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 … [Read more...]

San Antonio Seminar Helping Providers Understand Compliance and Enforcement Issues

san antonio seminar 7 feature

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 … [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 … [Read more...]

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

greg abbott2

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 … [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 … [Read more...]

HIPAA, Meaningful Use And The False Claims Act

health care providers

The term “Meaningful Use” is the federal government’s way of describing the use of certified Electronic Health Record (EHR) technology, in a meaningful manner to achieve specific standards, namely: Improve quality, safety, efficiency, and reduce health disparities Engage patients and family Improve care coordination, and population and public health Maintain privacy and security of … [Read more...]

HHSC Commissioner Kyle Janek to Resign

janek

The Texas Tribune just reported the following this morning: Kyle Janek, the head of the state’s embattled Health and Human Services Commission, will step down and be replaced by his former deputy, sources with direct knowledge of the move said Friday. Gov. Greg Abbott is expected to announce Friday that Chris Traylor, who recently retired from the health agency, will take over for Janek. … [Read more...]

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

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Back last August, the Department of Health and Human Services Office of Inspector General released an audit report that the Texas Health and Human Services Commission was responsible for the conduct of its Medicaid claims administrator for the hundreds of millions of dollars of increased spending on Medicaid orthodontia from 2008 to 2011. HHSC and Xerox found responsible for extent of Medicaid … [Read more...]

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

xerox -hhsc

On May 29th, the Texas Health and Human Services Commission issued its request for proposal for the contract management of Texas Medicaid. So if you are so inclined, you can take the place of Xerox as the state's Medicaid claims administrator.  Xerox was terminated as the prime contractor by HHSC in May of last year and sued by the state over its allegedly fraudulent Medicaid orthodontic prior … [Read more...]

UPDATE: SB 207 Going to Governor Abbott for Signature

Texas Capitol

Today, SB 207 with minor changes was approved by both Texas House and Senate conference committees. SB 207 is the bill that contains  the Sunset reforms to the Health and Human Services Commission Office of Inspector General. The next step is for the final bill to be sent to Governor Abbott for his signature to pass it into law. The bill progress can be tracked on the Texas Legislature … [Read more...]

SB 207 Passes Texas House 142-0

Texas State Representative Seats

Sunday night on this Memorial Day weekend, the Texas House of Representatives passed Senate Bill 207, the legislation that will reform the Health and Human Services Commission Office of Inspector General. The recorded vote was 142-0. The bill now goes back to the Senate to concur with the bill or conference any changes with the House. Then it goes before Governor Abbott for his … [Read more...]

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

xerox -hhsc

The front-page of the Austin American Statesman Sunday morning carried the full story of the unprecedented ruling by the State Office of Administrative Hearings (SOAH) to award a Medicaid dentist back some $380,000 in legal fees from the Health and Human Service Commission Office of Inspector General (OIG) on a Medicaid payment hold case. TDMR has obtained a copy of the SOAH proposal for … [Read more...]

Texas Dentists for Medicaid Reform

and Star Compliance Services

 are holding a healthcare compliance

seminar in:

Dallas, Friday, July 17