Harlingen Family Dentistry Seeks Court Order for Return of “Credible Allegation of Fraud” Payment Hold Funds

Suit against OIGIn a press release this past week, Harlingen Family Dentistry, the practice of Dr. Juan Villarreal in Harlingen, Tx, announced that through Austin attorney Jason Ray, it has filed a motion for a writ of mandamus in Travis County District Court. The writ seeks to have Texas Health and Human Services Commission Executive Commissioner Dr. Kyle Janek and Douglas Wilson, the HHSC Inspector General, compelled to return $1.3 million of funds previously withheld from HFD when the Inspector General claimed it had “credible allegation of fraud” against HFD. After a trial, the State Office of Administrative Hearings found no evidence to support a claim of fraud (SOAH Docket No. 529-13-3180 Harlingen Family Dentistry vs. Texas Health and Human Services Commission). Court documents show that hold had been in place since 2011.

According to the filings, in October 2012, a State Office of Administrative Hearings judge found that HFD had not committed any fraud in its Medicaid orthodontic billings and that the payment hold be reduced from 40% to 4% of HFD’s total Medicaid billings to account for some possible policy violations. The documents show that the Inspector General only proved, at best, a right to withhold $311,995.52 of the $1.414 million in total withheld by the state. The decision was upheld by an HHSC administrative judge in January of this year.

“OIG has refused to acknowledge the findings of the SOAH and HHSC judges and will not return the funds that they were never entitled to withhold in the first place,” states Mr. Ray of the firm Riggs Aleshire & Ray, P.C. “We have no choice but to go to court again to compel them to return the money.”

Under a writ of mandamus, a judge has the power to compel government officials to fulfill an official obligation. In this case, HFD is seeking court intervention to require the Inspector General to return funds which the officials never had the right to withhold, but still refuse to release. HFD claims the government has an obligation to return those improperly sequestered funds.

The hearing will be held May 29, 2013, at 9:00 a.m. in Travis County District Court.

Documents:

Petition for Writ of Mandamus
Notice of Hearing
Affidavit of Dr. Villarreal