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Chummy Relations in HHSC Caused $20 Million 21CT Debacle

UPDATE: The Travis County Public Integrity Unit has forwarded the criminal investigation into the 21 CT matter to another undisclosed investigative unit.  Per the Unit's head, the investigation is starting to move faster and was moved for reason of expertise and the complicated nature of the case. Yesterday, the Houston Chronicle lifted the veil on the beginnings of the 21CT no-bid contract for Medicaid fraud detection software that shook the foundations of the Health and Human Services Commission just over a year ago.  The scandal caused the resignations of then-Chief Counsel Jack Stick, HHSC Inspector General Doug Wilson and ultimately the demise of Executive Commissioner Kyle Janek. HHSC Deputy Chief of Staff had personal relationship with 21CT CEO The Chronicle, through open … Read More...

TDMR Launches the “Medicaid Difficulty Alert”

Medicaid symbol

There have been many changes for Medicaid dental providers over the last few years. The change from fee-for-service to managed care.   The upheaval caused by the former Health and Human Services Commission Office of Inspector General and  rampant allegations of Medicaid fraud by dentists.  The scandals at HHSC over no-bid contracts especially the 21CT affair involving Medicaid fraud detection software. At least six top-level executives resigning at HHSC and its OIG. A new HHSC Inspector … [Read More...]

Dental Fraud Found by DMOs in Texas Less Than $250,000

fraud

No, that wasn't $200 million.  It wasn't $50 million.  It wasn't even $500,000 or $250,000. The amount of dental fraud found and recovered by Texas dental management organizations in 2015 was only $243,982.84 per the "HHSC OIG Annual Report on Certain Fraud and Abuse Recoveries by Managed Care Organizations (MCOs) - SFY 2015" released a few days ago. This is the third report in a row (see 2012, no report for 2013, 2014) that has shown an almost insignificant amount of fraud compared to the … [Read More...]

Former Gov. Rick Perry Now Working at MCNA

perry

The Texas Tribune this morning reported that former Texas governor Rick Perry is now the chief strategy officer over at MCNA, one of the two managed care organizations Texas now employs to handle Medicaid dental.  It is Perry's first employment position after his recently ended run for President.  It turns out that MCNA was the largest political contributor to his campaign -  giving $37,800 directly to the campaign and another $20,000 to "Texans for Rick Perry," his state political action … [Read More...]

Inspector General Sends Out Second Quarterly Report

Inspector General Stuart Bowen Jr.

This afternoon, the Health and Human Services Commission Inspector General Stuart Bowen sent out his second quarterly report - quite unlike his predecessor who sent out no such reports.  It is a remarkable 28-pages and will take some time to digest.  However, we wanted to get this out as quickly as possible before commenting. Here is Bowen's initial message from the report: I am pleased to submit to Governor Abbott, Executive Commissioner Traylor, the Members of the Texas Legislature, and … [Read More...]

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TDMR’s Top 6 Important Stories of 2015

We want to close out 2015 with a round-up of the year's most important stories relating to TDMR issues. It has been an exceptional year for changes at the Health and Human Services Commission. The … Read More...

money

Taxpayers Left Holding the Bag Again on Massive Cost Overruns and Bureaucrats Sitting at Home on Paid Leave

With the Government Accounting Office estimating that in 2014 some $124 billion was siphoned off the Medicaid and Medicare system nationally, we are again witnessing the truly schizophrenic nature of … Read More...

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Health and Human Services Commission Looking for Public Input on Agency Transformation

The Texas Health and Human Services Commission sent out an email notification this morning that it is holding a number of public forums about the restructuring of the agency and requesting stakeholder … Read More...

court of law

HHSC Sued for Its Refusal to Release Medicaid “Credible Allegation of Fraud” Payment Hold Information

A suit to compel the Texas Health and Human Services Commission to release the full list of names of Medicaid providers that have been placed under a "credible allegation of fraud" payment hold since … Read More...

hhsc-building

Texas Medicaid Dentists Prevail Again Over State Agencies in Court

This past Friday, the Texas Supreme Court dismissed a petition from the Texas Office of Attorney General to review a 3rd Court of Appeal decision preventing the Health and Human Services Commission … Read More...

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Inspector General Settlements Good for Medicaid Dentists

As TDMR reported back at the end of September, the new Health and Human Services Commission Inspector General Stuart Bowen had started settling outstanding investigations and cases against Medicaid … Read More...

Jack Stick's $2,800 chair.

In Medicaid, It Appears Little Guys Go To Jail, Big Guys Don’t Get Contacted

Earlier this month, the Attorney Generals of Illinois and Arkansas  announced the arrest and/or conviction of three individuals in different cases for Medicaid fraud. Going to jail for … Read More...

hhsc-building

HHSC Dismisses Suggestions from Stakeholders on Changes to THSteps Caries Risk Assessment

Last Friday, the Health and Human Services Commission sent out a notice that it had "updated its Medicaid Medical and Dental Policy web page by posting stakeholder comments and HHSC responses for the … Read More...

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