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 payments from doctors it investigates — was illegal.
The 3rd Court of Appeals found the agency had improperly expanded a law allowing regulators to withhold payments from providers against whom there was a “credible allegation of fraud.” Since 2011, the inspector general has withheld tens of millions of dollars from 127 providers, much of it from dentists and orthodontists, as it developed cases against them.
via Texas Medicaid regulators hit with legal setback | www.mystatesman.com.