AUSTIN, November 11 – State Sen. Juan “Chuy” Hinojosa does not like the way the Texas Health and Human Services Commission Office of the Inspector General treats Medicaid providers and he wants to rein in the agency next session.
“It appears that healthcare providers are accused of fraud, presumed guilty, and are not given a due process finding from the OIG as to whether fraud exists or not. This is in direct violation of a provider’s inherent rights and the opposite of our safeguarded justice system,” Hinojosa wrote, in a recent letter to Inspector General Doug Wilson.
Calls to Wilson’s office for reaction to Hinojosa’s remarks were not returned at press time.
Hinojosa’s efforts to “safeguard our system of justice” have been boosted by a scathing review of the OIG by the Sunset Commission. The Commission will discuss the operations of the OIG at a hearing at the state Capitol in Austin on Wednesday.
In his letter to Wilson, Hinojosa gave an example of a provider of Medicaid services in his district that was targeted for fraud by the OIG. Here, in Hinojosa’s words, is what happened in that case:
Recently, one of my constituents who is a healthcare provider in the Rio Grande Valley with three service facilities, was put on a 100 percent payment hold by the OIG because he was told a credible allegation of fraud existed. The provider was told that he could request an Informal Resolution Hearing with OIG investigators to present his case. The provider promptly requested a hearing and was given a hearing date in Austin at the OIG offices.