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Why States are Ineffective at Fighting Medicaid Fraud

Texas Medicaid fraud

There is a primary reason why states around the nation have trouble fighting Medicaid fraud. States inept fighting fraud Both the KCBS videos from California we posted and the recent Sunset Commission report on Texas HHSC-OIG highlight that state agencies can talk about Mediciad fraud but when it comes to dealing with it, there is a significant problem of ineptitude and resolve. Why? Why?  That is a very good question. The answer may be found in a letter supplied to TDMR by Dr. David Gibson, CEO of Reflective Medical, one of the companies that did a "proof of concept" on their Medicaid fraud detection software for Texas HHSC-OIG back in 2011. FBI fraud experts successful in California Reflective Medical has a non-profit arm called the Fraud Prevention Institute, from … Read More...

jack stick testifying feat

HHSC Ditching Anti-Fraud Initiative Started by Stick

The following is republished from the Texas Tribune: When Jack Stick became the deputy inspector general of the Texas Health and Human Services Commission in 2012, he saw an opportunity to help investigators beef up their production in bringing potential fraud cases forward. For the first time, general investigators — who review whether recipients of food stamps, Children’s Medicaid and other … [Read More...]

stuart bowen

Governor Abbott Appoints New HHSC-Inspector General

PRESS RELEASE FROM THE GOVERNOR: Today, Texas Governor Greg Abbott announced the appointment of Stuart W. Bowen, Jr., as Inspector General for the Texas Health and Human Services Commission for a term to expire Feb. 1, 2016. The inspector general works to prevent, detect and investigate fraud, abuse and waste in state health and human services programs. Bowen previously served for nearly … [Read More...]

medicaid fraud

What Real Medicaid Fraud Looks Like

David Gibson, CEO from Reflective Medical, one of the companies that demonstrated their Medicaid fraud detection software to HHSC back in 2010 and 2011, sent TDMR links to a couple of YouTube videos that show the kind of fraud that exists today not only in Texas, but around the country. California Medi-Cal fraud expose appalling  The videos are from KCBS in Los Angeles and detail the results … [Read More...]

HHSC Executive Commissioner Kyle Janek

Influential State Senator Tells Janek to Resign Immediately for Good of Texas

Today, Sen. John Whitmire sent a letter to HHSC Executive Commissioner Kyle Janek suggesting he resign immediately for "the best interest of the State of Texas." "Enough is enough" The Austin American Statesman quoted Whitmire as telling them, “Enough is enough. I think he’s lost credibility to run this agency." and "“I think Kyle has conflicted himself out of being able to run his agency. … [Read More...]

children health insurance program

In 2011 More Medicaid Children in Texas Received…

The Texas Health and Human Services Commission sent out a … Read More...

HHSC Executive Commissioner Kyle Janek

Texas “Insiders” Entitlement Program Pays Off:…

In an era when Texas government is supposed to be efficient, … Read More...

Texas Medicaid fraud

Dentaquest, MCNA Recover $303,000 in Fraud, Abuse…

Today, HHSC-OIG issued a report detailing amounts recovered … Read More...

jack stick testifying feat

UPDATE: OIG Executive Hired by Stick Has Been…

A former aide to Jack Stick, hired by Stick when he was the … Read More...

THHSC building

HHSC: Not Just Xerox and 21CT, but Big Trouble…

While Texas is in drought,  the bad news floodgates have … Read More...

HHSC Executive Commissioner Kyle Janek

Health Chief Says He Was Misled on No-Bid Deal |…

*Editor's note: This story has been updated … Read More...

justice for texas medicaid providers

Dental Medicaid Providers to Get Their Day in…

TDMR has learned today that OIG administrative actions … Read More...

THHSC building

Janek’s Role Being Questioned in Contracting…

According to a story in the Austin American Statesman today, … Read More...

HHSC Executive Commissioner Kyle Janek

Stick leaves office, Janek suspends other HHSC…

AUSTIN -- Jack Stick has left the building. The … Read More...

doug wilson sunset

Inspector General resigns amid questions over…

Health and Human Services Commission Inspector General Doug … Read More...

Travis County DA opens investigation

Travis DA to open criminal probe of $110M contract…

AUSTIN – The Travis County District Attorney's office and … Read More...

court of law

Perry, senator call for investigations of…

A spokesman for House Speaker Joe Straus on Thursday said … Read More...

jack stick testifying feat

Media Fire Burning Hotter for Stick and HHSC on…

Within the last 24 hours, major media in Texas have … Read More...

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