Conduent Strikes Again! Texas Awards Company $147.7 million Medicaid Contract in December

ConduentWhat happens if a company gets sued for $2 billion by the State of Texas for Medicaid fraud as its former Medicaid claims administrator, then tries to pay the settlement by committing insurance fraud?

Texas gives them a new contract!  And for apparently the same position they were originally fired from -- approving fee-for-service Medicaid services!

Conduent gets big Medicaid contract

Yes, Texas Health and Human Services contracted in December with Conduent Health Services to "provide both acute and long-term care fee-for-service claims-processing services" for $147.7 million (contract and offer PDF files below).

Now the original fraud of which the company was accused, rubber stamping hundreds of millions of dollars in orthodontic Medicaid requests between 2004 and 2012, was committed by a predecessor ACS Health Services.  Xerox bought ACS in 2009 but continued the rubber stamping until investigative reporter Bryon Harris and WFAA exposed the extravagant billings in 2011.  In 2014, with great fanfare, the State fired Xerox as its Medicaid claims administrator over the fraud, then sued for billions a few months later.

The state had to fire Xerox because the claims of massive fraud by Medicaid dentists in HLD scoring were finally debunked.  Xerox spun off Conduent in 2017.

Insurance fraud

Keeping to old ways, Conduent tried to get its insurance companies to pay part of the $236 million settlement with the state in 2019.  Unfortunately, the insurance companies didn't like that and a Delaware jury found Conduent guilty of insurance fraud in 2022. The Texas Attorney General's Civil Medicaid Fraud unit apparently helped out.

After all, as long as the state gets its $236 million back, who cares how it is obtained?

Everything A-OK with HHS

When asked about the contract, according to a story by John C. Moritz, Austin Bureau Correspondent, for USA Today, HHS responded:

"Tiffany Young, spokeswoman for the state health commission, did not address the agency's past issues with Conduent, but expressed confidence that the state's interests will be protected under the current contract.  "Texas Health and Human Services has a strong, competitive procurement and contract-management process to ensure that vendors meet their obligations," Young said in a written statement.""

A similar question to Conduent brought this response:

"In a statement this week, Conduent spokesman Sean Collins said the now-reorganized company was selected by the Texas agency after "a competitive and rigorous bidding process."

"We fulfilled the terms of a settlement with the state more than three years ago to resolve an unrelated matter going back to the 2004–2014 time period," Collins said in an email. "Conduent supports 23 states with the same government health technology and eligibility services that we expect to provide to Texas, and we are committed to supporting the Commission’s focus on providing excellent service and support to meet the needs of the state’s residents.”"

A great story, don't you think?  Something Texas citizens might want to know.

Story buried

Well, apparently the only place this story is available is behind the paywall of a few local Gannet papers around the country like the Corpus Christi Caller Times.  You have to pay a buck for a short-term digital subscription.  The story is nice and buried.

Honestly, we were waiting for a story like this. It was just a matter of time.

Providers forgiven?

Is it just a matter of time before the state forgives Dr. Richard Malouf and makes him Medicaid dental director?  You might think so based on this circumstance.

But we don't think so.  Texas doesn't roll that way with providers.

Request for Offers November 2021

Conduent Contract December 2022

6 Responses

  • HHSC has never held any contractors, employees or providers (for that matter) accountable for wrongdoing. HHSC wants to make sure they keep getting their “wish lists” funded from the State. To take adverse action against a contractor or provider who is a huge campaign contributor to legislators who sit on key finance committees or appointment committees is just not going to happen. As for employees, Stick and Wilson were fired, but what about the HHSC staff who allowed Xerox to go so many years rubber stamping everything? Nothing. Everyone knows this so why ask silly questions? I don’t know how people in positions of authority look at themselves in the mirror and say they are doing what’s best for Texas taxpayers because they are all simply doing what’s best to keep their jobs. Always has been that way, always will be.

  • Dear Verite,

    I suspect you are referencing a troubling individual formerly serving in Texas state government, Billy Millwee. He was until August 2012, the Texas Health and Human Services Deputy Executive Commissioner and Texas Medicaid Director. His lack of effective oversight was very upsetting.

    Today, Billy Millwee has progressed. He is President/CEO and Founder of BM&A Public Policy, a Medicaid lobbyist & policy group.

    Michael W Davis, DDS
    Santa Fe, NM

  • How can a company who was removed from
    The Medicaid account for fraud, be awarded another contract?? ACS=Conduent…same players and same game…

  • Dear E Mesa,

    Serious money is to be made in dental Medicaid. It’s not so much as a provider of services, but as a state contracted managed care organization (MCO) or third party administrator (TPA).

    In the following article I examined public record lobbyist reports by these Texas MCOs & TPAs.

    As the old expression goes, “Follow the money.”

    Michael W Davis, DDS
    Santa Fe, NM

  • Learn your history. It started before Conduent. The ones who made out like bandits were gone after they dumped Xerox with a bad deal. ACS tried to get others to buy them but were left at the alter. The founder did alright. Founders family is doing pretty well too. Medicaid is political candy for well connected girls and boys. The players all know this, as well as how the game is played.

Leave a Reply

Your email address will not be published. Required fields are marked *