The Office of the Inspector General website now has a report detailing the 2012 fraud detection and recovery activity of all managed care organizations (MCOs) that participate in Texas Medicaid. Under Texas Government Code, Section 531.113, the MCOs are required … Read More
At the recent Texas Tribune Tribunefest on health care held between September 27th to 29th, there were a number of interesting sessions. The second session moderated by Tribune health care reporter Becca Aaronson discussed Medicaid. Entitled, “The Fight of Over … Read More
by Becca Aaronson October 15, 2013 Texans discovered nearly two years ago that the state was spending more on orthodontic claims in its Medicaid program than the other 49 states combined, but recovery of millions in purportedly misspent Medicaid money … Read More
By Donna Domino, Features Editor October 9, 2013 — A jury has found that Small Smiles dentists did not perform unnecessary dental procedures on a young boy at one of the chain’s clinics in New York. The judge found that … Read More
The following is from a story from the October 5th Austin American Statesman. Texas AG sued by own lawyer Plaintiff says his initial complaints about office garnered reprisals. By Jazmine Ulloa A lawyer for the Texas attorney general’s office has … Read More
Here is the final judge’s order directing the Texas Health and Human Services Commission’s Executive Commissioner Dr. Kyle Janek and Inspector General Doug Wilson to return $1,255,195.20 to Harlingen Family Dentistry. The order can be downloaded here. AMENDED FINAL JUDGMENT … Read More
TDMR has put together this article to give dental and other Medicaid providers some common language understanding of the provisions of Senate Bill 1803 now in force to protect their due process rights. We have used the text of … Read More
This morning the San Antonio Express published a feature article headlining the case of Harlingen Family Dentistry and Dr. Juan Villarreal and his fight against the Office of Inspector General and their “credible allegation of fraud” payment holds. Reporter Jeremy … Read More
Harlingen Family Dentistry has won a tremendous legal victory this week. Travis County District Court Judge Amy Clark Meachum has granted HFD’s motion for a writ of mandamus to force the Office of Inspector General to return more than $1 … Read More
Back on September 5th, the Texas Tribune hosted a conversation on the future of Latino health care with Dr. Esteban López, a regional president for Blue Cross Blue Shield of Texas, Dr. Amelie Ramirez, director of the Institute for Health … Read More
The Health and Human Services Commission has put online its self-report to the Sunset Commission as HHSC is coming up for review by the Commission this coming year. The link below will take you to the HHSC website where you … Read More
Here are the latest statistics just released by HHSC. Children Enrolled in Medicaid, CHIP and CHIP Perinatal Programs by Month Month Children Enrolled in Medicaid¹ Children Enrolled in CHIP² Children Enrolled in CHIP Perinatal Coverage Total Children Enrolled Sep-13 2,511,311 … Read More
This past week State Office of Administrative Hearings (SOAH) Judge Roy G. Scudday ruled that Christine Ellis and her qui tam lawyers had no standing to appear in a hearing regarding an HHSC-Office of Inspector General payment hold placed on … Read More
The following was in the latest HHSC newsletter “In Touch.” HHSC’s Office of Inspector General (OIG) will hire 127 new employees over the next year, two-thirds of whom will be in enforcement as the division looks to speed up fraud … Read More
Ever wonder why Medicaid and Medicare rates are so low or why there was a Frew lawsuit? What about the future for reimbursement rates for Medicaid or Medicare health care providers in Texas? No need to wonder. Here’s your answer. … Read More
This past week attorneys for Antoine Dental Center (ADC) and those representing the Office of the Inspector General filed their closing arguments in the pending State Office of Administrative Hearings (SOAH) case. The case challenges the 100% payment hold that … Read More
Karen Nelson is no longer with the Office of Inspector General. The former Deputy Inspector General for the HHSC-OIG is now working for the Austin office of the DLA Piper law firm. Nelson apparently left OIG last month. One can … Read More
Hearing Transcripts Now Available for Download Antoine Dental Clinic vs. HHSC-OIG – Vol. 1 Antoine Dental Clinic vs. HHSC-OIG – Vol. 2 Antoine Dental Center v. THHSC, OIG – Vol. 3 Antoine Dental Center v. THHSC, OIG – Vol. 4 … Read More
The Texas Tribune published today an article outlining the coming changes to the Texas State Board of Dental Examiners as a result of House Bill 3201 that was passed by the legislature and signed by the governor. The legislation will … Read More
Here are some recent media stories that relate to Medicaid and Medicaid fraud. June 18th – Medicaid Orthodontist found guilty July 19th – Perry orders investigation into oversight of troubled rural hospital chain _ Dallasnews July 24th – AG, Planned Parenthood Affiliate … Read More
