Dentists sue Texas, AG for ‘protecting’ Xerox | Dr. Bicuspid

May 27, 2014 — In the latest flurry of lawsuits in the Texas Medicaid scandal, eight dentists have filed suits claiming the state and attorney general (AG) “protected” Xerox because they feared a federal clawback for hundreds of millions of dollars in fraudulent orthodontic claims. The suits say state regulators gave Xerox a pass because acknowledging the company’s improper handling of claims would call into question why Texas repeatedly renewed Xerox’s contract.

Keeping track of the suits and countersuits in the state’s ongoing Medicaid saga is getting difficult. First, the state sued orthodontists to recover allegedly fraudulent Medicaid payments. Then, the dentists sued the state for withholding reimbursements for questionable claims. And earlier this month, the attorney general sued Xerox, alleging the company wrongly approved hundreds of millions of dollars’ worth of Medicaid claims for fraudulent orthodontic claims. Now, this fourth round of lawsuits has dentists blaming the state for continuing its contract with Xerox despite audits that questioned the claims approval process.

The dentists’ lawsuits were filed on May 15 in Travis County District Court seeking to intervene in the state’s lawsuit against ACS Healthcare, the Xerox subsidiary which handled Medicaid orthodontic claims. The suits were filed a week after Attorney General Greg Abbott filed the lawsuit against Xerox.

The lawsuits are identical and 25 pages in length. They were filed by Carlos Navarro, DDS, of Navarro Orthodontix; Rocky L. Salinas, DDS, of RGV Smiles; Scottie Nguyen, DDS, of Westmoreland Dental and Orthodontics in Dallas; Stephen Chu, DDS, in Richardson; Hieu Huynh, DDS, of Atlas Dental in Freeport; Richard Herrscher, DDS, in Athens; Victor Zurita, DDS, in Houston; and Irma Cantu-Thompson, DDS, in San Antonio.

“It is now believed that rather than prosecute Xerox for its failure to properly evaluate dentists’ prior authorization requests, the state and the Texas attorney general protected Xerox,” according to the complaints. “This protection included the state failing to allow TMHP [Texas Medicaid & Healthcare Partnership] to hire additional medically licensed staff, and in 2008-2009 telling TMHP to continue its prior authorization practices.” TMHP was an ACS/Xerox subsidiary that handled preauthorizations.

Dentists sue Texas, AG for ‘protecting’ Xerox.

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