HHSC announced this morning that Conduent’s recently awarded contract as TMHP’s claims vendor had been terminated for convenience. Termination for convenience means “a party to a contract to bring the contract to an end without the need to establish that the other party is in default,” per Wikipedia. Accenture will continue operating as the TMHP claims vendor until further notice per the statement.
Delaware Supreme Court to review case
There may or may not be a connection, but the surprise announcement follows the Delaware Supreme Court’s decision on Tuesday, as reported by Law 360, to review a lower court decision that set aside the jury verdict finding that Conduent had tried to defraud its insurance carriers into paying part of the huge $236 million settlement between Conduent and the Texas Office of the Attorney General in 2019.
Allegations swirled around the settlement that the State had amended its lawsuit to remove fraud allegations and allow Conduent to claim insurance repayment, which caused the insurers to sue the company.
The Conduent settlement, the largest of its kind for Texas, ended the State’s lawsuit filed in 2014 under the Texas Medicaid Fraud Prevention Act against the company over its botched Medicaid orthodontic prior authorization scheme that cost the state hundreds of millions of dollars. The state had terminated the company’s contract as Medicaid claims administrator before the lawsuit was filed.
So, Conduent is kicked out of Texas Medicaid for the second time now.
Lawsuit awaiting decision by Texas Third Court of Appeals
As reported by TDMR this week, Conduent also has a case before the Third Court of Appeals as dentists are suing the company over its flawed Medicaid orthodontic prior authorization debacle.
Delaware Supreme Court Decision