The Supreme Court of Texas has dismissed a petition that would have prevented practitioners from receiving Medicare funds when that provider is being investigated for fraud.
In the November 13 dismissal, the state Supreme Court upheld a lower court ruling that said rules allowing payment holds violated the accused dentists' due process rights.
The court's dismissal of the petition was the latest legal setback for the Texas Office of Inspector General (OIG) and the state Health and Human Services Commission (HHSC), which had withheld more than $1.5 million in Medicaid payments from Harlingen Family Dentistry. In 2013, a state appeals court ordered the state to repay the money to Harlingen.
Both high court decisions sided with plaintiffs Harlingen and Trueblood Dental Associates, reversing a trial court's ruling that allowed the payment holds.
State and federal law provides only for payment holds on Medicaid providers when there are "credible allegations" of fraud, the supreme court ruled.
Texas officials have given up on recovering most of the hundreds of millions of dollars spent on questionable Medicaid dental and orthodontic procedures. After years of an ongoing scandal over fraudulent billing and courtroom losses, the HHSC has offered settlements for pennies on the dollar for about 100 pending cases.
The HHSC expects to recoup $20 million or less of the $823 million in suspected fraud and waste.
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