An excellent, two minute primer and explanation of the Texas Medicaid orthodontic debacle. A must-see for quick background information on the history of what has been going on.


LATEST NEWS!

Lawsuit Alleges Xerox Wrote Misleading Documents on Ortho Prior Authorizations…

justice for texas medicaid providers

As part of the lawsuit against Xerox, the former lead contractor for the Texas Medicaid and Healthcare Partnership, the Texas Office of the Attorney General alleges that Xerox, from the beginning of its contract with Texas, wrote misleading documents that indicated each request for Medicaid orthodontic treatment was submitted to and reviewed by its dental director when this was not the case. Hide no case review done by Xerox's dental director The purpose of the subterfuge per the legal documents was to misrepresent and apparently hide the fact that the vast majority of Medicaid orthodontic prior authorization requests never were sent to the dental director but were "rubber stamped" by Xerox's "dental specialists."  These staff, according to the suit, were unqualified, never reviewed … Read More...

ACS Xerox

State Alleges Xerox Instructed Dental Staff to Approve HLD Scores of…

In the lawsuit against Xerox filed by the Texas Attorney General, there is one more startling revelation. The State is alleging that Xerox as early as 2004, when the company took over the contract as the state's Medicaid claims administrator, the lead contractor in the Texas Medicaid and Healthcare Partnership, immediately changed the Medicaid orthodontic prior authorization process. Xerox … [Read More...]

THHSC building

Dentists Told in 2009 to “Assume” Medicaid Ortho PAs Are…

Back in January 2009, a Medicaid Orthodontic Stakeholder meeting was held in Austin at the offices of the Texas Dental Association. Dr. Linda Altenhoff presided at the meeting. Dr. Altenhoff is currently the Dental Director for the Texas Health and Human Services Commission Office of Inspector General, a position that was created under SB 1803. Back in 2009, Dr. Altenhoff held the position of … [Read More...]

fraud

Xerox/TMHP “Dental Specialists” Trained Only to Add Up HLD…

Apparently TMHP/Xerox "dental specialists" were only trained to add up HLD scores on Medicaid orthodontic pre-approval requests and determine whether the total was 26 points or more, per allegations contained in the  lawsuit filed against Xerox by the Attorney General of Texas. Approved $700 Million in Orthodontic Pre-approvals These Xerox staff approved some $700 million in Medicaid … [Read More...]

Texas Medicaid fraud

Xerox Ortho Staff Worked from Home, Didn’t…

As reported in May, the Office of the Attorney General of … Read More...

whistleblower wrongful dismissal

Former HHSC OIG Deputy Counsel Reported Internal…

Michael McMillen, former Deputy Chief Counsel, Texas Health … Read More...

THHSC building

Kyle Janek Rules – “Dentists Found…

On May 7th,  Dr. Kyle Janek, the Executive Commissioner of … Read More...

budget

HHSC Collecting SOAH Medicaid Provider Hearing…

As was reported in the Austin American Statesman back on May … Read More...

ACS Xerox

Xerox Awarded $500 Million Medicaid Deal in NY…

Xerox Corp at the end of May was awarded a $500 million … Read More...

consulting report

HHSC Releases Deloitte Report “State of…

Wednesday, TDMR received a notice that HHSC had put online a … Read More...

US Capitol in Washington

HHSC/TMHP Comes Up Short $15 million on HHS Texas…

Yesterday, HHS-OIG issued an audit entitled "Acute-Care … Read More...

HIPAA compliance

HHS-OIG Says $6.7 Billion Wasted Nationwide on…

This morning it was reported that the Inspector General of … Read More...

Austin Texas Capitol

ACS/Xerox Paid $7,254,999 for Lobbying Texas…

As this information is all a matter of public record, we … Read More...

THHSC building

DRAFT Health and Human Services System Strategic…

HHSC yesterday sent out a notice that a new draft HHSC … Read More...