The news that Smile Magic Dental clinics recently settled with the Texas Health and Human Services Commission Office of Inspector General over allegations of Medicaid fraud confirms what TDMR has been saying for a long time – that the purpose of the large volume of orthodontic and dental fraud allegations against Medicaid dentists has been to either force them into bankruptcy … [Read more...]
OIG “All Messed Up” – Videos from Texas Sunset Advisory Commission Public Hearings Online
Last Thursday, November 13th, the Texas Sunset Advisory Commission held public hearings about its staff report on the Texas Health and Human Services Commission that was released in October. The Commission heard over nine straight hours of submissions from various individuals and organizations from across the state on the 15 major issues delineated in the report. The two … [Read more...]
Medicaid Dentists to Testify before Senate Committee Tomorrow
Three Medicaid dentists who are involved in HHSC-OIG cases will be testifying tomorrow before the Texas Senate Committee on Health and Human Services. Dr. Chad Evans of Smile Magic from Dallas, Dr. Vivian Teegardin of Harlingen Family Dentistry and Dr. Paul Dunn from Levelland will be giving testimony regarding the lack of effectiveness of the current due process provisions … [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...]
HHSC Collecting SOAH Medicaid Provider Hearing Costs Because SOAH Worried About Funding
As was reported in the Austin American Statesman back on May 25th, the Texas Health and Human Services Commission is seeking tens of thousands of dollars in advance from dentists who wish to go before the State Office of Administrative Hearings for either a Medicaid payment hold or overpayment hearing. "Abusive" Attorney Tony Canales portrayed the large amounts of the … [Read more...]
HHSC “Judge” Denies Disqualification of HHSC “Judge”
HHSC appeals "judge" Keith Grantham has denied a motion to disqualify HHSC appeals "judge" Rick Gilpin from presiding over the overpayment "hearing" of M&M Orthodontics of San Antonio. The ruling came out April 4th. "Court," not court TDMR is now placing quotes around judicial terms relating to the HHSC appeals process because the Attorney General of Texas has given … [Read more...]
The Other Side of the Texas Medicaid Orthodontic Fraud Debate
The following is an opinion piece written by Jason Ray, attorney for a number dentists who are being prosecuted by HHSC-OIG for their Medicaid orthodontic billings. Mr. Ray is with the firm of Riggs Aleshire & Ray, P.C. I am familiar with the salacious allegations that many Texas dentists got rich on the back of Medicaid by committing fraud. I represent … [Read more...]
Settlement in Medicaid Fraud Case Worries Health Providers – NYTimes.com
The NY Times, in conjunction with the Texas Tribune, has published an article on the recent $3.75 million settlement between Carousel Pediatrics and the Texas Health and Human Services Commission Office of the Inspector General and its affect on the health care community in Texas. A major legal settlement with a children’s health provider in hand, a Texas agency … [Read more...]
Attorney General: HHSC courts are not “trial courts” and HHSC judges are not “judges”
This week the Texas Attorney General filed a remarkable brief to oppose the motion to disqualify HHSC judge Rick Gilpin from a Medicaid payment hold case because he was a senior lawyer in the Attorney General’s office for some 38 years before becoming an administrative law judge with HHSC. The motion to disqualify was brought by lawyers for M&M Ortho of San Antonio. It … [Read more...]
State, Carousel Pediatrics Settle Medicaid Fraud Case | The Texas Tribune
by Alexa Ura, The Texas Tribune March 17, 2014 Carousel Pediatrics, which has been the subject of a multiyear investigation in Texas, has settled its Medicaid fraud case with the Health and Human Services Commission’s Office of Inspector General, agreeing to pay the state $3.75 … [Read more...]