On August 14th, the Senate Committee on Health and Human Services heard testimony regarding Medicaid fraud, waste and abuse. The full presentation given by Chris Traylor, Chief Deputy Commissioner, Douglas Wilson, Inspector General, Kay Ghahremani, Texas Medicaid/CHIP Director, and Joseph … Read More
The allegations state health regulators leveled against Rachel Trueblood two years ago were dramatic: The Austin dentist had billed the government for millions of dollars in unnecessary procedures and office time, they said. Regulators froze $100,000 of outstanding Medicaid payments … Read More
A quick search of the Travis Country Criminal Court docket shows that Jack Stick’s DWI was not dispensed with yesterday. Stick, the new Chief Counsel for the Texas Health and Human Rights Commission, has a new hearing set for October 2nd. His … Read More
August 26, 2014 — Texas health officials have accepted a $39,211 settlement from an Austin dental practice that had been charged with improperly billing more than $16 million in orthodontic Medicaid claims. Glenn Wood, MD, who owns Carousel Pediatrics, disputed … Read More
Texas Health and Human Services Commission Inspector General Doug Wilson told Sen. Judith Zaffirini and other members of the Senate Committee on Health and Human Services at their August 14th hearing on Medicaid fraud, waste and abuse that his agency … Read More
Sen. Jane Nelson quizzed Health and Human Services Commission Inspector General Doug Wilson about the lack of Medicaid fraud convictions in Texas despite the tremendous resources the Legislature gave to the OIG last session. The questioning occurred during the August 14th … Read More
The following is the testimony presented last week to the Texas Senate Committee on Health and Human Services by Jason Ray of Riggs Aleshire & Ray in Austin. Ray is an attorney for a number of Medicaid dentists who have … Read More
Three dentists testified before the Senate Health and Human Services Committee on Thursday about their experiences with the Texas Health and Human Services Commission Office of the Inspector General and how their due process rights are still being violated despite … Read More
Three Medicaid dentists who are involved in HHSC-OIG cases will be testifying tomorrow before the Texas Senate Committee on Health and Human Services. Dr. Chad Evans of Smile Magic from Dallas, Dr. Vivian Teegardin of Harlingen Family Dentistry and Dr. … Read More
Last Wednesday, the Department of Health and Human Services, Office of Inspector General released the results of its long anticipated audit of Texas Medicaid orthodontic spending. The feds conducted the audit because Texas Medicaid payments for orthodontic services rose from … Read More
At a recent deposition in Austin, lawyers for a dental Medicaid provider discovered that the State has invested thousands of dollars to employ a well-known Dallas jury consultant to help prepare the State’s witnesses to testify in depositions and in administrative … Read More
Last week Xerox filed a response to both the lawsuit filed by the State of Texas and its dentist intervenors about Xerox’s allegedly deficient Medicaid orthodontic prior authorization process that led to $1.1 billion in program spending without proper review. … Read More
Letters to both Rep. Richard Peña Raymond and Rep. Lois Kolkhorst, chairmen of the House Human Services and Public Health Committees respectively, have been sent from TDMR President Greg Ewing requesting a public hearing on SB1803 and HHSC’s compliance to … Read More
As part of the lawsuit against Xerox, the former lead contractor for the Texas Medicaid and Healthcare Partnership, the Texas Office of the Attorney General alleges that Xerox, from the beginning of its contract with Texas, wrote misleading documents that … Read More
In the lawsuit against Xerox filed by the Texas Attorney General, there is one more startling revelation. The State is alleging that Xerox as early as 2004, when the company took over the contract as the state’s Medicaid claims administrator, the … Read More
Back in January 2009, a Medicaid Orthodontic Stakeholder meeting was held in Austin at the offices of the Texas Dental Association. Dr. Linda Altenhoff presided at the meeting. Dr. Altenhoff is currently the Dental Director for the Texas Health and … Read More
Apparently TMHP/Xerox “dental specialists” were only trained to add up HLD scores on Medicaid orthodontic pre-approval requests and determine whether the total was 26 points or more, per allegations contained in the lawsuit filed against Xerox by the Attorney General … Read More
Michael McMillen, former Deputy Chief Counsel, Texas Health and Human Services Commission Office of Inspector General, is suing the HHSC for wrongful dismissal after reporting alleged violations of law within the agency. The nature of the alleged violations are not known. The … Read More
Jack Stick’s DWI hearing has again been delayed. It is now July 18th.
On May 7th, Dr. Kyle Janek, the Executive Commissioner of the Texas Health and Human Services Commission, issued his final order in the case of Antoine Dental Center of Houston. Upheld reversal of favorable SOAH ruling on Antoine Dental As expected, … Read More
DALLAS (CN) – A journalist’s false allegation of personal bankruptcy did not defame a dentist whose clinics were accused of fraud, a Texas appeals court ruled. Dr. Richard Malouf, the founder and former majority owner of All Smiles Dental Care, … Read More
This morning it was reported that the Inspector General of the Department of Health and Human Services issued a report that roughly 20% of all Medicare payments for evaluation and management claims in the United States are overpayments to physicians, … Read More
May 20, 2014 — In the wake of a Texas lawsuit that claims Xerox wrongly approved Medicaid claims for orthodontic services that were not medically necessary, some of the dentists being pursued for orthodontic overpayments are now suing Texas for … Read More
by Becca Aaronson, The Texas Tribune May 2, 2014 Part two of two. For nearly five years, a state contractor allowed workers with limited expertise to approve dental claims for Texas’ Medicaid program, the joint state-federal insurer. State spending on … Read More
by Becca Aaronson, The Texas Tribune May 1, 2014 Part one of two. In 2010 and 2011, Antoine Dental was among Texas’ top-billing Medicaid providers for orthodontic services, collecting more than $1 million annually for putting braces on poor children. … Read More
The probable next Chief Legal Counsel for the Texas Health and Human Services Commission Jack Stick has had his DWI hearing again delayed, now to May 12th. The original arrest date was September 2012. Per the Travis County Criminal Court … Read More
The following is an opinion piece written by Jason Ray, attorney for a number dentists who are being prosecuted by HHSC-OIG for their Medicaid orthodontic billings. Mr. Ray is with the firm of Riggs Aleshire & Ray, P.C. I … Read More
With a high-profile legal settlement with Carousel Pediatrics, a children’s health provider, under its belt, the Texas Health and Human Services Commission’s Office of Inspector General says its ramped-up efforts to rein in Medicaid fraud have started to pay off. … Read More
A recent review of our website content revealed to us that while PDF files containing these photos have always been on the site, perhaps they have not been as prominently displayed as they should be. Medicaid after all is about … Read More
The NY Times, in conjunction with the Texas Tribune, has published an article on the recent $3.75 million settlement between Carousel Pediatrics and the Texas Health and Human Services Commission Office of the Inspector General and its affect on the … Read More
This week the Texas Attorney General filed a remarkable brief to oppose the motion to disqualify HHSC judge Rick Gilpin from a Medicaid payment hold case because he was a senior lawyer in the Attorney General’s office for some 38 … Read More
A motion has been filed with the Texas Health and Human Services Appeal Division to have Judge Rick Gilpin disqualified as a hearing officer for cases involving dentists that started while Gilpin was still an attorney within the Attorney General’s … Read More
The same HHSC judge that overturned a favorable SOAH (State Office of Administrative Hearings) decision in the payment hold case of Antoine Dental of Houston, has denied a motion to have a Medicaid overpayment hearing held at SOAH. HHSC Administrative … Read More
Carousel Pediatrics, a chain of Austin clinics originally accused of defrauding the government of $18 million in Medicaid payments, has agreed to repay $3.75 million for what regulators called a “pattern of billing errors” over four years. The settlement allowed … Read More
by Alexa Ura, The Texas Tribune March 17, 2014 Carousel Pediatrics, which has been the subject of a multiyear investigation in Texas, has settled its Medicaid fraud case with the Health and Human Services Commission’s Office of Inspector General, agreeing to … Read More
The Health and Human Services Commission issued a press release this afternoon that OIG has now settled with Carousel Pediatrics of Austin on claims of Medicaid fraud, now deemed billing errors, for $3.75 million. $22.1 million settled for $3.75 million … Read More
TDMR has received notification that HHSC-OIG has begun a Provider Education series that will cover topics of particular interest to Medicaid providers. It is about time. The first topic is Understanding Waste, Abuse and Fraud and TDMR has rabble roused … Read More
The Travis County Clerk’s Office has recently put its court records online. In the public interest, we are publishing here the record of Jack Stick’s DWI case. The following are the meanings of the prefixes used in the entries. Event … Read More
For the record, the next DWI hearing for Jack Stick is set for April 7th.
Gov. Rick Perry has reappointed Douglas Wilson of Pflugerville as inspector general of the Texas Health and Human Services Commission (HHSC) for a term to expire Feb. 1, 2015. The inspector general works to prevent, detect and investigate fraud, abuse … Read More
