The state's $235 million settlement this week with Xerox/Conduent, its former Medicaid claims administrator, unfortunately, leaves unresolved some disturbing questions about how the company could operate its insanely irresponsible orthodontic prior authorization process for so long with state officials either looking the other way or incapable of doing anything about it. While … [Read more...]
Smelling Like a Rose: Xerox/Conduent Settles Texas for $235 Million, Renews Contract in Indiana for $232 Million
Two days after they settled with Texas, Indiana re-awarded a four-year contract for Medicaid services, food assistance and temporary financial assistance for pregnant women and families to Conduent. The company will earn $232 million. Conduent stock also rose sharply after news of the settlement in Texas. It took a one-day nosedive in November from $19.22 to … [Read more...]
Whistleblowers File Motion for Their Share of $235 Million Xerox/Conduent Settlement
Dr. Christine Ellis testifying in Washington TDMR was informed yesterday that indeed there are qui tam relators associated with the Xerox/Conduent Medicaid fraud settlement and that their lawyers have now filed a motion to obtain their share of the $235 million in proceeds. The relators are Christine Ellis, DDS, Madelayne Castillo, Mary Espinoza, Mireya Miranda, Yarubi … [Read more...]
Texas Settles with Xerox for $235 Million Out of “Desire to Buy Peace and Avoid Further Litigation”
This morning Attorney General Ken Paxton announced that the State of Texas had settled its $2 billion Medicaid fraud lawsuit against Xerox/Conduent, its former Medicaid administrator from 2004 to 2012, for $235 million. The settlement over Xerox/Conduent's inadequate orthodontic prior authorization process was touted as a record recovery for Medicaid fraud in Texas. The … [Read more...]
Xerox Quality Assurance Checks on Ortho PAs Apparently Consisted of Re-checking the Addition of HLD Score Sheets
For those following the $2 billion Medicaid fraud case against Xerox/Conduent here in Texas, another plank in the state's case against the company is that it alleges that no meaningful Quality Assurance check was ever done to ensure medical necessity on some 500,000 orthodontic prior authorizations the company approved from 2004 to 2012. "Can't recall" Under deposition, … [Read more...]
“I approved all of them regardless” – Xerox/Conduent Dental Director on Ortho PAs
Dr. Jerry Felkner Some of the evidence that the state is using to pursue Medicaid fraud allegations against its former Medicaid claims administrator on its orthodontic prior authorization program from 2004 to 2012 comes directly from depositions of the Xerox/Conduent dental director, Dr. Jerry Felkner. Xerox/Conduent kept telling the state in their policy manuals that he was … [Read more...]
Xerox/Conduent Settling Its $2 Billion Dental Medicaid Fraud Case with Texas?
TDMR has learned that Xerox/Conduent is in talks with the Office of Attorney General to settle the $2 billion Medicaid fraud case against the company, once Texas' Medicaid claims administrator. The amount is calculated to include triple damages and civil penalties for every illegal act performed for almost two hundred thousand alleged illegal acts. Started back in … [Read more...]
State Medicaid Managed Care Advisory Committee Meeting to be Held February 25
February 25, 2019 - 1:00pmHealth and Human Services Commission, Brown-Heatly Building, Public Hearing Room4900 North Lamar Blvd.Austin, TX 78751 This meeting will be webcast. To access the webcast, go to https://hhs.texas.gov/about-hhs/communications-events/live-archived-meetings the day and time of the meeting. Call to orderRoll callAdoption of December 12, 2018, draft … [Read more...]
State Board of Dental Examiners Holding Stakeholder Meeting Today in Austin
The TSBDE is holding a public stakeholder meeting this afternoon at the William B. Hobby Building in Austin on a "possible amendment of Board rule 22 TAC §108.14 - Pediatric and Special Needs Case Management; Protective Stabilization." Notice apparently not on website We could not find the notice shown below on the TSBDE website despite looking on various pages. The news … [Read more...]
Dental Managed Care Issues Receive Legislative Attention with Meeting at the Capitol
Back on November 21, House Human Services Committee Chairman Richard Peña Raymond held a meeting with a select group of dental providers regarding dental managed care issues. Providers requested meeting The meeting was initially requested by South Texas Dental but was expanded to include other dental groups and the Texas Dental Association which were invited through Raymond's … [Read more...]