Recently the Health and Human Services Office of Inspector General issued a report A-17-17-52000- U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES MET MANY REQUIREMENTS OF THE IMPROPER PAYMENTS INFORMATION ACT OF 2002 BUT DID NOT FULLY COMPLY FOR FISCAL YEAR … Read More
TDMR is releasing the results of its 2017 Medicaid Provider survey today. Not much has changed Not much has apparently changed for Medicaid providers from 2016. per the 337 individuals who answered our anonymous, 6 question survey in October and … Read More
The Statesman published a landmark article this morning by reporter Eric Dexheimer regarding the great Texas orthodontic debacle. Story finally pieced together Thanks to the state’s fraud suit against Xerox, its former Medicaid claims administrator summarily terminated back in early … Read More
A dozen years ago, Texas health care administrators hired a company to help determine when taxpayers should cover the cost of dental care for the state’s poorer residents, particularly children. The company, later acquired by the giant corporation Xerox, deployed … Read More
A purchasing official for Child Protective Services has resigned after a state investigation concluded she had a conflict interest when her husband took a job with a nonprofit that had multimillion-dollar contracts with the state. Patrick Crimmins, spokesman for the … Read More
Texas’ top health care fraud investigator resigned Wednesday night, the result of a news report that revealed he was “moonlighting as a federal contractor to provide consulting services and counsel to the government of Iraq.” The Austin American-Statesman reported Thursday … Read More
Stuart W. Bowen Jr., the inspector general for the Texas Health and Human Services Commission, resigned last night amid questions from Texas Monthly about his role in getting Iraq removed from President Trump’s ban on travel from Middle Eastern nations. … Read More
The Texas Monthly has reported that Health and Human Services Inspector General Stuart W. Bowen Jr. resigned last night. He was asked to resign by Gov. Greg Abbott because he had hidden the fact that he was also employed by … Read More
The Inspector General wants your feedback on our website, https://oig.hhsc.texas.gov/. Please take our quick, 7 question survey and let us know how you use our site, what you like about it, and what we can improve on. Click on the link … Read More
For the last several years, TDMR has provided contact information on its website for reporting Medicaid fraud, waste and abuse to both state and federal healthcare authorities. From the links provided on practically every page of our website, anyone could go … Read More
TDMR received a notice yesterday from the Health and Human Services Inspector General office that Inspector General Stuart Bowen will be hosting, along with Sen. Chuy Hinojosa, a “Rio Grande Valley Medicaid Integrity Symposium.” The event is to take place … Read More
The following is a statement received from MB2 Dental Solutions, the Dallas-area dental service organization, that recently settled with federal and state authorities for a whopping $8.45 million over allegations of Medicaid fraud. A company representative told us that they … Read More
TDMR has learned from a staffer in the office of Sen. Juan “Chuy” Hinojosa that they have been informed by Health and Human Services that managed care organizations, including MCNA, do not have any right under any Texas or federal … Read More
Update 3:30 p.m.: U.S. District Judge Sam Sparks issued a temporary order Thursday blocking Texas officials from ousting Planned Parenthood as a Medicaid provider — a termination set to take place Saturday.Sparks did not rule on the merits of the … Read More
The Texas Attorney General’s office has accused some of the state’s largest pharmacies of cheating the Medicaid program by reporting exaggerated prices on medications and raking in larger reimbursements than they deserve. And while several pharmacies have settled with the … Read More
At the same stakeholders meeting last February that representatives from MCNA and Dentaquest provided briefings, the then-dental director for the Health and Human Services Inspector General, Dr. Linda Altenhoff, presented on rules and regulations regarding solicitation by dental providers. Altenhoff … Read More
Sen. Lois Kolkhorst asked a pertinent question to Inspector General Stuart Bowen this past September, “Are you auditing MCOs for fraud?” The question came in the context of a hearing being held by the Senate Committee on Health and Human … Read More
In testimony before the Senate Committee on Health and Human Services in September, Inspector General Stuart Bowen shocked committee chairman Sen. Charles Schwertner with the revelation that the 22 MCOs (managed care organizations) operating in Texas had only found and … Read More
There have been rumors flying by the last few weeks that Inspector General Stuart Bowen wants to make it easier to place “credible allegation of fraud” (CAF) payment holds against Medicaid providers. We had no idea that this was difficult … Read More
Dr. Linda Altenhoff is no longer with the Inspector General’s office as Chief Dental Officer. In August, she moved over to MCNA and is now Associate Dental Director for MCNA Texas and works out of San Antonio. Named IG Chief Dental … Read More
The Texas Tribune this morning published an article that indicates the fate of Texas Health and Human Services Inspector General Stuart Bowen is uncertain at this time. Planned Parenthood investigation tied to fund-raising effort The context of the story was … Read More
Feeding on outrage sparked by the release of controversial undercover videos of Planned Parenthood officials, Gov. Greg Abbott vowed one year ago to cut off $3.1 million in Medicaid funding that the organization’s Texas affiliates receive to provide family planning … Read More
In his recent quarterly report, Health and Human Services Commission Inspector General Stuart Bowen announced the kickoff off his initiative to increase awareness and cooperation on fraud, waste and abuse between Medicaid stakeholders. The IG Integrity Initiative (IGII) is described as … Read More
This week the Health and Human Services Commission Inspector General released his June 2016 quarterly report on the activities of his agency. Besides announcing the creation of a Pediatric Dentistry Action Team, the report also discloses that more Medicaid dentists … Read More
One of the main items of interest to Medicaid dentists from the latest quarterly report from the Health and Human Services Commission Inspector General Stuart Bowen is that a “Pediatric Dentistry Action Team” has been created within his agency. The … Read More
Today, Health and Human Services Commission Inspector General Stuart Bowen Jr. issued his fourth quarterly report since he took office back in early 2015 replacing former Inspector General Doug Wilson. Please find a copy of the report below. It can … Read More
Over the past two weeks, it has been a major story that Attorney General Ken Paxton took a $100,000 donation for his personal legal fees from a friend whose company was accused of Medicaid fraud. The company just settled the … Read More
HHSC’s Inspector General is enlisting the help of managed care organizations and health care providers to fight Medicaid fraud, waste and abuse in a cooperative effort. The office’s Integrity Initiative creates a framework for managed care organizations, health care providers … Read More
Back on May 19, Sen. Chuy Hinojosa and Rep. Richard Peña Raymond hosted a town hall meeting for providers on Medicaid managed care in Edinburg at the Edinburg Conference Center at Renaissance. It has taken a while but here are … Read More
You might remember the case of Austin dentist, Dr. Rachel Trueblood. $16 million overpayment demand settled for $39,000 Back in 2014, Dr. Trueblood had been accused of Medicaid fraud, placed on “credible allegations of fraud” payment hold which closed her … Read More
The policy revision to the Medicaid orthodontic benefit process contemplated by representatives of the Texas Medicaid and Healthcare Partnership and the Health and Human Services Commission in 2009 was sweeping. Per the final draft of the confidential policy revision attached … Read More
The Health and Human Services Commission in February 2009 asked the individuals working on the new Medicaid orthodontic benefit policy to review whether or not a board certified orthodontist should review each and every prior authorization request for orthodontic treatment. … Read More
The TMHP document reported about in our last story that was recently appended to a court filing by Xerox shows that staff from the Health and Human Services Commission and its Office of Inspector General were well aware of the … Read More
A new document has come to light out of the lawsuit the state filed in 2014 against Xerox, its former Medicaid claims administrator, that shows Medicaid dentists were concerned as early as 2007 about Xerox’s prior authorization process and demanded … Read More
This coming Thursday, May 19 from 8:30 am to noon, a town hall meeting on Medicaid managed care is being held at the Edinburg Conference Center at Renaissance, 118 Paseo Del Prado, Edinburg,TX. The meeting has been set up to allow Medicaid providers … Read More
The Houston Chronicle reported this morning that Frianita Wilson, the wife of former Health and Human Services Commission Inspector General Doug Wilson and an HHSC executive in her own right, is now back at work at HHSC after being on administrative … Read More
Health and Human Services Commission Inspector General Stuart Bowen Jr. announced in his quarterly report a new initiative to help combat Medicaid fraud and also help Medicaid providers. This is the IG Integrity Initiative. It was formally rolled out on … Read More
The Health and Human Service Commission Inspector General’s office has replaced a controversial Medicaid fraud data analytics program with a statistical software package that cost the agency nothing. The 21CT contracting scandal cost the state $20 million and took out … Read More
This morning Health and Human Services Commission Inspector General Stuart Bowen Jr. issued his latest quarterly report on OIG activities and results. Bowen has ushered in a new era of transparency and accountability for the agency and these reports provide … Read More
A recent court ruling in favor of a Texas orthodontics provider adds to the state’s longstanding inability to prove claims that dental providers overbilled Medicaid tens of millions of dollars, according to the Austin American-Statesman. In the latest case, an … Read More
