The office of Attorney General Greg Abbott — the Republican gubernatorial candidate — is appealing a whistleblower’s lawsuit and $1.2 million verdict, arguing that an El Paso jury was wrong when it decided that the agency fired an employee in … Read More
June 19, 2014 — Colorado adults on Medicaid now have dental coverage, including an annual benefit of up to $1,000 in dental services. Previously, only emergency dental services were covered, according to Oral Health Colorado. The benefit enables adults age … Read More
Texas’ Republican leadership made sure the state didn’t expand its Medicaid program to poor, uninsured adults — an optional provision of the Affordable Care Act. But low-income parents here are increasingly getting covered by the joint state-federal insurer anyway — … Read More
The owner and operator of a Houston area ambulance company was sentenced today to serve 97 months in prison for her role in a $2.4 million Medicare fraud scheme. Assistant Attorney General Leslie R. Caldwell of the Justice Department’s Criminal … Read More
June 6, 2014 — Illinois lawmakers have passed a bill to restore adult dental coverage for Medicaid patients after emergency room costs for dental problems mushroomed when the program was cut. The bill now goes to Gov. Pat Quinn for … Read More
Xerox Corp at the end of May was awarded a $500 million contract to revamp New York’s Medicaid system despite Texas suing the company and discontinuing their contract as chief Medicaid claims administrator in the state. The Rochester Democrat and … Read More
HOUSTON – Leonard Kibert M.D., 63, of Houston, has been charged in a 47-count indictment alleging a conspiracy to defraud Medicare of $2.9 million, announced United States Attorney Kenneth Magidson. Also charged in the indictment are Tsolak Gevorgyan, 28, Christopher … Read More
AUSTIN — As he gears up for a possible second presidential run, Texas Gov. Rick Perry is crisscrossing the country extolling a business-first philosophy he says made his state’s economy white-hot — and can work for the rest of America … Read More
Yesterday, HHS-OIG issued an audit entitled “Acute-Care Hospitals In Texas Did Not Always Reconcile Invoice Records With Credit Balances And Refund To The State Agency The Associated Medicaid Overpayments.” The federal auditors, in looking over eight acute care hospitals in Texas, … Read More
Of the eight acute-care hospitals in our sample, one hospital always reconciled patient accounts and refunded associated Medicaid overpayments to the Texas Health and Human Services Commission (State agency). However, the seven remaining hospitals in our sample did not always … Read More
Deloitte Report for Texas As market pressures continue to mount, states are not only looking to derive more value from their managed care programs but also seeking to use these programs to address CMS’ Triple Aim: better health, better quality, … Read More
Health and Human Services (HHS) Secretary Kathleen Sebelius today announced the availability of up to $300 million under the Affordable Care Act to help the nation’s community health centers expand service hours, hire more medical providers, and add oral health, … Read More
Of the eight acute-care hospitals in our sample, one hospital always reconciled patient accounts and refunded associated Medicaid overpayments to the State agency. However, the seven remaining hospitals in our sample did not always reconcile patient account credit balances and … Read More
One doctor served prison time for health-care fraud. Another has been disciplined by regulators five times, on charges including dangerous overuse of anesthesia. A third devotes his practice to a controversial therapy that Medicare won’t cover. That didn’t stop Medicare … Read More
The Texas Health and Human Services Commission Office of Inspector General has published its annual report of Medicaid fraud and abuse recoveries by managed care organizations in the state. Well, it is a year behind. This one is for 2013. … Read More
Medicare spent $6.7 billion too much for office visits and other patient evaluations in 2010, according to a report from the inspector general of the Department of Health and Human Services. But in its reply to the findings, the Centers … Read More
May 28, 2014 — Two orthodontists have filed a civil rights lawsuit against the Arkansas State Dental Board of Examiners, seeking “declaratory and injunctive relief” and trying to change Arkansas’ Dental Practice Act, which prevents dental specialists from providing teeth-cleaning … Read More
HHSC yesterday sent out a notice that a new draft HHSC strategic plan has been issued to cover 2015 to 2019. They have invited public comment. Naturally, the report is 348 pages long and their first public hearing on the report … Read More
Texas has received federal approval to test an innovative idea that combines health services for people with both Medicaid and Medicare coverage into one plan, making it easier to get care and potentially saving money for the state and federal … Read More
A Texas dentist appointed by Gov. Rick Perry to a state board has resigned from the panel after being arrested on charges he secretly recorded an employee as she changed clothes. Dr. William Birdwell was a member of the Texas … Read More
May 27, 2014 — In the latest flurry of lawsuits in the Texas Medicaid scandal, eight dentists have filed suits claiming the state and attorney general (AG) “protected” Xerox because they feared a federal clawback for hundreds of millions of … Read More
Gov. Rick Perry has reappointed Cathleen Parsley of Austin as Chief Administrative Law Judge for the Texas State Office of Administrative Hearings for a term to expire May 15, 2016. The judge oversees hearings in contested cases to ensure they … Read More
May 20, 2014 — This year more than 181 million Americans won’t visit a dentist, nearly half of people older than 30 suffer from some form of periodontal disease, and about 1 in 4 children younger than age 5 already … Read More
May 20, 2014 — In the wake of a Texas lawsuit that claims Xerox wrongly approved Medicaid claims for orthodontic services that were not medically necessary, some of the dentists being pursued for orthodontic overpayments are now suing Texas for … Read More
The Obama administration’s efforts to crack down on bogus Medicare payments have ended up sweeping in too many “good actors” who get ensnared in a costly and tedious appeals process, House lawmakers said Tuesday. While tackling Medicare fraud is worthwhile, … Read More
The Texas Tech University System Board of Regents officially named state Sen. Robert Duncan, R-Lubbock, the sole finalist to be the system’s next chancellor in a press release issued Monday afternoon. Duncan is expected to start in his new position … Read More
Last week, Attorney General Greg Abbott filed a lawsuit against Xerox and its subsidiary, ACS Healthcare, alleging that the company had not properly vetted dentists’ pre-authorization requests to perform Medicaid orthdontic work on poor children, saddling taxpayers with hundreds of … Read More
Last year, state regulators accused Dallas-area dentist Everett Evans of bilking Medicaid out of millions of dollars by performing unnecessary procedures and billing for work he didn’t do. They froze more than $800,000 in pending payments to him from the … Read More
AUSTIN, Texas, May 9, 2014 /PRNewswire/ — The lawsuit filed today by the Texas Attorney General’s office regarding Xerox’s performance administering the state’s Medicaid orthodontic program is misdirected. Xerox will defend itself vigorously. We are also disappointed with the HHSC … Read More
The state of Texas on Friday moved against the contractor in charge of pre-authorizing controversial orthodontic and dental procedures, canceling a large contract with ACS Healthcare and suing the company and its corporate owner, Xerox Corp., to recover hundreds of … Read More
As the Texas Attorney General’s office on Friday announced it filed a lawsuit against state contractor Xerox, in an effort to reclaim hundreds of millions of dollars the company allegedly erroneously doled out for medically unnecessary Medicaid claims, the Health … Read More
AUSTIN — Attorney General Greg Abbott sued Xerox Corp. Friday over allegations that it let unscrupulous dentists put braces on thousands of poor children who didn’t meet the government’s strict criteria for the expensive work. Also Friday, the state’s Medicaid … Read More
AUSTIN – The Texas Attorney General’s Office today filed a civil lawsuit in state district court against Xerox Corporation and its wholly owned subsidiary, ACS Healthcare LLC. The State’s legal action seeks to recover fraudulent Medicaid payments for orthodontic and … Read More
Date: May 9, 2014 Contact: Stephanie Goodman, 512-424-6951 The Texas Health and Human Services Commission (HHSC) today notified Xerox Corp. that the state is terminating the company’s Medicaid claims administration contract for cause after Xerox staff approved thousands of requests for braces … Read More
San Antonio (CNN) — Clerks scheduling medical appointments for veterans were “cooking the books” at their bosses’ behest to hide the fact some had to wait weeks, if not months, for appointments, a VA scheduler in San Antonio said Thursday. … Read More
The New York Times has published Trib reporter Becca Aaronson’s article on TMHP. For nearly five years, a state contractor allowed workers with limited expertise to approve dental claims for Texas’ Medicaid program, the joint state-federal insurer. State spending on … Read More
ay 6, 2014 — Washington state is the leading provider of preventive dental care to children, with more than 54% of Medicaid-eligible preschoolers and younger children getting oral care, according to the U.S. Centers for Medicare and Medicaid Services. Some … Read More
May 1, 2014 — Chances are every six months an appointment shows up on your patient’s calendar that it is time for their biannual visit to the dentist. They didn’t make this appointment because they had an aching tooth or … Read More
by Becca Aaronson, The Texas Tribune May 2, 2014 Part two of two. For nearly five years, a state contractor allowed workers with limited expertise to approve dental claims for Texas’ Medicaid program, the joint state-federal insurer. State spending on … Read More
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. … Read More
