Three dentists testified before the Senate Health and Human Services Committee on Thursday about their experiences with the Texas Health and Human Services Commission Office of the Inspector General and how their due process rights are still being violated despite the passing of SB 1803. The testimony of Dr. Teegardin is below and we are requesting the testimony of the others for posting.
Attorney Jason Ray also testified and was very harsh in his condemnation of how dental Medicaid providers are being treated. He told the Committee that allegations of fraud need to lead to charges and prosecution not just payment holds in an attempt to “shakedown” the dentist.
The video is available on YouTube and is here. It is 18 minutes long.
Testimony of Dr. Vivian Teegardin of Harlingen Family Dentistry
Good afternoon Mr. Chairman and Committee Members. I am Dr. Vivian Teegardin from Harlingen. I am a General Dentist employed by Dr. Juan Villarreal with Harlingen Family Dentistry and have practiced there for the past 25 years.
I testified last year before the House Human Services Committee on due process rights for Medicaid providers. I was very happy to see Senate Bill 1803 passed by the Senate and the House and signed into law by Gov. Perry. I would like to thank this committee for the work it did on this bill. It is a very good beginning and I hope we can help better it today.
The point I would like to make with my testimony is that it doesn’t matter how good a piece of legislation is, no matter how well intended or beneficial, if it doesn’t change the actions of the agency it governs. To me, very little has changed when it comes to due process rights for providers dealing with an OIG investigation or payment hold.
In our case, we have a SOAH final order from February 2013 that states we did not commit any Medicaid fraud or abuse. But even in August of 2014, we are receiving calls from former staff , telling us that they are being phoned by lawyers from the state asking if we ever incited them to commit fraud.
This nightmare started for us in mid 2011. When will it end?
We have a large practice with 13 dentists and 130 staff. We were a high volume provider of orthodontic Medicaid services in south Texas. We had three dentists providing orthodontic services to Medicaid eligible children – two orthodontists, one of which was board certified, and myself.
The OIG investigation into our practice started in mid-2011 and they told us that 84 out of 85 cases they reviewed did not qualify for Medicaid although every case had received pre-approval from the state’s contractor.
At our hearing in April, 2012, the SOAH judge agreed with us and ruled we did not commit fraud. She also found the OIG witnesses were not credible and the whole issue of HLD scoring was flawed because the definitions under the Texas Medicaid manual were not clear. Our payment hold was greatly reduced and we expected a return of over a million dollars that the State had withheld.
HHSC-OIG didn’t respect this decision.
So we went to Travis County District Court in May of 2013 and a judge again agreed with us and ruled that it was the state’s obligation to return the funds.
HHSC-OIG didn’t respect this decision.
We still have an overpayment hearing that appears to be going to happen in 2015. Initially we were told that it would go to SOAH. But OIG scheduled our hearing before the HHSC appeals court.
I don’t understand how a state agency can be the investigator, accuser, prosecutor and judge in regard to serious allegations of Medicaid fraud and abuse.
Where are our due process rights?
I understand about taxpayer dollars. I am a taxpayer and pay my share. I hate seeing my tax money wasted either through fraud and abuse or through excessive bureaucratic red tape. Please fix this.
Thank you.