A recent open records request to the Texas Office of the Attorney General reveals that the state has paid out so far $457,416.67 to qui tam relator Joshua Lafountain.
No knowledge or evidence of wrongdoing
TDMR reported, starting last May, that Lafountain and his team of high-powered and well-connected attorneys were pursuing a Texas Medicaid Fraud Prevention Act (TMFPA) lawsuit against 71 Medicaid dental entities that Lafountain had never worked for nor had any personal knowledge or evidence of wrongdoing.
Lafountain, who has no formal dental training, worked only as an office manager for a dental office in Dallas. He admitted under oath that he used office computers while working to illegally gamble online and even borrowed money from dental staff to cover his debts. He was also found to be a scofflaw that had and possibly still has outstanding criminal charges for failing to appear in court in Collin County.
Lafountain’s only personal connection with the dentists he accused of Medicaid fraud is that they worked at the same dental office during his tenure before starting their own practices.
Such cases backed by OAG
That is apparently enough “evidence” to accuse health care professionals of Medicaid fraud under the TMFPA, according to the Civil Medicaid Fraud unit of the OAG, which benefits from any settlement even though it doesn’t necessarily take over the lawsuit.
Legal defense expense makes such brazen cases viable
These settlements occur and brazen relators and their attorneys benefit because the legal defense against such allegations under the TMFPA, no matter how spurious, is incredibly expensive. Worse, business-wise, such settlements make sense. It ends the horrible personal stress and strain and limits the financial expense of the provider. The costs of getting to and having a trial are exorbitant — millions of dollars. But such settlements are akin to paying off a state-sanctioned protection racket or, worse, extortion.
Legislation brought forward
Is it any wonder that legislation was brought forward this legislative session to amend the TMFPA and protect not just Medicaid dentists but all Medicaid providers from such suits?
HB3802 would have offered some measure of fix of the problem and passed out of the House Committee on Judiciary & Civil Jurisprudence unanimously. The bill then passed through calendars and was scheduled for a floor vote on May 12 but died on the vine as the clock ran out prior to its floor vote appearance on May 13 at midnight. Kudos to House Reps Matt Krause, Jeff Leach, Mike Schofield, and Jared Patterson, as well as the members of the House JCJ committee and the Calendars Committee for their great efforts to pass this bill and promote justice in Texas.
It is hoped, however, that the Senate may pick up the bill in another form and move it along the road to a signature by the Governor, passing it into law to help Medicaid providers.
Sad state of affairs
It is unbelievable that Texas has paid almost half a million dollars to this individual at the expense of Medicaid dental professionals who work to safeguard the health of Texans.
Could there be a larger betrayal of public trust?