Records show controversial contract cost state more, produced less – Houston Chronicle

AUSTIN – A sophisticated software program crunched through a sea of Texas hospital records in July 2013, instantaneously comparing payment records against Medicaid rules to identify $4.4 million in questionable spending and start a process that eventually returned the money to taxpayers.The anti-fraud system was not the now-infamous one made by local technology company 21CT, however. Instead, it … [Read more...]

Top Medicaid fraud convicts are nursing and home health aides, HHS-OIG says

Nearly one-third of Medicaid fraud criminal convictions the federal government obtained last year involved home health aides, the Inspector General for Health & Human Services reports. Thirty percent of the 2014 cases involved home health aides, while certified nursing aides were culprits in 9% of convictions. Next were medical support services workers (7%), the report found. All told, … [Read more...]

State contracting safeguards only as good as the enforcement

AUSTIN – A renewed effort to evaluate state contracting oversight could end up illustrating an uncomfortable reality, former lawmakers and government watchdogs say: even the strictest of safeguards will not work if not taken seriously by agency officials. Despite an avalanche of negative attention on high-dollar contracting irregularities, the state does have some controls in place, including a … [Read more...]

Senate Passes Needed Reforms for HHSC Office of Inspector General

Sen. Juan "Chuy" Hinojosa

Yesterday, the Texas Senate passed and sent down to the House of Representatives Senate Bill 207, the bill setting out much needed reforms to the Health and Human Services Commission Office of Inspector General that came out of the Sunset Advisory Commission hearings last December.  The bill had ten amendments on the Senate floor and then was passed 30-0.  The bill will provide more due process … [Read more...]

National Dental Medicaid Fraud, Waste and Abuse $12 Million out of $2.2 Billion Total in 2014


The U.S. Department of Health and Human Services Office of Inspector General issued a report today detailing the cumulative efforts of state Medicaid Fraud Control Units in dealing with Medicaid fraud, waste and abuse in 2014. Pharmaceutical settlements are largest recoveries - $1.26 billion Cumulatively, $1.961 billion was recovered civilly from 889 providers and $293 million recovered from … [Read more...]

Overhaul of troubled Medicaid fraud division passes Senate

Health care providers who say they’ve been unfairly targeted by Texas Medicaid fraud investigators tallied a win Tuesday when the Senate passed a bill to crack down on that office and give doctors room to push back against bogus fraud allegations. The bill, Senate Bill 207, is part of a package of reforms to five health and human services agencies and seeks to address widespread problems within … [Read more...]

Senate okays Medicaid watchdog overhaul

The Senate passed a bill Tuesday that seeks to revamp the state agency that investigates fraud, waste and abuse in Medicaid and other state health services. The Office of Inspector General at the Health and Human Services Commission is supposed to act as a watchdog over state healthcare services, but Senator Juan “Chuy” Hinojosa of McAllen said the agency was rife with problems. During its very … [Read more...]

Medicaid Fraud Control Units Fiscal Year 2014 Annual Report

WHY WE DID THIS STUDY The Department of Health and Human Services (HHS) OIG is the designated Federal agency that oversees State Medicaid Fraud Control Units (MFCUs or Units or Unit). This MFCU Fiscal Year (FY) 2014 Annual Report highlights statistical achievements from the investigations and prosecutions conducted by the 50 MFCUs nationwide. The report also explores issues that affect Medicaid … [Read more...]

Senate aims to quell abuse from office meant to quell abuse

AUSTIN — A new bill to curb alleged abuses of an organization that is itself supposed to police abuses got Texas Senate approval Tuesday. Senators voted 30-0 to pass Senate Bill 207 by state Sen. Juan "Chuy" Hinojosa, D-McAllen, which would reform the Office of Inspector General of the Texas Health and Human Services Commission, the top state health agency. "Many of the issues have to do … [Read more...]

House Launches Contracting Inquiry at 11 State Agencies | The Texas Tribune

State Rep. John Kuempel, chairman of the House General Investigating and Ethics Committee, launched an official inquiry Monday into contracting practices at 11 state agencies.Kuempel requested information on contracts at the Health and Human Services Commission, where questions surrounding a $20 million, no-bid contract to Austin tech firm 21CT has prompted a string of resignations and multiple … [Read more...]

Public Integrity Unit rejects DPS bid to reopen border…

Gregg Cox, the Travis County prosecutor who oversees the embattled Public Integrity Unit, on Monday rejected a request from the Department of Public Safety to re-open an investigation into controversial border security contracts, telling Director Steve McCraw the unit does not have “sufficient staff or resources to accommodate your request at this time.” On Friday, McCraw sent a sharply-worded … [Read more...]

Is That Pile of Straw on Kyle Janek’s Camel About to Break Its Back?


Yesterday both the Austin American Statesman and Texas Tribune published new scathing exposes on contract handling at the Texas Health and Human Services Commission. Close personal relations with lobbyist of successful contractor This time however the stories did not involve either Jack Stick or the 21 CT contract but instead revolved around HHSC Executive Commissioner Kyle Janek and the … [Read more...]


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