House of Representatives passed Senate Bill 207, the legislation that will reform the Health and Human Services Commission Office of Inspector General. The recorded vote was 142-0. The bill now goes back … Read More
HARLINGEN, Texas, May 18, 2015 /PRNewswire/ — Nestled within its 900-plus pages of legalese, the Patient Protection and Affordable Care Act, or ACA, requires healthcare providers participating in federal programs to have an effective compliance program in place. For providers without … Read More
Texas regulators entered a courtroom late last year claiming they should be able to keep more than $300,000 confiscated from a Corpus Christi dentist they claimed defrauded the state through a Medicaid billing scheme. Source: State’s decisive legal loss could … Read More
TDMR has started a regular video news segment that will be carrying Texas Medicaid news plus relevant stories from around the country. Over the next few weeks, we will be starting to include interviews with key players in Texas. Our … Read More
Today, the Health and Human Services Commission announced that it has put up a new page on its website for Medicaid providers to comment and stay abreast of policy changes relating to Medicaid covered medical and dental treatments. The new … Read More
UPDATE: After publishing this article, TDMR was alerted that it is a DENTIST, not a medical doctor that is involved in this case. It involves the Rhoden Group from Corpus Christi with Dr. Cheryl Rhoden, DDS as the principal. This … Read More
With billions of dollars in hospital aid at stake, health care officials are anxious for state leaders to resolve the federal government’s concerns about extending a program that helps cover the staggering cost of caring for uninsured and needy Texans. … Read More
Dr. Paul Dunn, a small town general dentist who practices orthodontics out of Levelland, has had a case outstanding with the Health and Human Services Commission Office of Inspector General since 2011. He has been under severe financial strain since … Read More
Senate Bill 207 which details legislative reforms to be made to the structure and function of the Health and Human Services Commission Office of Inspector General as recommended by the Sunset Advisory Commission has cleared the Texas Senate and is set … Read More
This past week, the Texas Health and Human Services Commission in its monthly In Touch newsletter announced that Deputy Executive Commissioner Chris Traylor is retiring as of May 31st. Traylor has been in the Texas public service for 25 years … Read More
Two articles from the Houston Chronicle this last week should send shivers down the spine of every Texan about what kind of government his or her tax dollars are buying. The whole contracting fiasco in the Texas Health and Human Services … Read More
Yesterday, the Texas Senate passed and sent down to the House of Representatives Senate Bill 207, the bill setting out much needed reforms to the Health and Human Services Commission Office of Inspector General that came out of the Sunset … Read More
AUSTIN — A new bill to curb alleged abuses of an organization that is itself supposed to police abuses got Texas Senate approval Tuesday. Senators voted 30-0 to pass Senate Bill 207 by state Sen. Juan “Chuy” Hinojosa, D-McAllen, which … Read More
AUSTIN — A discussion about restructing the Texas health agency morphed into a heated argument about President Obama’s health care law in the state Senate on Wednesday, as Democrats frustrated at not getting a committee hearing on a Medicaid expansion plan … Read More
The Texas Senate on Wednesday tentatively approved a measure to partially consolidate the state’s massive health and human services system. Under Senate Bill 200 by Jane Nelson, R-Flower Mound, three of the state’s five health and human services agencies — the … Read More
April 2, 2015 — Dentists and other private healthcare providers cannot sue to force states to raise their Medicare reimbursement rates, according to a U.S. Supreme Court ruling issued on March 31. This ruling means that dentists and other healthcare … Read More
The news that Smile Magic Dental clinics recently settled with the Texas Health and Human Services Commission Office of Inspector General over allegations of Medicaid fraud confirms what TDMR has been saying for a long time – that the purpose … Read More
Rep. Bobby Guerra filed H.B. No. 3023 this week. The purpose of the bill is to make it mandatory for Medicaid providers to get an overpayment hearing before the State Office of Administrative Hearings if they dispute an recoupment demand from the Health and Human … Read More
Members of the Texas Senate will likely propose significant additions to a bill introduced this week on agency contracting now pending before the Senate Finance Committee. Sen. Jane Nelson, R-Flower Mound, introduced Senate Bill 20 to address what she called … Read More
