Lafountain Settlement Continues TMFPA Travesty and Highlights Need for Change

Back in 2020, we started reporting on the various whistleblower claims brought by Joshua Lafountain, a former dental office manager in Dallas with no formal dental training, against 71 various Medicaid dentists and dental entities. Although he had never worked in any of the offices nor seen any of their patient records, he filed lawsuits in 2016 under the Texas Medicaid Fraud Prevention Act claiming the dentists involved had committed Medicaid fraud. His argument? The dentists had worked at the same dental office as him briefly, so he suspected them although they had done nothing wrong.

Lafountain filed his legal actions four years after leaving dental healthcare in 2012, and at the time of his deposition in 2020, he was unemployed after he quit driving for a ride-sharing service.

Pretty shady, you say?

Under oath in his April 2020 deposition, Lafountain testified, among other things, that he had gambled during office hours using office computers and even borrowed money from dental staff to pay his gambling debts. Public records showed he had an outstanding criminal charge for a traffic violation in Collin County since 2017 and had had a criminal charge outstanding against him in Florida for a decade.

It should be noted that four days after TDMR published the article in October 2020 on Lafountain's outstanding criminal charge in Collin County, the Collin County court records show that a lawyer associated with one of his qui tam law firms was added as his attorney of record. After a pre-trial hearing in August of this year, the charge was dismissed. Check it out here - case number 01-TR-17-01651.

Guess someone realized their client didn't look so good

Regardless of this charge being dismissed, an online public records firm currently rates Lafountain's reputation as 0.0 out of five, 0.0 being the worst.

How can the OAG and its Civil Medicaid fraud division justify this?  

It is an irony that an individual with such a low reputation and admitting under oath to horrendous workplace misbehavior should have his allegations against Medicaid providers with unblemished records supported by the Civil Medicaid Fraud division of the Texas Office of the Attorney General.

It becomes less funny when such an individual has now probably received over $500,000 for this scheme while dedicated healthcare providers get taken for millions.

Frankly, it's outrageous. It is legitimized extortion, in our opinion.

We've written about the need for honest Medicaid providers to be protected from such schemes. Members of the House Committee on Judiciary & Civil Jurisprudence were outraged about it. Earlier this year the committee members unanimously passed HB 3082 to fix the TMFPA and they had some harsh words to say about the abuse of the act on providers.

Raymond C. Winter, the head of the Civil Medicaid fraud division, was there and heard their concerns. He even testified. But nothing seems to have changed in the conduct of the Civil Medicaid division of the OAG. The tragedy of the Lafountain cases still moved forward afterward.

Lafountain case trial date set  for November

Two weeks ago, we reviewed Dallas County 162nd District Court records which showed that one Lafountain case was still outstanding. The online portal showed that a public jury trial was scheduled before Judge Marciella Moore on November 9.

A jury trial? Getting one's day in court before a judge and jury is the dream of many providers so accused. To test these serious allegations of Medicaid fraud against actual evidence is what many providers so accused have said they desired to prove their innocence.

It is something we have wanted to happen for many years.

Settlement occurred in June

However, this will not happen in this case. After looking at the court record, we made inquiries and were informed that a settlement had been reached months ago. So TDMR received a copy of the settlement agreement by way of an open records request to the OAG.  The agreement was signed by the parties in June.

In checking the Dallas Court record today, we found that a notice of dismissal with prejudice ending the case was finally signed by Judge Maricela Moore last Thursday, one day after the open records request to the OAG for the settlement agreement was sent to and received by the OAG.  You can check out the Dallas County court record here - use the Smart Search and case number DC-20-03366.

With the agreement in hand, we can now report that a settlement was reached for $800,000 to be paid to the state. The agreement is below.

It is sad and amazing what a high-powered, politically connected legal team can do for the brazen yet reputationally challenged empowered by the state.

OAG approved $800,000 settlement despite legislative concerns

Despite the concerns of members of the legislature about such cases made in public hearings just a few months ago, the OAG wrote in the settlement agreement that "The STATE has concluded and agrees that the settlement, as set forth in this Agreement, is in the public interest and is fair, adequate, and reasonable under all the circumstances."

We even found a new clause in this agreement that attempts to shut down criticism of such agreements by the parties involved.

It states: "The [Parties] and their respective agents and attorneys agree not to disparage, defame, or discredit any party to this Agreement or their respective agents or attorneys or engage in any activity which would have the effect of disparaging, defaming, or discrediting any party to this Agreement or their respective agents or attorneys. [The Parties] and their respective agents and attorneys will keep confidential and will not disclose to any third party (except for the purposes of obtaining tax or legal advice or complying with a lawful request, subpoena, or order) the terms of this Agreement or any information relating to the [lawsuit]."

For the record, no party to the settlement agreement has approached TDMR about this settlement, commented upon it to us, or provided us a copy of the agreement.  Again, the agreement was obtained via open records request.

Government employees, when they do their jobs well, deserve the thanks of the people of Texas.

But when the stress and financial harm that comes to Medicaid healthcare professionals from untested allegations from unworthy individuals goes unchecked, unhindered by the state so the state profits, something is wrong.

Smells like a shakedown or some other protection racket

We echo the words of Rep. Mike Schofield, a member of the House Committee on Judiciary & Civil Jurisprudence, who said it well: "Not just in qui tam suits but this is the cost of frivolous lawsuits to Texans. Too often the legal profession as long as lawyers make money everything is okay — that suing people is a business model instead an avenue to seek justice. You see here first hand the devastation that is brought on the innocent victims who are sued by people looking to make money. My question isn't just about the relator, what do we do to the lawyer? This kind of nonsense has to stop. This is not 1950 anymore where if you sue somebody you grab a file and go to court. Even defending yourself isn't that expensive. Defending yourself [today] from a frivolous suit can wipe out a family, can wipe out a company...."

The TMFPA needs to change or heads should roll at the OAG just like heads rolled at HHSC and OIG in 2014/15 partly over the Great Ortho Debacle.