Back on September 5th, the Texas Tribune hosted a conversation on the future of Latino health care with Dr. Esteban López, a regional president for Blue Cross Blue Shield of Texas, Dr. Amelie Ramirez, director of the Institute for Health … Read More
The Health and Human Services Commission has put online its self-report to the Sunset Commission as HHSC is coming up for review by the Commission this coming year. The link below will take you to the HHSC website where you … Read More
Here are the latest statistics just released by HHSC. Children Enrolled in Medicaid, CHIP and CHIP Perinatal Programs by Month Month Children Enrolled in Medicaid¹ Children Enrolled in CHIP² Children Enrolled in CHIP Perinatal Coverage Total Children Enrolled Sep-13 2,511,311 … Read More
This past week State Office of Administrative Hearings (SOAH) Judge Roy G. Scudday ruled that Christine Ellis and her qui tam lawyers had no standing to appear in a hearing regarding an HHSC-Office of Inspector General payment hold placed on … Read More
The following was in the latest HHSC newsletter “In Touch.” HHSC’s Office of Inspector General (OIG) will hire 127 new employees over the next year, two-thirds of whom will be in enforcement as the division looks to speed up fraud … Read More
Ever wonder why Medicaid and Medicare rates are so low or why there was a Frew lawsuit? What about the future for reimbursement rates for Medicaid or Medicare health care providers in Texas? No need to wonder. Here’s your answer. … Read More
This past week attorneys for Antoine Dental Center (ADC) and those representing the Office of the Inspector General filed their closing arguments in the pending State Office of Administrative Hearings (SOAH) case. The case challenges the 100% payment hold that … Read More
Karen Nelson is no longer with the Office of Inspector General. The former Deputy Inspector General for the HHSC-OIG is now working for the Austin office of the DLA Piper law firm. Nelson apparently left OIG last month. One can … Read More
Hearing Transcripts Now Available for Download Antoine Dental Clinic vs. HHSC-OIG – Vol. 1 Antoine Dental Clinic vs. HHSC-OIG – Vol. 2 Antoine Dental Center v. THHSC, OIG – Vol. 3 Antoine Dental Center v. THHSC, OIG – Vol. 4 … Read More
The Texas Tribune published today an article outlining the coming changes to the Texas State Board of Dental Examiners as a result of House Bill 3201 that was passed by the legislature and signed by the governor. The legislation will … Read More
Here are some recent media stories that relate to Medicaid and Medicaid fraud. June 18th – Medicaid Orthodontist found guilty July 19th – Perry orders investigation into oversight of troubled rural hospital chain _ Dallasnews July 24th – AG, Planned Parenthood Affiliate … Read More
This week the staff of the Committee on Finance and Committee for Judiciary for the U.S. Senate released a negative report about DSOs entitled the “JOINT STAFF REPORT ON THE CORPORATE PRACTICE OF DENTISTRY IN THE MEDICAID PROGRAM.” The report suggested that one … Read More
The following is information on upcoming court hearings that are vitally important to this whole dental Medicaid provider issue. On August 13 at 9:00 a.m., an HHSC Appeals Judge will hear M&M Orthodontics of San Antonio’s Plea to the Jurisdiction. … Read More
Last week, Antoine Dental Centers of Houston and Harlingen Family Dentistry of Harlingen brought a motion before the Travis County District Court to unseal the massive Christine Ellis qui tam suit filing that in redacted form appears to have 46 … Read More
TDMR has learned that Harlingen Family Dentistry has filed a lawsuit against HHSC and the OIG challenging their authority to impose a payment hold on Medicaid providers for a simple program violation. The case, styled Harlingen Family Dentistry, P.C. vs. … Read More
As was reported in the media, on June 25th, 2012, Texas orthodontist Christine Ellis filed a qui tam suit against dental chain All Smiles with the Dallas firm of Waters and Kraus acting on her behalf. Ellis has been one of the … Read More
Before the end of the legislative session, TDMR posted an online survey, asking dental Medicaid providers their opinions about a number of important questions. What are the biggest challenges Medicaid providers face today? In your opinion, what is a Medicaid … Read More
TDMR has learned that Jason Ray, attorney at the Austin law firm of Riggs, Aleshire & Ray, P.C., recently negotiated a full settlement of an OIG complaint and payment hold against a dentist in the Dallas area. The dentist, who … Read More
On Friday, June 14th, without fanfare, Gov. Rick Perry signed Senate Bill 1803 into law. The legislation will take effect September 1st. This is a tremendous victory for all Medicaid providers in Texas as it provides for legislated due process … Read More
On May 29th, lawyers for Harlingen Family Dentistry and the Texas HHSC-OIG appeared in Travis County District Court before The Honorable Judge Amy Clark Meachum. As outlined in a previous article “Harlingen Family Dentistry Seeks Court Order for Return of … Read More
