UPDATE: YouTube video added of hearing
22-1046 Malouf v. State ex rel. Ellis Supreme Court Hearing, January 31, 2024
It might just be possible that more than a dozen years after the great WFAA expose on “Crooked Teeth,” a Medicaid dentist might get his day in court.
Someone getting their day in court
That would be wonderful.
TDMR was founded on the premise of “innocent before proven guilty” and due process to offset the wide brush of Medicaid fraud allegations that were being flung around at the time.
The late Dr. Juan D. Villarreal, TDMR’s founder, tried for years to get his case to court so a jury of his peers could decide his fate. He wasn’t interested in the quick, vague, no-admission-of-guilt settlements that let prosecutors crow to the public that you were really guilty after all. But the OAG Civil Medicaid Fraud unit, where his case had been sent, put up roadblocks to make getting to court as expensive as possible, mired with legal wrangling. His heart literally gave out before he could get through it.
Court seems amenable to trial
According to a Bloomberg Law article published this week, observers at Dr. Malouf’s hearing before the Texas Supreme Court to vacate the summary judgment against him believe the court is likely to send the case to a lower court for trial due to the comments of several justices on the panel.
Some justices seemed inclined to send the case back to the trial court, this time letting a jury decide the winner.
“This sounds like a great argument for a jury,” Justice Brett Busby said.
Justice Debra Lehrmann agreed, saying, “It sounds like a fact issue.”
Comments from Dr. Malouf’s attorney about the facts of the case against Dr. Malouf will make a trial very interesting indeed.
Both sides agree Malouf used his Medicaid provider identification number for claims on services performed by dentists who weren’t registered for the program, but the sides differ on whether the state told Malouf he could do that. He and a member of his billing department testified at trial that an unidentified employee in the Medicaid program said he could, but the state says there’s no evidence that conversation ever took place.
For the state to prove Malouf committed fraud…, it must show not only that he submitted the incorrect Medicaid identification number but also the wrong license type of the treating employee. The state can’t prove the incorrect license type because the reimbursement form doesn’t ask for it…
It would be wonderful to see some of the actors of this drama finally get on the stand, like Dr. Linda Altenhoff, maybe now still a vice-president of MCNA.