In all the raw data I’ve seen out of Texas, this one would nearly always fall in the top 5. This one alone is said to have stolen $18 million from taxpayers. Just imagine the hundreds and hundreds of millions, if not billions stolen from scam dentists and dental companies in the state of Texas! Perp walk please!!
I’m sure the “pity” party has begun.
American-Statesman Staff
Carousel Pediatrics began shutting down its Austin dental practice Tuesday night, displacing about 28,000 low-income pediatric patients, after state health investigators cut off Medicaid payments over allegations of fraudulent activity.
Carousel’s owner, Dr. Glenn Wood, who disputed the fraud allegations, said the loss of about $400,000 a month in Medicaid payments required him to shut down his dental affiliate, Trueblood Dental Associates, and lay off about 40 staff members and six dentists.
Wood said Carousel also will have to close its South Austin medical clinic on Stassney Lane because its finances were already stretched thin by a similar fight with state health officials over allegations that Carousel’s medical practice had defrauded the state of $18 million. More than $343,000 in Medicaid payments have been withheld since spring in that investigation, which is continuing.
Wood said he believed the dental penalty was in retaliation for his outspoken criticism of the $18 million fraud allegation by the Office of Inspector General, the investigative arm of the Health and Human Services Commission. Wood said the investigation was biased and mistake-ridden.
He also criticized the practice of cutting off Medicaid payments based on an unproven fraud allegation.
“This, to me, is punitive,” Wood said. “Our finances, because of the ‘medical withhold’ are very limited, so they have basically made our finances that much worse, which I am sure is part of the intention.”
Stephanie Goodman, spokeswoman for the Health and Human Services Commission, said she could not comment on a pending investigation but called Wood’s statement “nonsense.”
“Continuing Medicaid payments to offices with highly suspect billing practices doesn’t help children,” Goodman said. “Once we’re able to make all the facts in this case public, it will be very clear that the Office of Inspector General’s actions are necessary to protect children and protect taxpayers.”
Goodman also said her agency has begun working with other Medicaid dental plans “to make sure that we’re able to find good care” for Trueblood Dental’s patients.
State health officials began withholding the Medicaid dental payments Friday, based on finding a “credible allegation of fraud” in Trueblood Dental’s billing records. The practice of withholding payments is authorized by the Affordable Care Act to keep money from being paid to fraudulent enterprises because full repayment is often difficult, if not impossible.
On Wednesday, Carousel submitted documents disputing the fraud charge, which included improper solicitation of patients, payments for dental work that was not performed and billing irregularities that included seeking multiple reimbursements for the same treatment.
That same day, the Office of Inspector General declined to remove or reduce the Medicaid payment hold.
Texas Medicaid Data from 2011 (Excel 2010 or new required)
