A board certified orthodontist hired by HHSC-OIG was apparently reluctant to "second guess" Xerox/Conduent prior authorization (PA) approvals per a March 2009 email contained as an exhibit in the July 2018 Xerox court filing mentioned in last week's TDMR articles. However, the consultant was not told that TMHP (Texas Medicaid & Healthcare Partnership with Xerox as the lead … [Read more...]
“I Guess No One Really Cares” – HHSC OIG Director of Medicaid Integrity
In the same Xerox/Conduent court filing from July 2018 mentioned in our previous article, there is another exhibit worth mentioning. It is the complete email chain involving HHSC OIG officials discussing OIG investigator Ray Acuña's meeting notes on the Xerox/Conduent ortho prior authorization (PA) process. Stopped requiring molds for PA Some of the correspondence … [Read more...]
OIG: Texas Improperly Collected $20.7M In Federal Medicaid Money, Owes CMS
Texas overcharged the federal government for a portion of primary care reimbursement following a state Medicaid rate cut, according to the HHS Office of Inspector General, so Texas should refund the federal government $20.7 million for those overcharges and other claims that were inappropriately charged. Source: OIG: Texas Improperly Collected $20.7M In Federal Medicaid … [Read more...]
The top 10 management and performance challenges facing the Department of Health and Human Services
If he’s confirmed as the next secretary of the Department of Health and Human Services, Alex Azar will have his hands full. The Office of Inspector General has identified 10 management and performance challenges that the HHS faces across all its programs and that cover the agency’s critical responsibilities. In its 48 page report (PDF), the OIG listed the top … [Read more...]