AUSTIN – The Texas Attorney General’s Office today filed a civil lawsuit in state district court against Xerox Corporation and its wholly owned subsidiary, ACS Healthcare LLC. The State’s legal action seeks to recover fraudulent Medicaid payments for orthodontic and … Read More
Date: May 9, 2014 Contact: Stephanie Goodman, 512-424-6951 The Texas Health and Human Services Commission (HHSC) today notified Xerox Corp. that the state is terminating the company’s Medicaid claims administration contract for cause after Xerox staff approved thousands of requests for braces … Read More
Back in mid-April, TDMR sent to our dental Medicaid provider mailing list a simple one question survey – What is your biggest practice challenge? We received over 90 responses and results are now tabulated. The survey shows that Medicaid dentists are now most … Read More
The New York Times has published Trib reporter Becca Aaronson’s article on TMHP. For nearly five years, a state contractor allowed workers with limited expertise to approve dental claims for Texas’ Medicaid program, the joint state-federal insurer. State spending on … Read More
by Becca Aaronson, The Texas Tribune May 2, 2014 Part two of two. For nearly five years, a state contractor allowed workers with limited expertise to approve dental claims for Texas’ Medicaid program, the joint state-federal insurer. State spending on … Read More
by Becca Aaronson, The Texas Tribune May 1, 2014 Part one of two. In 2010 and 2011, Antoine Dental was among Texas’ top-billing Medicaid providers for orthodontic services, collecting more than $1 million annually for putting braces on poor children. … Read More
The Washington Times reported yesterday that ACS/Xerox is being sued in a class action by Nevada residents who purchased health insurance from the state health insurance exchange that was set up by the company. The state government contracted with ACS/Xerox … Read More
HHSC appeals “judge” Keith Grantham has denied a motion to disqualify HHSC appeals “judge” Rick Gilpin from presiding over the overpayment “hearing” of M&M Orthodontics of San Antonio. The ruling came out April 4th. “Court,” not court TDMR is now placing … Read More
In an unheralded August 2012 audit report that is available online, the federal Health and Human Services Office of Inspector General found that the Texas Health and Human Services Commission had not returned $2.6 million in Medicaid funding back to … Read More
The following is an opinion piece written by Jason Ray, attorney for a number dentists who are being prosecuted by HHSC-OIG for their Medicaid orthodontic billings. Mr. Ray is with the firm of Riggs Aleshire & Ray, P.C. I … Read More
The American Association of Orthodontists have updated their definition of “medically necessary” care to include “emotional well-being.” They have done so because they state that recent studies have linked a “patient’s dental appearance and the incidence of bullying.” Will such … Read More
A recent review of our website content revealed to us that while PDF files containing these photos have always been on the site, perhaps they have not been as prominently displayed as they should be. Medicaid after all is about … Read More
A new security risk assessment (SRA) tool to help guide health care providers in small to medium sized offices conduct risk assessments of their organizations is now available from HHS. The SRA tool is the result of a collaborative effort … Read More
The NY Times, in conjunction with the Texas Tribune, has published an article on the recent $3.75 million settlement between Carousel Pediatrics and the Texas Health and Human Services Commission Office of the Inspector General and its affect on the … Read More
This week the Texas Attorney General filed a remarkable brief to oppose the motion to disqualify HHSC judge Rick Gilpin from a Medicaid payment hold case because he was a senior lawyer in the Attorney General’s office for some 38 … Read More
A motion has been filed with the Texas Health and Human Services Appeal Division to have Judge Rick Gilpin disqualified as a hearing officer for cases involving dentists that started while Gilpin was still an attorney within the Attorney General’s … Read More
The same HHSC judge that overturned a favorable SOAH (State Office of Administrative Hearings) decision in the payment hold case of Antoine Dental of Houston, has denied a motion to have a Medicaid overpayment hearing held at SOAH. HHSC Administrative … Read More
The Health and Human Services Commission issued a press release this afternoon that OIG has now settled with Carousel Pediatrics of Austin on claims of Medicaid fraud, now deemed billing errors, for $3.75 million. $22.1 million settled for $3.75 million … Read More
The Big Conversation If the University of Texas System regents tap Gov. Rick Perry favorite Kyle Janek as their next chancellor, they won’t get pushback from the president of the system’s flagship campus. “I’ve known Kyle for a long … Read More
TDMR has received notification that HHSC-OIG has begun a Provider Education series that will cover topics of particular interest to Medicaid providers. It is about time. The first topic is Understanding Waste, Abuse and Fraud and TDMR has rabble roused … Read More
