Earlier this month, the Attorney Generals of Illinois and Arkansas announced the arrest and/or conviction of three individuals in different cases for Medicaid fraud. Going to jail for $1,000 The amounts of the fraud involved were around $1,000 per party … Read More
Last Friday, the Health and Human Services Commission sent out a notice that it had “updated its Medicaid Medical and Dental Policy web page by posting stakeholder comments and HHSC responses for the THSteps Diagnostic Dental Services policy in development.” … Read More
A document received from an open records request filed in early September shows that the Civil Medicaid Fraud division of the Office of Attorney General (OAG) has expended some 20,953 staff legal hours against 16 dentists and dental practices accused … Read More
The Texas State Board of Dental Examiners is under review by the Sunset Advisory Commission this year. The Board has published a 154-page self-evaluation report that can be downloaded from the Commission website. TDMR has not yet reviewed it. The Sunset Commission … Read More
As reported in the press this week, there has been a tremendous effort on the part of the new Health and Human Services Commission Inspector General Stuart Bowen to settle old, outstanding investigations against Medicaid providers—including dentists. Per the Chronicle, … Read More
UPDATE: Stick has been sentenced to six days in jail. The man who famously carried a toy stuffed wolf into informal resolution meetings with Medicaid providers and quipped that he could “find a program violation on Jesus Christ” if Jesus … Read More
As reported last week by the Austin American Statesman, Stuart Bowen, the new Inspector General for the Texas Health and Human Services Commission, is sending his first report to the Governor today. TDMR has obtained a copy of the full … Read More
The recent decision by a Travis County District Court judge that again vindicated Antoine Dental Center of Houston on allegations of Medicaid fraud and vacated a three-year “credible allegation of fraud” payment hold has been appealed by the Civil Medicaid … Read More
Back in May of 2014, the State of Texas terminated Xerox as the state’s Medicaid claims administrator and filed suit against the company. The state is seeking recompense for hundreds of millions of taxpayer dollars paid out by the company for … Read More
Dallas TV station WFAA is losing its long-time, award-winning investigative reporter Byron Harris to retirement. Harris announced a few weeks ago that he would be leaving the station in October, after spending 40 years with WFAA. It goes without saying … Read More
The Health and Human Services Commission has just put online proposed changes to the THSteps Diagnostic Dental Services Policy and is requesting stakeholder feedback on the changes. The updated policy will require the use of a professionally developed and … Read More
Yesterday, Travis County District Court Judge Amy Clark Meachum issued her decision in the case of Antoine Dental Centers of Houston, vindicating the practice in its payment hold case. The practice had been accused of “credible allegations of fraud” in … Read More
UPDATE, August 11, 2015: We have been informed by a very keen-eyed and interested observer that the definition of “physician” under the Social Security Act includes dentists. So we are not sure why the Texas Health and Human Services Commission … Read More
A name familiar to many Medicaid dentists who have felt the sting of Doug Wilson and Jack Stick’s Office of Inspector General in the last few years has resigned, per the Texas Tribune. Cody Cazares, an aide to former Health … Read More
The story about Dr. Rachel Trueblood settling in October 2014 with the Health and Human Services Commission Office of Inspector General for $39,000 after the agency was demanding $16 million in Medicaid overpayments is well-known. However, the story of another … Read More
In January, Stuart Bowen took charge of a state office rocked by accusations of corruption, incompetence and inefficiency. Responsible for ferreting out fraud amid the programs and procedures of the sprawling Health and Human Services Commission, the office of Inspector General … Read More
TDMR has learned that the new Health and Human Services Commission Inspector General Stuart Bowen, Jr. has been taking on and overhauling the agency’s use of statistical sampling and extrapolation. This is the most controversial tool that the agency had … Read More
The vicissitudes of Dr. Paul Dunn have been chronicled by TDMR over the last several years. Dunn first appeared on the scene when he came to Austin during the 2013 legislative session. “Credible allegation of fraud” payment hold, but told … Read More
Last Wednesday, July 16, lawyers for Antoine Dental Centers of Houston again went to court. Going Travis County District Court This time they appeared before Travis County District Court to appeal the Medicaid payment hold final decision by former Health … Read More
The eight steps you need to take to put together a program for yourself! Many people have asked what the process for establishing an effective compliance program is. At one point, having a compliance program was optional. As a result … Read More
