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 “protecting” Xerox.
On May 9, Texas Attorney General Greg Abbott filed a lawsuit against Xerox, alleging the company wrongly approved hundreds of millions of dollars’ worth of Medicaid claims for orthodontic services that were not medically necessary. The civil suit was filed against Xerox and its ACS Healthcare subsidiary to recover allegedly fraudulent Medicaid payments for orthodontic services that were approved by Xerox.
State officials also terminated the company’s $168 million contract “after Xerox staff approved thousands of requests for braces that weren’t medically necessary.”
Xerox denied culpability and instead blamed the dentists who submitted the allegedly fraudulent claims.
Now, several lawsuits have been filed in Travis County District Court by dentists who are being pursued in court by the state for orthodontic overpayments, according to a statesman.com story. The complaints say that rather than prosecute Xerox for its failure to properly evaluate dentists’ prior authorization requests, the state and the attorney general protected Xerox. The suits claim Texas didn’t allow Xerox to hire additional medically licensed staff and told the company to continue its prior authorization practices.