Texas Capitol StatueOn March 20th, HB 1536 came before the House Committee on Human Services and four hours of testimony was heard by Committee Chair Rep. Richard Peña Raymond, Vice Chair Rep. Naomi Gonzalez, Rep. Pat Fallon, Rep. Stephanie Klick, Rep. Elliott Naishtat, Rep. Toni Rose, Rep. Scott Sanford, Rep. Scott Turner and Rep. John Zerwas.

The bill had a great deal of support including the Texas Academy of General Dentistry, the second largest dental organization in the state, the Texas Hospital Association and the Texas Medical Association.

Rep. Bobby Guerra of District 41, co-author of the legislation, introduced the bill and spoke about the necessity of providing Medicaid providers due process rights as outlined in the bill which provides for the State Office of Administrative Hearings to hear OIG overpayment hearings rather than the HHSC appeals division. It also provides, if the SOAH judges rules against a provider, for a judicial appeal for a trial de novo in Travis County Court if the amount in question is more than $50,000. The point of the bill is that HHSC-OIG is investigator, prosecutor and judge with a vested interest in finding against the provider. No other state agency has such power.

Jack Stick, Deputy Inspector General for Enforcement, was on hand to answer Committee questions. He said he did not have a position on the bill. However the thrust of his comments was that OIG already provided enough due process, was fair with Medicaid providers under investigation and that there was a fiscal note on the bill.

His position was controverted on numerous occasions by subsequent testimony particularly by attorney Tony Canales who proposed HB 1536, Fread Houston, former Director of Sanctions for OIG and Dr. Paul Dunn DDS, a 62 year-old small Medicaid dental practitioner from west Texas who OIG is seeking to collect over $2 million dollars. Stick was called back several times to answer committee member questions.

Because Dunn had testified about his case with OIG before the Committee, Stick stated to the Committee that he was taking that act as permission to discuss the particulars of Dunn’s case publicly. Chuck Young, TDMR Director of Communication, at the beginning of his testimony, forcefully chastised Stick for retaliation against Dunn for coming forward to speak about injustices in a public forum with lawmakers.

Tony Canales explained the need for HB 1536 to the Committee members. He said that OIG and HHSC was the only state agency that had the powers of accuser, investigator, prosecutor and judge rolled into one. And that in his experience “in the pit” as a lawyer whose clients are currently involved with the HHSC-OIG system, OIG is an agency “run amok.” The testimony of Dunn and others added credence to Canales’ remarks.

Houston testified at length about problems he saw internally at OIG, in particular the quest to recoup money rather than find and prosecute actual fraud. He found as well a disregard for the distress and harm coming to Medicaid providers from OIG actions although fraud and misrepresentation allegations were still unproven.

Further testimony from other dental Medicaid providers corroborated Dunn’s problems with OIG.

The hearing on the bill ended with Rep. Guerra’s final remarks and the Committee Chair Raymond moving to keep the bill pending in the Committee.

The text of the written testimony for numerous individuals is available on the TDMR website.