This past Friday, the Texas Supreme Court dismissed a petition from the Texas Office of Attorney General to review a 3rd Court of Appeal decision preventing the Health and Human Services Commission Office of Inspector General from placing payment holds … Read More
As TDMR reported back at the end of September, the new Health and Human Services Commission Inspector General Stuart Bowen had started settling outstanding investigations and cases against Medicaid dentists and providers. Senator Charles Perry was quoted in the media … Read More
Earlier this month, the Attorney Generals of Illinois and Arkansas announced the arrest and/or conviction of three individuals in different cases for Medicaid fraud. Going to jail for $1,000 The amounts of the fraud involved were around $1,000 per party … Read More
Last Friday, the Health and Human Services Commission sent out a notice that it had “updated its Medicaid Medical and Dental Policy web page by posting stakeholder comments and HHSC responses for the THSteps Diagnostic Dental Services policy in development.” … Read More
A document received from an open records request filed in early September shows that the Civil Medicaid Fraud division of the Office of Attorney General (OAG) has expended some 20,953 staff legal hours against 16 dentists and dental practices accused … Read More
The Texas State Board of Dental Examiners is under review by the Sunset Advisory Commission this year. The Board has published a 154-page self-evaluation report that can be downloaded from the Commission website. TDMR has not yet reviewed it. The Sunset Commission … Read More
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, … Read More
UPDATE: Stick has been sentenced to six days in jail. The man who famously carried a toy stuffed wolf into informal resolution meetings with Medicaid providers and quipped that he could “find a program violation on Jesus Christ” if Jesus … Read More
As reported last week by the Austin American Statesman, Stuart Bowen, the new Inspector General for the Texas Health and Human Services Commission, is sending his first report to the Governor today. TDMR has obtained a copy of the full … Read More
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 … Read More
Back in May of 2014, the State of Texas terminated Xerox as the state’s Medicaid claims administrator and filed suit against the company. The state is seeking recompense for hundreds of millions of taxpayer dollars paid out by the company for … Read More
Dallas TV station WFAA is losing its long-time, award-winning investigative reporter Byron Harris to retirement. Harris announced a few weeks ago that he would be leaving the station in October, after spending 40 years with WFAA. It goes without saying … Read More
The Health and Human Services Commission has just put online proposed changes to the THSteps Diagnostic Dental Services Policy and is requesting stakeholder feedback on the changes. The updated policy will require the use of a professionally developed and … Read More
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 … Read More
UPDATE, August 11, 2015: We have been informed by a very keen-eyed and interested observer that the definition of “physician” under the Social Security Act includes dentists. So we are not sure why the Texas Health and Human Services Commission … Read More
A name familiar to many Medicaid dentists who have felt the sting of Doug Wilson and Jack Stick’s Office of Inspector General in the last few years has resigned, per the Texas Tribune. Cody Cazares, an aide to former Health … Read More
The story about Dr. Rachel Trueblood settling in October 2014 with the Health and Human Services Commission Office of Inspector General for $39,000 after the agency was demanding $16 million in Medicaid overpayments is well-known. However, the story of another … Read More
In January, Stuart Bowen took charge of a state office rocked by accusations of corruption, incompetence and inefficiency. Responsible for ferreting out fraud amid the programs and procedures of the sprawling Health and Human Services Commission, the office of Inspector General … Read More
TDMR has learned that the new Health and Human Services Commission Inspector General Stuart Bowen, Jr. has been taking on and overhauling the agency’s use of statistical sampling and extrapolation. This is the most controversial tool that the agency had … Read More
The vicissitudes of Dr. Paul Dunn have been chronicled by TDMR over the last several years. Dunn first appeared on the scene when he came to Austin during the 2013 legislative session. “Credible allegation of fraud” payment hold, but told … Read More
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 … Read More
The eight steps you need to take to put together a program for yourself! Many people have asked what the process for establishing an effective compliance program is. At one point, having a compliance program was optional. As a result … Read More
Here is the June/July edition of the Texas Medicaid News! Hello and welcome to the Texas Medicaid news update, I’m Andy Zajac. Things have been hot and heavy over the last few weeks in Austin. 1) Our top story is … Read More
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 … Read More
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 … Read More
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 … Read More
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. … Read More
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 … Read More
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 … Read More
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. … Read More
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 … Read More
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 … Read More
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 … Read More
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 … Read More
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 … Read More
TDMR has started a regular video news segment that will be carrying Texas Medicaid news plus relevant stories from around the country. Over the next few weeks, we will be starting to include interviews with key players in Texas. Our … Read More
Today, the Health and Human Services Commission announced that it has put up a new page on its website for Medicaid providers to comment and stay abreast of policy changes relating to Medicaid covered medical and dental treatments. The new … Read More
UPDATE: After publishing this article, TDMR was alerted that it is a DENTIST, not a medical doctor that is involved in this case. It involves the Rhoden Group from Corpus Christi with Dr. Cheryl Rhoden, DDS as the principal. This … Read More
Dr. Paul Dunn, a small town general dentist who practices orthodontics out of Levelland, has had a case outstanding with the Health and Human Services Commission Office of Inspector General since 2011. He has been under severe financial strain since … Read More
Senate Bill 207 which details legislative reforms to be made to the structure and function of the Health and Human Services Commission Office of Inspector General as recommended by the Sunset Advisory Commission has cleared the Texas Senate and is set … Read More
