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You are here: Home / Archives for texas health and human services commission

No Penalty or Fine for Xerox Using High School Dropouts to Approve Medicaid Prior Authorizations for Eight Years?

February 22, 2019 By TDMR Leave a Comment

The state's $235 million settlement this week with Xerox/Conduent, its former Medicaid claims administrator, unfortunately, leaves unresolved some disturbing questions about how the company could operate its insanely irresponsible orthodontic prior authorization process for so long with state officials either looking the other way or incapable of doing anything about it. While … [Read more...]

Filed Under: Medicaid Reform News, Slider Tagged With: medicaid fraud, texas health and human services commission, u.s. government, xerox

Texas Settles with Xerox for $235 Million Out of “Desire to Buy Peace and Avoid Further Litigation”

February 19, 2019 By TDMR 2 Comments

This morning Attorney General Ken Paxton announced that the State of Texas had settled its $2 billion Medicaid fraud lawsuit against Xerox/Conduent, its former Medicaid administrator from 2004 to 2012, for $235 million.  The settlement over Xerox/Conduent's inadequate orthodontic prior authorization process was touted as a record recovery for Medicaid fraud in Texas.  The … [Read more...]

Filed Under: Medicaid Reform News, Slider Tagged With: attorney general texas, medicaid fraud, texas health and human services commission, xerox

Xerox Quality Assurance Checks on Ortho PAs Apparently Consisted of Re-checking the Addition of HLD Score Sheets

February 18, 2019 By TDMR Leave a Comment

For those following the $2 billion Medicaid fraud case against Xerox/Conduent here in Texas, another plank in the state's case against the company is that it alleges that no meaningful Quality Assurance check was ever done to ensure medical necessity on some 500,000 orthodontic prior authorizations the company approved from 2004 to 2012. "Can't recall" Under deposition, … [Read more...]

Filed Under: Medicaid Reform News, Slider Tagged With: medicaid fraud, texas health and human services commission, xerox

“I approved all of them regardless” – Xerox/Conduent Dental Director on Ortho PAs

February 15, 2019 By TDMR 9 Comments

Dr. Jerry Felkner Some of the evidence that the state is using to pursue Medicaid fraud allegations against its former Medicaid claims administrator on its orthodontic prior authorization program from 2004 to 2012 comes directly from depositions of the Xerox/Conduent dental director, Dr. Jerry Felkner. Xerox/Conduent kept telling the state in their policy manuals that he was … [Read more...]

Filed Under: Medicaid Reform News, Slider Tagged With: medicaid fraud, texas health and human services commission, xerox

Texas lawmaker introduces bill requiring name and photo be added to Lone Star card to fight fraud

February 11, 2019 By TDMR Leave a Comment

A Texas lawmaker has authored a bill that would require photographs and names on Lone Star cards to help fight fraud. Dade Phelan (R-Beaumont) filed HB 1250 on Jan. 31. The bill requires that the name and photograph of the recipient or other authorized person must be on the front of the card. The card also must show the words "Fraud Hotline" followed by the hotline's … [Read more...]

Filed Under: Media Tagged With: texas health and human services commission

Dental Managed Care Issues Receive Legislative Attention with Meeting at the Capitol

January 31, 2019 By TDMR Leave a Comment

Back on November 21, House Human Services Committee Chairman Richard Peña Raymond held a meeting with a select group of dental providers regarding dental managed care issues. Providers requested meeting The meeting was initially requested by South Texas Dental but was expanded to include other dental groups and the Texas Dental Association which were invited through Raymond's … [Read more...]

Filed Under: Medicaid Reform News, Slider Tagged With: dmos, Medicaid managed care, texas health and human services commission, texas medicaid reform

Comments on Dental Radiation Machine Regulations Proposed Rules Due 2/10

January 18, 2019 By TDMR Leave a Comment

Texas Health and Human Services is accepting comments from stakeholders on the following proposed rules. The comment period ends February 10, 2019. Department of State Health Services 25 TAC, Part 1, Chapter 289, Radiation Control Interested parties can participate by: offering informal comments.commenting on proposed rules published in the Texas Register.providing … [Read more...]

Filed Under: Media Tagged With: dental radiation, texas health and human services commission

Texas Health and Human Service Commission sued by Home Health Agencies Over Reimbursement Halt

January 17, 2019 By TDMR Leave a Comment

A group of home health agencies is suing the Texas Health and Human Service Commission (HHSC) for allegedly halting reimbursements for telemonitoring services. The agencies claim they will go out of business and deprive Texans of necessary care if the court doesn’t step in. Unidos Healthcare LLC; Corazon Health Care Services LLC; Cleveland Health Care LLC, which operates as … [Read more...]

Filed Under: Media Tagged With: texas health and human services commission

TDMR Six Years Old and Still Going Strong

December 28, 2018 By TDMR 1 Comment

As we approach the New Year, we at TDMR have taken a few minutes to contemplate the last few years - six so far.   We had no idea back in 2012 that we would still be going strong today. Come a long way On December 7, 2012, we launched this website and published our first article "Harlingen Family Dentistry Wins Major, Precedent-Setting Decision in Texas Medicaid Orthodontics … [Read more...]

Filed Under: Medicaid Reform News, Slider Tagged With: medicaid fraud, state medicaid, texas health and human services commission

New Texas Medicaid and CHIP Guide, the Pink Book, Now Available

December 20, 2018 By TDMR Leave a Comment

HHS has published the 12th edition of a reference guide for Texas Medicaid and CHIP, commonly known as the Pink Book. The new version that has under gone a complete redesign is posted here.   … [Read more...]

Filed Under: Media Tagged With: texas health and human services commission

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Conduent Stock Price Watch

As the Texas Medicaid fraud suit against Xerox/Conduent moves towards trial, watch the company's stock price. The company's 52-week high was on June 14 at $20.85.

Most Viewed Posts & Pages

  • Whistleblowers File Motion for Their Share of $235 Million Xerox/Conduent Settlement
    Whistleblowers File Motion for Their Share of $235 Million Xerox/Conduent Settlement
  • Smelling Like a Rose: Xerox/Conduent Settles Texas for $235 Million, Renews Contract in Indiana for $232 Million
    Smelling Like a Rose: Xerox/Conduent Settles Texas for $235 Million, Renews Contract in Indiana for $232 Million
  • No Penalty or Fine for Xerox Using High School Dropouts to Approve Medicaid Prior Authorizations for Eight Years?
    No Penalty or Fine for Xerox Using High School Dropouts to Approve Medicaid Prior Authorizations for Eight Years?
  • Texas Settles with Xerox for $235 Million Out of "Desire to Buy Peace and Avoid Further Litigation"
    Texas Settles with Xerox for $235 Million Out of "Desire to Buy Peace and Avoid Further Litigation"
  • Jury convicts former Missouri dental clinic owners of $1 million health care, payroll tax fraud
    Jury convicts former Missouri dental clinic owners of $1 million health care, payroll tax fraud

Recent Comments by Readers

  • Kenneth Bolin on “I approved all of them regardless” – Xerox/Conduent Dental Director on Ortho PAs
  • Kenneth Bolin on Texas Settles with Xerox for $235 Million Out of “Desire to Buy Peace and Avoid Further Litigation”
  • Joe Knows on “I approved all of them regardless” – Xerox/Conduent Dental Director on Ortho PAs
  • Beans on “I approved all of them regardless” – Xerox/Conduent Dental Director on Ortho PAs
  • Graham D. Shea, DDS on Texas Settles with Xerox for $235 Million Out of “Desire to Buy Peace and Avoid Further Litigation”
  • TDMR on “I approved all of them regardless” – Xerox/Conduent Dental Director on Ortho PAs

Recent Media of Interest

Virginia couple accused of defrauding Medicaid

February 22, 2019

Jury convicts former Missouri dental clinic owners of $1 million health care, payroll tax fraud

February 22, 2019

Firm announces $232M contract with Indiana, just two days after settling huge Medicaid fraud case in Texas

February 21, 2019

Xerox Reaches $235M Deal to Settle Medicaid Fraud Claims

February 19, 2019

Sentencing delayed in Texas medical equipment fraud case

February 18, 2019

Walgreens to Pay $269.2 To Settle Civil Fraud Lawsuits

February 17, 2019

Voters in four states have approved Medicaid expansion by ballot. Will Texas do the same?

February 15, 2019

Thousands of Texans shocked by surprise medical bills. Requests for help overwhelm the state.

February 15, 2019

Ohio joins alleged overbilling and fraud settlement with Walgreens

February 15, 2019

Lessons for Distributors from Dental Lawsuits

February 14, 2019

Minnesota Attorney General Ellison’s office wins state’s largest medicaid fraud case

February 12, 2019

DOJ Announces More Than $21M in Home Health Fraud, Kickback Schemes

February 12, 2019

Texas lawmaker introduces bill requiring name and photo be added to Lone Star card to fight fraud

February 11, 2019

Federal indictment in Ohio charges 6 in $48M Medicaid fraud

February 8, 2019

Georgia hospital enters $5M settlement with feds to resolve false claims case

February 8, 2019

California man sentenced, ordered to pay $1.5 million for healthcare fraud

February 7, 2019

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