Dentist’s Nightmare Over – Settles for $120,000 Withheld Medicaid Funds

Dr. Paul Dunn
Dr. Paul Dunn

The vicissitudes of Dr. Paul Dunn have been chronicled by TDMR over the last several years. Dunn first appeared on the scene when he came to Austin during the 2013 legislative session.

“Credible allegation of fraud” payment hold, but told he hadn’t committed fraud

He had been placed earlier under a 100% “credible allegation of fraud” payment hold for his Medicaid orthodontic billings by then deputy inspector general for enforcement Jack Stick. He had an informal resolution meeting with Stick who told him that Dunn apparently hadn’t committed any fraud but the agency still wanted its money back. As a result of the meeting, Stick eventually reduced Dunn’s payment hold to 51% which barely kept his doors open.

Courageous in testifying before legislative committees

In Austin, Dunn courageously testified before the House Human Services Committee on HB 1536.  He told about his experiences with OIG and Stick who was also at the hearing representing the agency. Dunn explained to the committee that the agency based its demands on only four cases out of 50 which investigators had looked at and that he had been told he owed back $1.2 million as a result of the extrapolation.

He said he couldn’t understand why the agency was still withholding money under a “credible allegation of fraud” payment hold if Stick said he hadn’t committed fraud.

OIG overpayment demand went from $1.2 million to over $2 million

Stick faced stiff questioning from the committee members as a result. Dunn obviously raised Stick’s ire as the amount demanded from Dunn increased up to over $2 million shortly after he testified.  But he continued to testify.

Dr. Paul Dunn testifying before a legislative committee
Dr. Paul Dunn testifying before a legislative committee

Kept afloat barely

By hook or by crook since then, Dunn has kept personally afloat. He liquidated insurance policies and life savings, some $200,000 he was saving for his retirement after 40 years serving the citizens and Medicaid patients of Levelland. He is 68 years old.

However, he didn’t have funds for his legal defense as his Medicaid patient roll decreased and 51% of little is littler.

Paid bankruptcy trustee but not yet filed forms

Earlier this year, Dunn said he was going to file for bankruptcy this time and had already paid a trustee her fees. But the forms had not yet been filed.

At the same time, OIG had set a court date for him to go before the HHSC Appeals Court this month on the alleged overpayment. Considering that the judge would have been Rick Gilpin, the judge who overturned the Antoine Dental decision by the State Office of Administrative Hearings that found Antoine innocent of allegations of Medicaid fraud, it would have been fruitless to represent himself.

In fact, as TDMR reported, Dunn was told by an OIG lawyer to go bankrupt if he wanted things to end. It would be considerate of Dunn to do so as it would be “easier on everyone” and save the state court costs.

Saga ends with OIG settling for $120,000 already withheld from Dunn

It seems more rational heads prevailed at OIG. They decided to settle with Dunn for the $120,000 they had withheld from him and drop everything else. No admission of guilt or wrongdoing. This was just completed within the last week or so.

Small hurrah. Giving Dunn back his money would have been better and restoring his reputation.

But, as Dunn said, he would have loved to fight the allegations to the bitter end if he had the money. The settlement is bittersweet as at least now he can get on with the rest of his life without this cloud hanging over his head. He didn’t want to go bankrupt. But he would have preferred to be fully exonerated.

We wonder if HHSC-OIG is demanding that Jack Stick pay any money back to the state for his excesses – the $2,800 executive chairs, the $86 OIG badges, any of the $20 million given to 21CT.

Highly doubtful, isn’t it?

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