Another Legal Win for Medicaid Dentist: Appeals Court Tells OIG To Return Payment Hold Monies

Court roomThe 3rd Texas Court of Appeals has agreed with a Travis County District Court judge and has issued a ruling that the Office of the Inspector General should return over $1.2 million in withheld Medicaid funds to Harlingen Family Dentistry.  TDMR received a copy of the decision this morning and the Austin American Statesman has already published the story.

Appeal over a year old

Back in September of 2013, Travis County District Court Judge Amy Clark Meachum granted HFD’s motion for a writ of mandamus to force the Office of Inspector General to return the monies that OIG had taken under a “credible allegation of fraud” payment hold.

HFD brought the motion back in May, 2013 after HFD had been earlier found innocent of allegations of Medicaid fraud, waste and abuse at a payment hold hearing before the State Office of Administrative Hearings.  OIG refused to return the withheld funds despite the ruling. The whole chronology of the Harlingen Family Dentistry case is on the TDMR website.

Series of legal losses for OIG

The decision is another in a series of legal losses for OIG in prosecuting Medicaid dentists accused of “credible allegations of fraud.” It also follows on the heels of the recent Texas Sunshine Commission report which highlighted OIG’s many deficiencies in its investigations and handling of such cases.

OIG will likely appeal further

Austin attorney Jason Ray who brought forward both the original motion and the successful appeal believes that OIG most likely will further appeal the decision to a higher court rather than follow both the appeals court and district court order.

If this occurs, it highlights OIG’s serious need of reform, as highlighted by the Sunset Commission report, by again wasting taxpayer money and agency time in unnecessary litigation.

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