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HHSC Allegedly Paid Out $104 Million to 8,000 Medicaid Providers the Agency Suspected Of Fraud

Former HHSC Chief Counsel Jack Stick's $87 OIG Badges

Four firms provided “proof of concept” demonstrations of their Medicaid fraud detection software to the Texas Health and Human Services Commission and its Office of Inspector General back in 2011. These proof of concept projects allowed the firms to access Medicaid claims data to evaluate it for fund diversion to fraud. In the case of Reflective Medical (RMIS), as already reported in the press and by TDMR, they were able to look at three years of Texas Medicaid data and found inexplicable claims being paid such as for men giving birth, nine-year old girls receiving tubal ligations and 198-year old women getting testicular biopsies all paid for by the program. RMIS Identified 6,470 fraud suspects, but HHSC already had a list of 8,000 David Gibson, CEO of Reflective Medical, told … Read More...

San Antonio Seminar Helping Providers Understand Compliance and Enforcement Issues

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This past Friday at the Leon Valley Conference Center in San Antonio, Star Compliance Services and TDMR held our third healthcare compliance seminar, following our recent successful seminar in Houston and the earlier one held in February at Weslaco. Gregory Ewing and Dr. Juan D. Villarreal were once again the presenters and provided attendees the benefits of their knowledge and personal experience in the area of healthcare compliance. Greg is a compliance expert and attorney with 17 years of … [Read More...]

Offer of Free Fraud Detection Software and Other Skeletons Still in the HHSC Medicaid Closet

THHSC building

The press has uncovered a lot of conduct unbecoming at the Texas Health and Human Services Commission and its Office of Inspector General in the last eight months. First there was the Sunset Advisory Commission with its damning report on OIG and its treatment of Medicaid providers, its poor handling of investigations and lack of due process.  Then, the 21CT scandal surfaced with former HHSC chief counsel and OIG deputy inspector general for enforcement Jack Stick resigning.  After a … [Read More...]

SB 207 Signed by Governor Abbott on Heels of FBI Medicaid Fraud Arrests in RGV

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This morning, TDMR was notified that Governor Greg Abbott has now signed into law SB 207, the legislation which makes major changes and improvements to the way the Texas Health and Human Services Commission Office of Inspector General will work. Agency meltdown The last half of 2014 and 2015 was a tumultuous period for the agency. It started with hearings before the House Human Services Committee about the agency's subversion of due process rights supposedly guaranteed Medicaid providers … [Read More...]

Houston Compliance Seminar Successful in Communicating Vast Amount of Information on Compliance Issues and Providing Tools for Application

Houston Seminar June 12

Texas Dentists for Medicaid Reform assisted Star Compliance Services this past Friday to hold a one-day healthcare compliance seminar in Houston at the Norris Conference Center – City Centre.  It is the first in a series of seminars that were demanded by dental Medicaid providers after TDMR’s first such seminar in Weslaco in February.  Further seminars are scheduled for San Antonio on June 26 and Dallas July 17. Dr. Juan D. Villarreal, DDS and founder of TDMR and 17-year veteran in healthcare … [Read More...]

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HIPAA, Meaningful Use And The False Claims Act

The term “Meaningful Use” is the federal government’s way of … Read More...

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HHSC Commissioner Kyle Janek to Resign

The Texas Tribune just reported the following this … Read More...

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Breaking News: Texas Owes Feds $133 Million for Medicaid Ortho Debacle

Back last August, the Department of Health and Human … Read More...

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Want to Take Over Texas Medicaid Like Xerox? Here is Your Chance

On May 29th, the Texas Health and Human Services Commission … Read More...

Texas Capitol

UPDATE: SB 207 Going to Governor Abbott for Signature

Today, SB 207 with minor changes was approved by both Texas … Read More...

Texas State Representative Seats

SB 207 Passes Texas House 142-0

Sunday night on this Memorial Day weekend, the Texas House … Read More...

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OIG Originally Demanded $3.2 Million, Now Owes Medicaid Dentist $380,000

The front-page of the Austin American Statesman … Read More...

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Texas Medicaid News Video Show Now Online

TDMR has started a regular video news segment that will be … Read More...