Judge rightfully reins in anti-fraud unit after abusive action By Chris TomlinsonNovember 26, 2014 Doctors, dentists and other health care providers who care for the state’s most disadvantaged got some much needed relief Tuesday from an over-zealous, politically motivated anti-fraud … Read More
Law360, Dallas (November 25, 2014, 5:55 PM ET) — A Texas appeals court on Tuesday invalidated three Texas Health and Human Services Commission rules related to payment holds imposed during Medicaid fraud investigations, holding they violate due process rights. The … Read More
AUSTIN – Texas officials have been illegally withholding millions of dollars from dozens of dentists and orthodontists based on only the suspicion of minor wrongdoing, an appeals court ruled Tuesday, dealing another blow to the state’s beleaguered unit charged with … Read More
The Texas agency charged with investigating health care fraud suffered a serious setback Tuesday, when a state appeals court ruled that the Health and Human Services Commission’s Office of Inspector General’s expansive use of a key tactic — withholding Medicaid … Read More
Today, the Texas 3rd Court of Appeals overturned a lower court decision and negated Health and Human Services Commission rules that allow for the Office of Inspector General to place Medicaid payment holds in certain circumstances, basically for only program violations … Read More
As Texas’ top health officials steer $110 million in no-bid contracts to an Austin tech company they say is revolutionizing Medicaid fraud investigations, the state’s top contract manager says those contracts are too loosely written and raise questions about what … Read More
In a letter to the Texas Sunset Advisory Commission, TDMR President Gregory Ewing has recommended, based on the testimony in the public hearings held last week, that all pending OIG cases be stayed for external review. All pending cases should … Read More
November 18, 2014 — The Texas agency charged with investigating Medicaid fraud is finalizing a $90 million contract for Medicaid fraud detection software. of software licenses and services from the company, 21CT, according to a statesman.com story . Austin-based 21CT is a … Read More
Last Thursday, November 13th, the Texas Sunset Advisory Commission held public hearings about its staff report on the Texas Health and Human Services Commission that was released in October. The Commission heard over nine straight hours of submissions from various … Read More
The Austin American Statesman reported this weekend that the Texas Health and Human Services Commission Office of Inspector General is finalizing a deal with an Austin company for Medicaid fraud detection software. The company involved, 21CT, is primarily a defense … Read More
AUSTIN, Texas (AP) — The state office responsible for investigating Medicaid fraud and waste is finalizing a $90 million contract with an Austin company that has little experience with Medicaid spending. The inspector general’s office for the Texas Health and … Read More
The state office charged with investigating Medicaid fraud and waste, criticized this week by state auditors and legislators as dysfunctional and “broken,” is finalizing a $90 million contract with an Austin analytics company that had no experience with Medicaid before … Read More
The 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 … Read More
Responding to an audit critical of the state’s network of health agencies, as well as the embattled Medicaid fraud investigative unit, a panel of state lawmakers this week endorsed an overhaul of the state’s umbrella health agency, the Health and … Read More
AUSTIN – Texas officials voiced support Wednesday for a proposal to combine five big state health and human services agencies into a mega-agency so massive that it would have a bigger budget than many states. The agencies made their support … Read More
The latest edition of the Texas Health and Human Service Commission’s online newsletter InTouch says that OIG is bringing in an outside firm to review its investigative, sampling and extrapolation processes in light of the recent scathing Sunset Commission staff report on … Read More
The Sunset Commission has set out their agenda for the upcoming public hearings on the Texas Health and Human Services Commission to be held on Wednesday and Thursday, November 12 and 13. Meeting materials will be available on the Sunset … Read More
The Texas Rangers are now investigating the Health and Human Services Commission Office of Inspector General and the firing of actuary Brad Nelson per a story in the Houston Chronicle. The Commission requested the investigation after Nelson was fired for … Read More
AUSTIN – The Texas Rangers have opened a criminal investigation into a recently fired state employee whose alleged falsification data could cost the state the chance to recoup millions of dollars from dentists and orthodontists of Medicaid fraud, officials confirmed … Read More
The 3rd Texas Court of Appeals has agreed with a Travis County District Court judge and has issued a ruling that the Office of the Inspector General should return over $1.2 million in withheld Medicaid funds to Harlingen Family Dentistry. TDMR received a … Read More
In another setback for the state health agency charged with rooting out Medicaid fraud, an appeals court Thursday said almost $1.26 million was improperly withheld from a dental practice even after state regulators acknowledged that no fraud had taken place. … Read More
A key legislator with oversight of the state’s Health and Human Services Commission has asked that agency’s Office of Inspector General to review all Medicaid fraud cases handled by an actuary who admitted recently to falsifying numbers on at least … Read More
The Austin American Statesman reported this morning that Rep. Richard Peña Raymond, D-Laredo, has requested that the Texas Health and Human Services Commission Office of Inspector General review all Medicaid cases that were worked on by the now-terminated actuary that admitted to … Read More
A Texas Health and Human Services Commission employee in the Office of the Inspector General was fired because he apparently “cooked the books” in OIG’s case against Dr. Rachel Trueblood, according to a story published in the Austin American Statesman … Read More
This past week HHSC released a report on executive compensation within HHSC. (Staff Compensation) Per the report, the average base salary for non-executive staff on August 31, 2014 was $37,326. The following table is excerpted from the report to show only … Read More
This past Friday, TDMR sent its comments about the recent Sunset Commission staff report on the Texas Health and Human Services Commission to the Texas Sunset Commission. The following is what was sent from TDMR president Gregory Ewing. A downloadable … Read More
This summer, state regulators settled a Medicaid fraud case against an Austin dentist for literally pennies on the dollar. Although the Texas Health and Human Services Commission’s Office of Inspector General had initially accused Rachel Trueblood of bilking the government … Read More
TDMR received a notice from the Texas Sunset Commission on Tuesday requesting feedback on the staff report just issued on HHSC which was particularly scathing of the Office of Inspector General. Make your voice heard Any Texan can comment on … Read More
AUSTIN – The top health official in Texas has decided to appoint a special assistant to review the state’s Medicaid anti-fraud program after an audit found it is so poorly run that it may be better for taxpayers if it … Read More
The government agency charged with rooting out medical fraud and waste is poorly managed, occasionally is unfair to those it investigates and has failed to do an effective job identifying and recovering money lost to medical fraud, according to a … Read More
by Becca Aaronson, The Texas Tribune In a blistering 225-page report on the Texas Health and Human Services Commission, the Texas Sunset Advisory Commission recommended that the state’s health and human services system undergo a massive overhaul. The Sunset Commission, which reviews the … Read More
The government agency charged with rooting out medical fraud and waste is poorly managed, occasionally is unfair to those it investigates and has failed to do an effective job identifying and recovering money lost to medical fraud, according to a … Read More
The following article was published today in the Texas Tribune, authored by Christine Ayala and Jay Root. UPDATE: The same article was republished in the New York Times with the title “A Texas Official’s D.W.I. Case Is Being Seen in … Read More
AUSTIN – Call it the billion-dollar blame game. Six years after auditors discovered signs that some Texas orthodontists were putting unneeded braces on teeth of the state’s poorest children, an army of lawyers are battling over who is liable for … Read More
On September 3rd, Rachel Hammond of the Texas Association for Homecare and Hospice testified before the House Human Services Committee on SB 1803 and due process rights for Medicaid providers. Hammond gave examples of difficulties that their members were having … Read More
Dr. Behzad Nazari of Houston testified before the House Human Services Committee on September 3rd on SB 1803 and due process rights for Medicaid providers. Nazari’s Antoine Dental clinics was put under a 100% payment hold for their Medicaid orthodontic … Read More
OIG SNAP Fraud Strategies Report Required by Senate Bill 8 is published by HHSC. This PDF file is available here:
Dr. Paul Dunn testified before the House Human Services Committee last week about his experiences with the Health and Human Services Commission Office of the Inspector General and SB 1803. Dunn testified last year before the same committee and more … Read More
This past Wednesday, the Texas House Human Services Committee held public testimony on the effectiveness of SB 1803 passed last session to put into legislation due process rights for Medicaid providers under investigation by the Health and Human Services Commission … Read More
This past Wednesday, the same day as the House Committee on Human Services hearing on SB 1803, HHSC sent out a notice that it had placed online a video for Medicaid providers about Office of the Inspector General investigations. This … Read More
