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
In the lawsuit against Xerox filed by the Texas Attorney General, there is one more startling revelation. The State is alleging that Xerox as early as 2004, when the company took over the contract as the state’s Medicaid claims administrator, the … Read More
Back in January 2009, a Medicaid Orthodontic Stakeholder meeting was held in Austin at the offices of the Texas Dental Association. Dr. Linda Altenhoff presided at the meeting. Dr. Altenhoff is currently the Dental Director for the Texas Health and … Read More
GAO identified a gap in state and federal efforts to ensure Medicaid managed care program integrity. Federal laws require the states and the Centers for Medicare & Medicaid Services (CMS) to ensure the integrity of the Medicaid program, including payments … Read More
Work continues to move the Medicaid claims administration contract from Xerox to Accenture. HHSC is reviewing Accenture’s readiness to take over the contract, which also includes processing claims for the Children with Special Health Care Needs program and vendor drug … 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
DALLAS (CN) – A journalist’s false allegation of personal bankruptcy did not defame a dentist whose clinics were accused of fraud, a Texas appeals court ruled. Dr. Richard Malouf, the founder and former majority owner of All Smiles Dental Care, … Read More
The owner and operator of a Houston area ambulance company was sentenced today to serve 97 months in prison for her role in a $2.4 million Medicare fraud scheme. Assistant Attorney General Leslie R. Caldwell of the Justice Department’s Criminal … Read More
Xerox Corp at the end of May was awarded a $500 million contract to revamp New York’s Medicaid system despite Texas suing the company and discontinuing their contract as chief Medicaid claims administrator in the state. The Rochester Democrat and … Read More
Yesterday, HHS-OIG issued an audit entitled “Acute-Care Hospitals In Texas Did Not Always Reconcile Invoice Records With Credit Balances And Refund To The State Agency The Associated Medicaid Overpayments.” The federal auditors, in looking over eight acute care hospitals in Texas, … Read More
Medicare spent $6.7 billion too much for office visits and other patient evaluations in 2010, according to a report from the inspector general of the Department of Health and Human Services. But in its reply to the findings, the Centers … 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
With the Attorney General of Texas filing suit against Xerox and the Health and Human Services Commission publicly washing its hands of the Fortune 500 company as lead contractor in the Texas Medicaid and Healthcare Partnership, Xerox now joins dental … Read More
Gov. Rick Perry has reappointed Cathleen Parsley of Austin as Chief Administrative Law Judge for the Texas State Office of Administrative Hearings for a term to expire May 15, 2016. The judge oversees hearings in contested cases to ensure they … 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
TDMR filed an open record request a while ago to obtain the Texas dental Medicaid spending figures for the years from 2000 to 2005 and 2012, 2013. Texas Medicaid orthodontic spending from 2006 to 2011 has been heavily reported so we … 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
Last year, state regulators accused Dallas-area dentist Everett Evans of bilking Medicaid out of millions of dollars by performing unnecessary procedures and billing for work he didn’t do. They froze more than $800,000 in pending payments to him from the … 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
REPUBLISHED FROM THE TEXAS TRIBUNE BY BECCA AARONSON Editor’s Note: This story has been updated throughout to reflect the state’s decision to cancel its contract with the Texas Medicaid and Healthcare Partnership, and the company’s response to the state’s actions. As the … 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
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
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 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
HOUSTON—Jeffery Parsons, of Crockett, and David Edson, of Palm Harbor, Florida, have been charged in a 13-count indictment alleging a conspiracy to pay kickbacks to several area personal care home owners and patient advocates, announced United States Attorney Kenneth Magidson … Read More
HOUSTON – Yolanda Nowlin, 42, has been ordered to federal prison for 11 years following her multiple convictions in relation to a large health care fraud conspiracy, announced United States Attorney Kenneth Magidson. A federal jury in Houston convicted Nowlin … 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
April 4, 2014 — The Indiana attorney general has filed Medicaid fraud and other criminal charges against three dentists and six others at a dental office in Anderson. The charges allege that Anderson Dental Center owner Sally Metzner, the dentists, … Read More
Nothing about Texas Medicaid spending on dental or orthodontia. Medicaid Integrity Program Report for Fiscal Year 2013.
Pharmaceutical manufacturer Teva Pharmaceuticals USA Inc. and a subsidiary, IVAX LLC, have agreed to pay the government and the state of Illinois $27.6 million for allegedly violating the False Claims Act by making payments to induce prescriptions of an anti-psychotic … Read More
DALLAS — Dr. Nicolas Alfonso Padron, 54, of Garland, Texas, was sentenced this morning by U.S. District Judge David C. Godbey to 57 months in federal prison and ordered to pay $9,484,111 in restitution to the Centers for Medicare and … Read More
The Idaho Department of Health and Welfare (State agency) did not implement adequate information system general controls over its Medicaid claims processing system. We identified 19 reportable weaknesses, which we consolidated into 5 findings and grouped into access controls, configuration … Read More
The New Jersey Department of Human Services (State agency) generally claimed Federal reimbursement for Disproportionate Share Hospital (DSH) payments that did not exceed hospital-specific limits. DSH payments may not exceed hospitals’ uncompensated care costs for providing services to patients who … Read More
March 28, 2014 — Some 23 New York state general dentists and six orthodontists received $13.2 million in Medicaid payments in 2012 for services that appeared unnecessary or may not have been performed at all, according to a new report … Read More
With a high-profile legal settlement with Carousel Pediatrics, a children’s health provider, under its belt, the Texas Health and Human Services Commission’s Office of Inspector General says its ramped-up efforts to rein in Medicaid fraud have started to pay off. … Read More
