Today the Sixth Court of Appeals issued their decision in the Medicaid payment hold case of Antoine Dental Center of Houston. The court again exonerated the practice from allegations of Medicaid fraud, again terminated the payment hold and, for the first time, awarded them court costs. The court's decision can be downloaded here and its judgment awarding court costs … [Read more...]
OIG Settling Old Dental Medicaid Cases, But the OAG Retooling Some of Them
As reported in the press this week, there has been a tremendous effort on the part of the new Health and Human Services Commission Inspector General Stuart Bowen to settle old, outstanding investigations against Medicaid providers—including dentists. Per the Chronicle, Bowen has offered settlements to nearly 100 Medicaid dental providers “to clear the decks” as previous … [Read more...]
Antoine Dental Center District Court Victory Appealed – Are Taxpayers Being Served?
The recent decision by a Travis County District Court judge that again vindicated Antoine Dental Center of Houston on allegations of Medicaid fraud and vacated a three-year "credible allegation of fraud" payment hold has been appealed by the Civil Medicaid Fraud division of the Office of Attorney General. A copy can be downloaded here - Notice of Appeal. The Civil Medicaid … [Read more...]
Antoine Dental Vindicated! Court Overturns HHSC Ruling on Alleged Fraud and Payment Hold
Yesterday, Travis County District Court Judge Amy Clark Meachum issued her decision in the case of Antoine Dental Centers of Houston, vindicating the practice in its payment hold case. The practice had been accused of "credible allegations of fraud" in its Medicaid orthodontic billings from 2008 to 2011. Appeal of Janek's decision Antoine was appealing the final decision … [Read more...]
State loses yet another round in dental fraud war | Statesman
A district court judge on Wednesday handed state Medicaid regulators another decisive courtroom loss, adding one more notch to the Health and Human Service Commission’s Office of Inspector General’s unenviable losing streak pursuing dentists and orthodontists it claims have bilked the federal entitlement program. In fact, regulators have yet to claim a single outright court … [Read more...]
Janek’s “Capricious” Decision in Antoine Dental Case Challenged in District Court
Last Wednesday, July 16, lawyers for Antoine Dental Centers of Houston again went to court. Going Travis County District Court This time they appeared before Travis County District Court to appeal the Medicaid payment hold final decision by former Health and Human Services Commission Executive Commissioner Kyle Janek that was issued back on May 7, 2014. Janek decision … [Read more...]
Court Sides with Medicaid Dentists and Negates HHSC-OIG Rules on Medicaid Payment Holds for Program Violations
Today, the Texas 3rd Court of Appeals overturned a lower court decision and negated Health and Human Services Commission rules that allow for the Office of Inspector General to place Medicaid payment holds in certain circumstances, basically for only program violations not fraud, and then keep the funds to offset alleged overpayments by the provider. A copy of the decision is … [Read more...]
Kyle Janek Rules – “Dentists Found Innocent by SOAH, Are Guilty”
On May 7th, Dr. Kyle Janek, the Executive Commissioner of the Texas Health and Human Services Commission, issued his final order in the case of Antoine Dental Center of Houston. Upheld reversal of favorable SOAH ruling on Antoine Dental As expected, Janek overturned SOAH’s payment hold ruling, which was favorable for Antoine Dental. That SOAH ruling found no prima facie … [Read more...]
Company That OK’d Unnecessary Braces Kept Its Contract | The Texas Tribune
by Becca Aaronson, The Texas Tribune May 1, 2014 Part one of two. In 2010 and 2011, Antoine Dental was among Texas’ top-billing Medicaid providers for orthodontic services, collecting more than $1 million annually for putting braces on poor children. Its three Houston-area clinics employed 15 dentists and orthodontists and treated more than 2,500 young patients annually … [Read more...]
Medicaid Ortho Case Photos with HLD Scores by Provider and Experts
A recent review of our website content revealed to us that while PDF files containing these photos have always been on the site, perhaps they have not been as prominently displayed as they should be. Medicaid after all is about benefiting indigent children and the controversy is whether or not children such as these should have been treated under Texas Medicaid as the … [Read more...]