As reported in the press this week, there has been a tremendous effort on the part of the new Health and Human Services Commission Inspector General Stuart Bowen to settle old, outstanding investigations against Medicaid providers—including dentists. Per the Chronicle, … Read More
The recent decision by a Travis County District Court judge that again vindicated Antoine Dental Center of Houston on allegations of Medicaid fraud and vacated a three-year “credible allegation of fraud” payment hold has been appealed by the Civil Medicaid … Read More
Back in May of 2014, the State of Texas terminated Xerox as the state’s Medicaid claims administrator and filed suit against the company. The state is seeking recompense for hundreds of millions of taxpayer dollars paid out by the company for … Read More
AUSTIN – Texas Health and Human Services Executive Commissioner Chris Traylor today announced John Scott is stepping down as chief operating officer of The Health and Human Services Commission (HHSC). Scott joined HHSC in January, where he served as the … Read More
McALLEN — A Pharr woman pleaded guilty Friday for her role in connection with a federal healthcare insurance fraud scheme, prosecutors said. Martha Lidia Flores admitted to engaging in a kickback scheme of exchanging referrals of Medicare beneficiaries for money … Read More
Yesterday, Travis County District Court Judge Amy Clark Meachum issued her decision in the case of Antoine Dental Centers of Houston, vindicating the practice in its payment hold case. The practice had been accused of “credible allegations of fraud” in … Read More
Gov. Abbott’s Health and Human Services Commission Strike Force, besides reviewing the Medicaid fraud software contract with 21CT and Jack Stick, looked at the Health and Human Services Commission dealings with Xerox and its contract dealing with the company’s handling of Medicaid … Read More
TDMR has learned today that OIG administrative actions against a number of dental providers that have been accused of “credible allegations of fraud” have been nonsuited by OIG. UPDATE: Here is the document State v. Dentists The affected providers include Antoine Dental … Read More
A former CFO at a now-shuttered hospital has pleaded guilty to submitting false documents so the medical center could receive $785,000 in payments under the HITECH Act electronic health records financial incentive program. Some legal experts predict that more federal … Read More
Two weeks ago, the Texas Office of the Attorney General quietly filed a lawsuit against yet another company associated with Texas Medicaid – the drug company AstroZeneca. Millions of dollars in excess reimbursements It accuses the company of defrauding the Texas … Read More
AUSTIN—Texas Attorney General Greg Abbott has resolved an enforcement action against Ranbaxy, a generic drug manufacturer. The agreement resolves the State’s lawsuit under the Texas Medicaid Fraud Prevention Act (“TMFPA”) against Ranbaxy Pharmaceuticals, Inc., Ranbaxy Laboratories, Inc., Ranbaxy USA, Inc. … Read More
While critics were hounding Gov. Rick Perry a decade ago about his job-luring Texas Enterprise Fund, his lawyers went to Attorney General Greg Abbott to block the release of applications that supposedly had been filled out by the entities requesting … Read More
The owner of a home health services company was sentenced to serve five years in prison for his leading role in a conspiracy to structure over $1.8 million in bank withdrawals to conceal a $4.5 million healthcare fraud scheme. Assistant … Read More
The following excerpt is from the Houston Chronicle about Xerox and the State coming to an agreement on the disputed files. AUSTIN – Lawyers for the Xerox Corp. agreed Thursday to temporarily turn over private health information about millions of … Read More
Law360, New York (August 11, 2014, 2:39 PM ET) — The state of Texas has reached a $19.5 million settlement with Taro Pharmaceuticals USA Inc. to resolve allegations that the drug company fraudulently reported inflated drug prices to the Medicaid … Read More
Texas is “ultimately responsible” for millions of misspent Medicaid dollars, according to a new federal audit, because a state agency failed to properly oversee the contractor that reviewed the medical necessity of Medicaid claims. For nearly five years, the Texas … Read More
At a recent deposition in Austin, lawyers for a dental Medicaid provider discovered that the State has invested thousands of dollars to employ a well-known Dallas jury consultant to help prepare the State’s witnesses to testify in depositions and in administrative … Read More
At the end of July, Xerox, Texas Medicaid’s disgraced former claims administrator, filed for a protective order with the Travis County District Court. The stated reason for the order is because the Office of the Attorney General has apparently demanded … Read More
t was the summer of 2002 and it appeared that Democrat Tony Sanchez might be gaining traction in his campaign against Gov. Rick Perry by depicting the incumbent — who had received $1 million in insurance company money in his … Read More
AUSTIN — When Baylor Regional Medical Center in Plano was accused of protecting a neurosurgeon whose patients died or were maimed, it got some outside help from Attorney General Greg Abbott. Abbott has intervened in three federal cases on the … Read More
Last week Xerox filed a response to both the lawsuit filed by the State of Texas and its dentist intervenors about Xerox’s allegedly deficient Medicaid orthodontic prior authorization process that led to $1.1 billion in program spending without proper review. … Read More
ALBANY—New York State’s decision to award a $550 million Medicaid management contract to Xerox is being challenged by two companies who say the company’s recent history of Medicaid management in other states should disqualify it from running New York’s system. … Read More
As part of the lawsuit against Xerox, the former lead contractor for the Texas Medicaid and Healthcare Partnership, the Texas Office of the Attorney General alleges that Xerox, from the beginning of its contract with Texas, wrote misleading documents that … Read More
As Texas neared the end of a decade-long legal fight over homeowners’ insurance rates with Farmers Insurance Group in December, the company’s employees PAC gave $50,000 to the gubernatorial campaign of Attorney General Greg Abbott — the top lawyer in … Read More
Apparently TMHP/Xerox “dental specialists” were only trained to add up HLD scores on Medicaid orthodontic pre-approval requests and determine whether the total was 26 points or more, per allegations contained in the lawsuit filed against Xerox by the Attorney General … Read More
On May 7th, Dr. Kyle Janek, the Executive Commissioner of the Texas Health and Human Services Commission, issued his final order in the case of Antoine Dental Center of Houston. Upheld reversal of favorable SOAH ruling on Antoine Dental As expected, … Read More
The office of Attorney General Greg Abbott — the Republican gubernatorial candidate — is appealing a whistleblower’s lawsuit and $1.2 million verdict, arguing that an El Paso jury was wrong when it decided that the agency fired an employee in … Read More
May 27, 2014 — In the latest flurry of lawsuits in the Texas Medicaid scandal, eight dentists have filed suits claiming the state and attorney general (AG) “protected” Xerox because they feared a federal clawback for hundreds of millions of … Read More
May 20, 2014 — In the wake of a Texas lawsuit that claims Xerox wrongly approved Medicaid claims for orthodontic services that were not medically necessary, some of the dentists being pursued for orthodontic overpayments are now suing Texas for … Read More
Last week, Attorney General Greg Abbott filed a lawsuit against Xerox and its subsidiary, ACS Healthcare, alleging that the company had not properly vetted dentists’ pre-authorization requests to perform Medicaid orthdontic work on poor children, saddling taxpayers with hundreds of … Read More
Several suits by Medicaid providers filed today in Travis County’s 53rd Civil District Court seek to intervene in the recent lawsuit brought by the state of Texas against former state Medicaid claims contractor, ACS/Xerox (henceforth “Xerox”). Recover damages from both … Read More
AUSTIN, Texas, May 9, 2014 /PRNewswire/ — The lawsuit filed today by the Texas Attorney General’s office regarding Xerox’s performance administering the state’s Medicaid orthodontic program is misdirected. Xerox will defend itself vigorously. We are also disappointed with the HHSC … Read More
The state of Texas on Friday moved against the contractor in charge of pre-authorizing controversial orthodontic and dental procedures, canceling a large contract with ACS Healthcare and suing the company and its corporate owner, Xerox Corp., to recover hundreds of … Read More
As the Texas Attorney General’s office on Friday announced it filed a lawsuit against state contractor Xerox, in an effort to reclaim hundreds of millions of dollars the company allegedly erroneously doled out for medically unnecessary Medicaid claims, the Health … Read More
AUSTIN — Attorney General Greg Abbott sued Xerox Corp. Friday over allegations that it let unscrupulous dentists put braces on thousands of poor children who didn’t meet the government’s strict criteria for the expensive work. Also Friday, the state’s Medicaid … Read More
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
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
WHY WE DID THIS STUDY OIG oversees the activities of all Medicaid Fraud Control Units (MFCUs or Units). As part of this oversight, OIG conducts periodic reviews of all Units and prepares public reports based on these reviews. The reviews … 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
The Baylor Regional Medical Center at Plano, accused of protecting a neurosurgeon who allegedly killed and maimed patients, gained an ally this week in Texas Attorney General Greg Abbott. Abbott filed motions to intervene in three separate federal court suits … Read More
