“We Have Lost Confidence in Your Office” – OIG Under the Gun at Sunset Commission Hearings

sunset commission2The Texas Sunset Commission held public hearing both Wednesday and Thursday this week on the Health and Human Services Commission as well as its beleaguered Office of Inspector General.  Sunset and HHSC staff testified on Wednesday about the recent Sunset Commission staff report on HHSC which was scathing about the performance of OIG.  Public testimony was heard yesterday.

Loss of confidence

As reported both in the Texas Tribune and the Statesman, Sen. Charles Schwertner, member of the Commission and also chair of the Senate Health and Human Services Committee, summed up the legislative attitude towards the agency when he told Inspector General Doug Wilson that “we have a loss of confidence in your office.”

OIG is “just broken”

Rep. Richard Peña Raymond echoed Sen. Schwernter’s sentiment.  Raymond is the chair of the House Committee on Human Services.  He said “I look at an agency that’s just broken.”

Overblown claims

Last legislative session, Inspector General Wilson and then-deputy director for enforcement Jack Stick testified repeatedly that dental and orthodontic Medicaid fraud was in the hundreds of millions of dollars and error rates in dental cases they were investigating were over 90% . They used these estimates to push for an increased budget for new data mining software and a larger staff.

Yet, OIG, over the last year has so far recovered under $6 million per the Statesman article, throwing doubt on the veracity of the estimates.  Indeed, in the case of Dr. Rachel Trueblood, OIG was attempting to collect $16 million but settled for $39,000 last August because an OIG staffer had fudged the figures in the case.  A criminal investigation has been started into the incident by the Texas Rangers.

Dentists testify 

Yesterday several Medicaid dentists, Dr. Paul Dunn, Dr. Behzad Nazari and Dr. Chad Evans testified as well as Austin attorney Jason Ray.  The dentists’ testimony again highlighted the lack of due process, presumption of guilt and the severe financial hardship that has been placed on their lives and practices by OIG investigations.

Video excerpts of the hearings will be available online shortly.


2 Responses

  • The due process hearings should be done by an appointed group of dentists and not the state dental board. From the private sector. They simply say, yes (credible) or no (not credible) a simple majority and submit their report to the judge who would give the final ruling on whether there is credible evidence of misconduct/fraud.

    If yes, 100% pay hold by state, federal and private insurance companies. If no, all monies returned to the dentist and case is over.

    This would take 2 weeks. The dentist then has a right to a trial by jury within a month.

    I’m all for due process. These Dr’s would be literally laughed at by their peers and sent to trial in about 2 minutes. Let’s expedite the process and find an orange jumpsuit for these guys.

    • Interesting suggestion. But you don’t know the facts on fraud and probably Medicaid in these cases. SOAH heard the evidence in two large cases and found the providers innocent.

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