TMHPTexas Medicaid Healthcare Partnership
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The amount of moisture that migrates from PI to TO during time dt at change of the TMHP value is determined by the differential equation:
where [tau] is the moisture transfer time constant; [MATHEMATICAL EXPRESSION NOT REPRODUCIBLE IN ASCII] is the PI humidity [W.sub.c] at TMHP [[theta].sub.h1], %; [MATHEMATICAL EXPRESSION NOT REPRODUCIBLE IN ASCII] is the PI humidity [W.sub.c] at TMHP [[theta].sub.h2], %.
8a (GMA monomer) shows that the use of LP26 and TMHP as initiators alters the gelation process above the physical percolation threshold.
Finally, mechanical properties (Young modulus, elongation, and stress at break) for several reactive plastisols composed of different methacrylates (GMA, HMA, LMA, EGDMA, TEGDMA) and initiators (DCP, LP, TMHP, AIBN) have been characterized.
Federal auditors now say the Texas Health and Human Services Commission is responsible for the uncontrolled spending growth because the state agency failed to ensure that its contractor, TMHP, followed state Medicaid guidelines to evaluate the medical necessity of orthodontic claims.
"Although TMHP failed to properly use the prior-authorization process to determine the medical necessity of orthodontic services, the State agency is ultimately responsible for contractor compliance," the audit says.
The OIG is also assisting in a federal audit of TMHP.
He did not believe he committed any wrongdoing, because he had submitted the necessary documentation to the state and received prior approval from TMHP to provide orthodontic services to those patients.
The state argues that TMHP violated its contract by pre-authorizing medically unnecessary claims, and Medicaid providers violated their contracts by submitted inaccurate patient information for medically unnecessary claims.
State and federal auditors are currently conducting a joint audit of TMHP. By looking at a statewide sample of authorization records, both state and federal auditors hope to identify how much funding should be recovered for medically unnecessary claims.
TMHP "did not provide enough qualified people to evaluate the cases.