Carousel Pediatrics, a chain of Austin clinics originally accused of defrauding the government of $18 million in Medicaid payments, has agreed to repay $3.75 million for what regulators called a “pattern of billing errors” over four years. The settlement allowed … Read More
On February 27th, administrative law judge Rick Gilpin of Texas Health and Human Services Commission issued a final order in the “credible allegation of fraud” payment hold case of Antoine Dental of Houston, fully reversing the Proposal for Decision written … Read More
In a highly unusual move, a judge working for the Texas Health and Human Services Commission last week overturned findings of an outside judge — essentially changing a finding of innocence to one of guilt. The case is particularly unusual … Read More
March 5, 2014 — A Texas judge has upheld payment holds on Medicaid payments for Houston dental clinic Antoine Dental Center (ADC), citing credible evidence of Medicaid fraud. The clinics billed about $8.1 million for orthodontic services in less than … Read More
In 2011, state regulators announced that they were taking a giant stride toward fighting blatant insurance fraud. They said they had identified nearly four dozen dentists and orthodontists who had ripped off taxpayers by billing Medicaid tens of millions of … Read More
This past week a number of Medicaid dentists filed suit against ACS, Affiliated Computer Systems, the state’s Medicaid claims administrator better known as TMHP or the Texas Medicaid and Health Partnership. The dentists allege that ACS was negligent in their … Read More
Antoine Dental Center of Houston, Harlingen Family Dentistry of Harlingen, M&M Orthodontics of San Antonio and Dr. Paul Dunn of Levelland filed suit this past Monday against ACS, Affiliated Computer Services, the state’s private contractor which handles claims administration for … Read More
Texas State Office of Administrative Hearings judges, the Honorable Howard Seitzman and the Honorable Catherine Egan, provided their final Proposal for Decision in the case of Houston’s Antoine Dental Center to HHSC Excecutive Director Dr. Kyle Janek on Thursday. Antoine … Read More
The Texas Sunset Commission is evaluating the state Health and Human Services Commission this coming year under its mandate to periodically review Texas state agencies for their operation and need to exist. About the Commission The Texas Legislature created the … Read More
After a 40-year career, Dr. Paul Dunn is now on the verge of bankruptcy because he helped Medicaid children. In 2012, HHSC-OIG placed Dunn’s practice in Levelland under a 100% “credible allegation of fraud” payment hold for his orthodontic Medicaid … Read More
Austin: (PR Web): Two administrative law judges with the Texas State Office of Administrative Hearings (SOAH) have issued their proposal for decision in the case of Antoine Dental Center of Houston (ADC) SOAH Docket No. 529-13-0997. ADC had been placed … Read More
by Becca Aaronson, The Texas Tribune November 5, 2013 The Texas Health and Human Services Commission’s Office of Inspector General, which says that hundreds of millions of dollars have been misspent on fraudulent Medicaid orthodontic and dental claims, has lost … 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
Nearly two years after news broke that Texas spent more on orthodontic claims in its Medicaid program than the other 49 states combined, the Health and Human Services Commission’s Office of Inspector General is barely knee deep in its effort … 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
September 23, 2013 — A Texas judge has ordered the state to return $1.3 million that was withheld from Harlingen Family Dentistry (HFD) based on unfounded allegations of fraud on orthodontic Medicaid billings. Travis County Judge Amy Clark Meachum has … 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
SPECIAL TO THE EXPRESS NEWS- HARLINGEN,Tx July 30,2013- Dr. Juan Villarreal, a dentist at Harlingen Family in Harlingen Texas gets ready to check a patient at his office Tuesday July 30,2013. Photo by Delcia Lopez via In Medicaid, docs guilty … 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
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
Some members of Congress are alarmed by our latest investigative report on Dr. Tariq Mahmood’s hospitals. The story, published Sunday, showed that regulators gave the six Texas hospitals nearly $18 million in economic stimulus funds for switching to electronic medical records … Read More
State lawmakers approved a wide range of measures in the 83rd legislative session that will affect Texans’ medical care. Use this interactive to take a look at 31 ways those laws will change Texas health policy. Full story click below. … 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 following is information on upcoming court hearings that are vitally important to this whole dental Medicaid provider issue. On August 13 at 9:00 a.m., an HHSC Appeals Judge will hear M&M Orthodontics of San Antonio’s Plea to the Jurisdiction. … Read More
TDMR has learned that Jason Ray, attorney at the Austin law firm of Riggs, Aleshire & Ray, P.C., recently negotiated a full settlement of an OIG complaint and payment hold against a dentist in the Dallas area. The dentist, who … Read More
On Friday, June 14th, without fanfare, Gov. Rick Perry signed Senate Bill 1803 into law. The legislation will take effect September 1st. This is a tremendous victory for all Medicaid providers in Texas as it provides for legislated due process … Read More
On May 29th, lawyers for Harlingen Family Dentistry and the Texas HHSC-OIG appeared in Travis County District Court before The Honorable Judge Amy Clark Meachum. As outlined in a previous article “Harlingen Family Dentistry Seeks Court Order for Return of … Read More
In 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 … Read More
TDMR has responded in the McAllen Monitor to a piece reprinted there from the Texas Tribune from April 25th “Legislators Seek Action on Medicaid Fraud Measures.” TDMR Director of Communications Chuck Young penned an opinion piece regarding problems in the … Read More
On May 16th, SB 1803 (CSSB 1803) came before the Texas House of Representatives for third reading. Rep. Kolkhorst and Rep. Guerra added amendments and made comments about the necessity of putting in legislation due process rights for all Medicaid … Read More
This morning, the Texas House of Representatives passed CSSB 1803 with a vote of 119 to 20 in favor. This is a great victory for Medicaid providers as it for the first time outlines in legislation due process rights. The … Read More
Texas Dentists for Medicaid Reform questions why Texas taxpayers will pay up to $500 an hour to Dallas law firm Waters & Kraus when legislators have already approved monies for OIG staff expansion; a trend if applied to all cases … Read More
The bill that was to enshrine due process rights for Medicaid providers now heads for a House vote and bears less resemblance to the bill that entered the House. SB 1803, now CSSB 1803, while having many good points remaining, … Read More
Since public testimony on Tuesday, the House Human Services Committee voted on a committee substitute for SB 1803, adding a number of clarifications and additions to the bill, and passed it 6-0, with three members not in attendance. The bill … Read More
Public testimony on SB 1803 was held on Tuesday, April 30th, before the House Human Services Committee. The House sponsor of the bill was no less that the chair of the House Public Health Committee Lois Kolkhorst. Again a number … Read More
AUSTIN, (April 30th, 2013) — Medicaid providers will speak out today in favor of Senate Bill 1803 before the Human Services Committee of the Texas House of Representatives. The bill provides for more thorough vetting of fraud claims by the … Read More
On Tuesday April 30th at 10:30 am, the Texas House Human Services Committee will hear public testimony on Senate Bill 1803. This bill passed the Senate unanimously 31-0 a few weeks ago and was drafted by Senator Joan Huffman, a … Read More
Group producing videos to show the human cost of enforcement actions against Medicaid providers without due process protections in place Austin, Tx (PRWeb): Texas Dentists for Medicaid Reform (“TDMR”) has posted 13 videos of the public testimony given on March … Read More
The following dentists and one dental staff person spoke about their experiences with the Office of Inspector General while testifying in favor of House Bill 1536 during public testimony in front of the House Human Services Committee on March 19th. … Read More
