Texas and the federal government tentatively resolved a high-stakes health care funding inquiry on Monday, averting a major disruption to hospital funding. The Texas Health and Human Services Commission and the federal Centers for Medicare and Medicaid Services reached the … Read More
December 2, 2014 — A Texas appeals court has invalidated several rules related to payment holds imposed during Medicaid fraud investigations, saying they violate due process rights. The Third Court of Appeals invalidated rules that authorized the Texas Office of … Read More
The Statesman reports today that HHSC’s chief counsel Jack Stick, former OIG director for enforcement, who steered business to an Austin software firm for OIG Medicaid fraud detection data mining software, has for years had close connections to the firm’s … Read More
Houston Chronicle business columnist Chris Tomlinson blasted the Texas Health and Human Services Commission Office of Inspector General for its treatment of Medicaid providers in his column Wednesday. His criticism however goes further than OIG and alleges that OIG’s overzealousness … Read More
Judge rightfully reins in anti-fraud unit after abusive action By Chris TomlinsonNovember 26, 2014 Doctors, dentists and other health care providers who care for the state’s most disadvantaged got some much needed relief Tuesday from an over-zealous, politically motivated anti-fraud … Read More
Law360, Dallas (November 25, 2014, 5:55 PM ET) — A Texas appeals court on Tuesday invalidated three Texas Health and Human Services Commission rules related to payment holds imposed during Medicaid fraud investigations, holding they violate due process rights. The … Read More
AUSTIN – Texas officials have been illegally withholding millions of dollars from dozens of dentists and orthodontists based on only the suspicion of minor wrongdoing, an appeals court ruled Tuesday, dealing another blow to the state’s beleaguered unit charged with … Read More
The Texas agency charged with investigating health care fraud suffered a serious setback Tuesday, when a state appeals court ruled that the Health and Human Services Commission’s Office of Inspector General’s expansive use of a key tactic — withholding Medicaid … Read More
Today, the Texas 3rd Court of Appeals overturned a lower court decision and negated Health and Human Services Commission rules that allow for the Office of Inspector General to place Medicaid payment holds in certain circumstances, basically for only program violations … Read More
In a letter to the Texas Sunset Advisory Commission, TDMR President Gregory Ewing has recommended, based on the testimony in the public hearings held last week, that all pending OIG cases be stayed for external review. All pending cases should … Read More
Last Thursday, November 13th, the Texas Sunset Advisory Commission held public hearings about its staff report on the Texas Health and Human Services Commission that was released in October. The Commission heard over nine straight hours of submissions from various … Read More
The state office charged with investigating Medicaid fraud and waste, criticized this week by state auditors and legislators as dysfunctional and “broken,” is finalizing a $90 million contract with an Austin analytics company that had no experience with Medicaid before … Read More
Responding to an audit critical of the state’s network of health agencies, as well as the embattled Medicaid fraud investigative unit, a panel of state lawmakers this week endorsed an overhaul of the state’s umbrella health agency, the Health and … Read More
Texas’ top health official told lawmakers Wednesday that they should combine the state’s five health departments into one “mega-agency.” A single, consolidated health commission would better serve the state’s most vulnerable populations, Health and Human Services Executive Commissioner Kyle Janek told the Sunset Advisory … Read More
This past week, the Texas Health and Human Services Commission published on their website a circular about the process for audits being done by the Centers for Medicare and Medicaid Services (CMS) on Medicaid providers in Texas. All Medicaid providers in … Read More
The Sunset Commission has set out their agenda for the upcoming public hearings on the Texas Health and Human Services Commission to be held on Wednesday and Thursday, November 12 and 13. Meeting materials will be available on the Sunset … Read More
The Texas Rangers are now investigating the Health and Human Services Commission Office of Inspector General and the firing of actuary Brad Nelson per a story in the Houston Chronicle. The Commission requested the investigation after Nelson was fired for … Read More
AUSTIN – The Texas Rangers have opened a criminal investigation into a recently fired state employee whose alleged falsification data could cost the state the chance to recoup millions of dollars from dentists and orthodontists of Medicaid fraud, officials confirmed … Read More
The 3rd Texas Court of Appeals has agreed with a Travis County District Court judge and has issued a ruling that the Office of the Inspector General should return over $1.2 million in withheld Medicaid funds to Harlingen Family Dentistry. TDMR received a … Read More
In another setback for the state health agency charged with rooting out Medicaid fraud, an appeals court Thursday said almost $1.26 million was improperly withheld from a dental practice even after state regulators acknowledged that no fraud had taken place. … Read More
A Texas Health and Human Services Commission employee in the Office of the Inspector General was fired because he apparently “cooked the books” in OIG’s case against Dr. Rachel Trueblood, according to a story published in the Austin American Statesman … Read More
Another HHS-OIG audit about to be released of the Texas Medicaid program will cost Texas another $30 million, according to a story in this morning’s Austin American Statesman. The federal audit covers 2011 for non-emergency medical transportation services. The article reports … Read More
The federal government wants Texas to pay back more than $30 million for incorrectly claimed Medicaid reimbursements. An audit to be released Wednesday by the Office of Inspector General within the U.S. Department of Health and Human Services describes how … Read More
This past week HHSC released a report on executive compensation within HHSC. (Staff Compensation) Per the report, the average base salary for non-executive staff on August 31, 2014 was $37,326. The following table is excerpted from the report to show only … Read More
This past Friday, TDMR sent its comments about the recent Sunset Commission staff report on the Texas Health and Human Services Commission to the Texas Sunset Commission. The following is what was sent from TDMR president Gregory Ewing. A downloadable … Read More
This summer, state regulators settled a Medicaid fraud case against an Austin dentist for literally pennies on the dollar. Although the Texas Health and Human Services Commission’s Office of Inspector General had initially accused Rachel Trueblood of bilking the government … Read More
The Houston Chronicle has reported that as a result of the Sunset Commission’s scathing report on the Health and Human Services Commission Office of Inspector General, HHSC Executive Commissioner Kyle Janek is appointing a special assistant to review OIG procedures … Read More
AUSTIN – The top health official in Texas has decided to appoint a special assistant to review the state’s Medicaid anti-fraud program after an audit found it is so poorly run that it may be better for taxpayers if it … Read More
The government agency charged with rooting out medical fraud and waste is poorly managed, occasionally is unfair to those it investigates and has failed to do an effective job identifying and recovering money lost to medical fraud, according to a … Read More
by Becca Aaronson, The Texas Tribune In a blistering 225-page report on the Texas Health and Human Services Commission, the Texas Sunset Advisory Commission recommended that the state’s health and human services system undergo a massive overhaul. The Sunset Commission, which reviews the … Read More
The government agency charged with rooting out medical fraud and waste is poorly managed, occasionally is unfair to those it investigates and has failed to do an effective job identifying and recovering money lost to medical fraud, according to a … Read More
After two years, the Chief Counsel of the Texas Health and Human Services Commission and former director for enforcement of the Office of Inspector General Jack Stick had a day in court on his DWI on Thursday. Judge to rule on … Read More
The Texas Health and Human Services Commission claimed $746,000 in unallowable supplemental payments made to the University of North Texas for the period May 1, 2004, through September 30, 2007. via Review of Physician Supplemental Payments Made to the University … Read More
The Houston Chronicle (story behind a paywall) reported this morning that Leah Rayne, HHSC’s business technology architect, was fired because she “admitted to officials that she leaked details about an internal strategy meeting to Truven Health Analytics…[the] company that was in final negotiations for … Read More
AUSTIN – Call it the billion-dollar blame game. Six years after auditors discovered signs that some Texas orthodontists were putting unneeded braces on teeth of the state’s poorest children, an army of lawyers are battling over who is liable for … Read More
AUSTIN — The Texas Health and Human Services Commission (HHSC) plans to re-issue a request for proposals (RFP) for a major data project this fall. The original procurement was canceled so the state could make revisions to help lower the … Read More
The Houston Chronicle reported yesterday and today that the Texas Health and Human Services Commission ended a tentative contract with Truven Health Analytics of Ann Arbor, Mich., because of potential insider influence for the company. The contract was for a major “enterprise data … Read More
AUSTIN – Texas health officials abruptly have pulled the plug on a major data project amid concerns about its cost and suggestions the tentative contract winner was receiving inside information from state negotiators. The decision to end negotiations with Truven … 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
August 29, 2014 — In the latest development in the ongoing Texas Medicaid scandal, the state Health and Human Services Commission (HHSC) has filed a second lawsuit against Xerox, claiming the company is refusing to turn over patient records. Without … Read More
