Tag: texas medicaid

AUSTIN, Texas – Texas providers have been finding themselves at risk of getting disenrolled from the state Medicaid program dues to glitches in a new technology system, says Adrienne Trigg, chair of the legislative committee for TexMEP.   The glitches in the system, compounded by a guide manual that wasn’t updated, made it difficult, if not impossible, for providers to update their information.  “It’s just a bond,” she said. “You’re not having...

MCALLEN, Texas - Anna Ramirez-Ambriz, owner of Compassionate Medical Supply in Edinburg, Texas, has been sentenced to 78 months in jail and ordered to pay more than $3 million in restitution for fraudulently billing Texas Medicaid for incontinence supplies. From 2007 through 2013, Ramirez-Ambriz billed the Medicaid program for higher quantities and more costly incontinence supplies than were actually delivered to more than 100 beneficiaries. As a result, Texas Medicaid suffered a loss of $3.1 million.

AUSTIN, Texas - Providers in Texas have staved off reimbursement cuts proposed by Superior HealthPlan, a managed care company that oversees part of the state's Medicaid program.Providers were notified in February that Superior was reducing rates for certain product categories from 85% of Texas Medicaid rates to 60%, with a few providers receiving a reduction of 65% to 70%, effective May 1. Providers were given 30 days to accept or reject the plan.In response, VGM Group organized a conference...

AUSTIN, Texas - The state Medicaid program may have forced Superior HealthPlan to modify its contract with Medline for DME and supplies, but providers say, in reality, they fear not much has changed.During a hearing in August that prompted the modifications, provider Barry Johnson says the state and Superior HealthPlan agreed that Medicaid recipients would be able to opt out of the contract with a simple phone call to the managed care organization.“They're being told they have to fill out an...

DALLAS - The state's plans to create a reuse program for home medical equipment just don't make sense, say HME providers. “After people use this equipment, it's not in very good shape and unsanitary,” said Barry Johnson, executive director of the Texas Alliance for Home Care Services and president of Duncanville, Texas-based Texas Medical. “Who's going to be responsible for collecting it, cleaning it and repairing it? Where are they going to warehouse it?”In June, Governor...

WASHINGTON - The Texas Medicaid program could have saved $2 million in the Dallas/Forth Worth area alone if it had used competitive bidding pricing for certain DME items in fiscal year 2011, according to a new study from the Office of Inspector General (OIG).The OIG found that Texas Medicaid's payment amounts for 30 of 32 DME items exceeded competitive bidding amounts.“Our findings provide a tangible example of potential state and federal savings for Medicaid programs if the programs were to...