The Houston Chronicle (story behind a paywall) reported this morning that Leah Rayne, HHSC’s business technology architect, was fired because she “admitted to officials that she leaked details about an internal strategy meeting to Truven Health Analytics…[the] company that was in final negotiations for … Read More
On September 24th, the House Public Health Committee chaired by Rep. Lois Kolkhorst heard testimony from the Texas State Board of Dental Examiners about implementation of changes to the dental board from legislation enacted last legislative session, in particular HB … Read More
The following article was published today in the Texas Tribune, authored by Christine Ayala and Jay Root. UPDATE: The same article was republished in the New York Times with the title “A Texas Official’s D.W.I. Case Is Being Seen in … Read More
On September 3rd, Douglas Wilson Inspector General for the Texas Health and Human Commission Office of Inspector General, testified on the implementation by his department of due process rights under SB 1803 before the House Human Services Committee. Wilson testified … Read More
The following is a writeup done by a dentist on the Medicaid orthodontic program. He previously wrote on his experience with the program. This is a discussion of the Medicaid Insurance Program that covered general dentistry and the specialty of … Read More
The Houston Chronicle reported yesterday and today that the Texas Health and Human Services Commission ended a tentative contract with Truven Health Analytics of Ann Arbor, Mich., because of potential insider influence for the company. The contract was for a major “enterprise data … Read More
TDMR received the following from a Texas Medicaid dentist who wishes to tell his story about his history with the HLD scoring system and the current state of Medicaid for orthodontia. He asked to remain anonymous. When I began working with … Read More
On September 3rd, Rachel Hammond of the Texas Association for Homecare and Hospice testified before the House Human Services Committee on SB 1803 and due process rights for Medicaid providers. Hammond gave examples of difficulties that their members were having … Read More
Dr. Behzad Nazari of Houston testified before the House Human Services Committee on September 3rd on SB 1803 and due process rights for Medicaid providers. Nazari’s Antoine Dental clinics was put under a 100% payment hold for their Medicaid orthodontic … Read More
Dr. Chad Evans of Smile Magic Dentistry in Dallas testified before the House Committee on Human Services last week regarding his experience with due process rights for Medicaid providers under SB 1803 and the HHSC Office of the Inspector General. … Read More
Dr. Paul Dunn testified before the House Human Services Committee last week about his experiences with the Health and Human Services Commission Office of the Inspector General and SB 1803. Dunn testified last year before the same committee and more … Read More
This past Wednesday, the Texas House Human Services Committee held public testimony on the effectiveness of SB 1803 passed last session to put into legislation due process rights for Medicaid providers under investigation by the Health and Human Services Commission … Read More
This past Wednesday, the same day as the House Committee on Human Services hearing on SB 1803, HHSC sent out a notice that it had placed online a video for Medicaid providers about Office of the Inspector General investigations. This … Read More
The following excerpt is from the Houston Chronicle about Xerox and the State coming to an agreement on the disputed files. AUSTIN – Lawyers for the Xerox Corp. agreed Thursday to temporarily turn over private health information about millions of … Read More
On August 14th, the Senate Committee on Health and Human Services heard testimony regarding Medicaid fraud, waste and abuse. The full presentation given by Chris Traylor, Chief Deputy Commissioner, Douglas Wilson, Inspector General, Kay Ghahremani, Texas Medicaid/CHIP Director, and Joseph … Read More
The Texas House of Representatives Committee on Human Services has announced that it will be holding a public hearing on Wednesday, September 3rd, which will include hearing testimony regarding the effectiveness of SB 1803 and changes that should be made to the … Read More
The state is suing Xerox for a second time, afraid the company’s recent actions in withholding a large number of documents relating to its tenure as the state’s primary Medicaid claims administrator will lead to millions of dollars of federal … Read More
In a stunning reversal of their previous hard-line stance, State regulators have settled a high profile “fraud” case for less than a penny on the dollar. Trueblood Dental Associates, an Austin dental practice with four locations and a high percentage … Read More
Texas Health and Human Services Commission Inspector General Doug Wilson told Sen. Judith Zaffirini and other members of the Senate Committee on Health and Human Services at their August 14th hearing on Medicaid fraud, waste and abuse that his agency … Read More
Sen. Jane Nelson quizzed Health and Human Services Commission Inspector General Doug Wilson about the lack of Medicaid fraud convictions in Texas despite the tremendous resources the Legislature gave to the OIG last session. The questioning occurred during the August 14th … Read More
The following is the testimony presented last week to the Texas Senate Committee on Health and Human Services by Jason Ray of Riggs Aleshire & Ray in Austin. Ray is an attorney for a number of Medicaid dentists who have … Read More
As part of its charge in its hearing last Thursday, the Texas Senate Committee on Health and Human Services looked into the state of the Texas State Board of Dental Examiners. The Executive Director Julie Hildebrand, the Director of Enforcement Lisa … Read More
Three dentists testified before the Senate Health and Human Services Committee on Thursday about their experiences with the Texas Health and Human Services Commission Office of the Inspector General and how their due process rights are still being violated despite … Read More
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. … Read More
Last Wednesday, the Department of Health and Human Services, Office of Inspector General released the results of its long anticipated audit of Texas Medicaid orthodontic spending. The feds conducted the audit because Texas Medicaid payments for orthodontic services rose from … Read More
At a recent deposition in Austin, lawyers for a dental Medicaid provider discovered that the State has invested thousands of dollars to employ a well-known Dallas jury consultant to help prepare the State’s witnesses to testify in depositions and in administrative … Read More
At the end of July, Xerox, Texas Medicaid’s disgraced former claims administrator, filed for a protective order with the Travis County District Court. The stated reason for the order is because the Office of the Attorney General has apparently demanded … Read More
The Senate Committee on Health and Human Services has sent out public notice that it will be holding a public hearing at the Capitol in Austin on Thursday, August 14th. One of the charges the Committee will look into at … Read More
Last week Xerox filed a response to both the lawsuit filed by the State of Texas and its dentist intervenors about Xerox’s allegedly deficient Medicaid orthodontic prior authorization process that led to $1.1 billion in program spending without proper review. … Read More
Letters to both Rep. Richard Peña Raymond and Rep. Lois Kolkhorst, chairmen of the House Human Services and Public Health Committees respectively, have been sent from TDMR President Greg Ewing requesting a public hearing on SB1803 and HHSC’s compliance to … Read More
Back in May, shortly after Texas filed suit against Xerox and removed the company as the lead contractor in the Texas Medicaid and Healthcare Partnership for its failure to properly handle Medicaid orthodontic prior authorizations leading to $1.1 billion in … Read More
As part of the lawsuit against Xerox, the former lead contractor for the Texas Medicaid and Healthcare Partnership, the Texas Office of the Attorney General alleges that Xerox, from the beginning of its contract with Texas, wrote misleading documents that … Read More
In the lawsuit against Xerox filed by the Texas Attorney General, there is one more startling revelation. The State is alleging that Xerox as early as 2004, when the company took over the contract as the state’s Medicaid claims administrator, the … Read More
Back in January 2009, a Medicaid Orthodontic Stakeholder meeting was held in Austin at the offices of the Texas Dental Association. Dr. Linda Altenhoff presided at the meeting. Dr. Altenhoff is currently the Dental Director for the Texas Health and … Read More
Apparently TMHP/Xerox “dental specialists” were only trained to add up HLD scores on Medicaid orthodontic pre-approval requests and determine whether the total was 26 points or more, per allegations contained in the lawsuit filed against Xerox by the Attorney General … Read More
As reported in May, the Office of the Attorney General of Texas filed suit against Xerox as the state’s lead contractor in the Texas Medicaid and Healthcare Partnership. The state is seeking to recover fraudulent Medicaid payments for orthodontic and dental … Read More
Michael McMillen, former Deputy Chief Counsel, Texas Health and Human Services Commission Office of Inspector General, is suing the HHSC for wrongful dismissal after reporting alleged violations of law within the agency. The nature of the alleged violations are not known. The … Read More
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, … Read More
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 … 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
