Seeking to prove Medicaid fraud, state regulators lose again 

State Medicaid regulators pursuing orthodontists who they claim bilked Texas out of tens of millions of dollars suffered another decisive setback Thursday, when an appeals court ruled investigators hadn’t proven any fraud had occurred in one of the state’s largest cases. Unless the state appeals the decision to the Texas Supreme Court, it means Texas must return millions of dollars in payments it has withheld from the Houston-based Antoine Dental Center.The loss is the latest in a string of legal struggles in which judges at three different levels have determined the Health and Human Services Commission failed to prove practitioners intentionally billed for orthodontic services not covered by Medicaid. Despite claims five years ago that it had identified widespread fraud, the commission’s Office of Inspector General has yet to win a contested court case against an accused orthodontist.

Source: Seeking to prove Medicaid fraud, state regulators lose again | www.mystatesman.com

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