Showing posts with label ACS. Show all posts
Showing posts with label ACS. Show all posts

Thursday, February 21, 2019

Xerox Pays $236 Million to Settle State of Texas Dental Fraud Case Legal Team: Whistleblowers Dr. Christine Ellis, Madelayne Castillo, Yarubi Morales and others Are Vindicated

Xerox Pays $236 Million to Settle State of Texas Dental Fraud Case
Legal Team: Whistleblowers Dr. Christine Ellis, Madelayne Castillo, Yarubi Morales
and others Are Vindicated


AUSTIN, Feb. 20, 2019 – The $236 million settlement of the State of Texas’ Medicaid fraud
claims against Xerox Corp. business units vindicated whistleblowers Dr. Christine Ellis,
Madelayne Castillo, Yarubi Morales and other whistleblowers, their legal teams said today. The
settlement is the largest recovery ever in a healthcare fraud recovery suit in Texas for Medicaid
related claims.

The State’s lawsuit alleged that Xerox violated the Texas Medicaid Fraud Prevention Act and
“rubber-stamped” prior authorization requests by unqualified clerical employees, allowing “vast
numbers” of orthodontic procedures for children whose condition did not meet Medicaid criteria
for treatment. The company, formerly known as Affiliated Computer Services, Inc., before Xerox
acquired it, also was accused of making false statements or representations in Medicaid filings
with the state.

Dr. Ellis, an orthodontist in Dallas, testified before a congressional committee in Washington in April 2012 about alleged Medicaid fraud in orthodontic billings by Texas dentists.

Ms. Castillo was an employee of the now-defunct All Smiles dental chain and West Texas Dental. Ms. Morales was a former employee of the now defunct All Smiles dental chain and Rodeo Dental.

Dr. Ellis, Ms. Castillo, Ms. Morales and several other whistleblowers all filed suits approximately
two years before the State filed its suit. The State has acknowledged that the facts underlying its
suit are the same as those underlying the whistleblowers’ previous filings.

Xerox became the state’s Medicaid administrator in 2003. Between 2004 and 2012, Texas
expended approximately $1.1 billion on orthodontics under the Texas Medicaid program.
According to the State’s lawsuit, Xerox, and ACS, Inc. before it, repeatedly represented to Texas
Medicaid officials that their prior authorization system ensured proper predeterminations of
qualifications.

Ms. Castillo, Ms. Morales and several other whistleblowers who filed cases against ACS/Xerox
are represented by Rusty Tucker of the Law Offices of James R. Tucker, P.C. of Dallas and MikeTibbals of Dallas. Ketan U. Kharod, of Guerrero & Whittle, PLLC, of Austin, Charles S. Siegel
and Caitlyn Silhan, of Waters and Kraus, of Dallas, Daniel L. Hargrove, of the Hargrove Law Firm
of San Antonio, and James R. Moriarty, of the Law Office of James R. Moriarty of Houston
represent Dr. Ellis.

Charles Siegel of Waters and Kraus said, “Because of Dr. Ellis and other whistleblowers who
brought lawsuits against ACS/ Xerox, the State of Texas ultimately showed how Xerox and ACS,
Inc. deeply compromised the integrity of the Texas Medicaid program. They faced vicious legal
attacks in their courageous efforts to set the record straight.”


Rusty Tucker of the Law Offices of James R. Tucker, P.C. said, “Our legal team hopes this
settlement sends a strong message that companies that prey upon Texas families and defraud the
state will face the judgment of the courts. Companies who commit unlawful acts in violation of
the Texas Medicaid Fraud Prevention Act will be held accountable. Dr. Ellis, Ms. Castillo, Ms.
Morales and other whistleblowers who came forward should be recognized for helping expose this
massive fraud.”

The case is “The State of Texas v. Xerox Corporation, et al.,” Cause No. D-1-GV-14-000581 in
the 53rd Judicial District of Travis County, Texas.

CONTACTS:
Rusty Tucker, Law Offices of James R. Tucker, P.C. (214) 505-0097
Charles Siegel, Waters and Kraus (214) 357-6244
James Moriarty, Law Offices of James R Moriarty (713) 857-1212

Saturday, May 03, 2014

Faulted in Medicaid Fraud, Company Keeps Contract

Faulted in Medicaid Fraud, Company Keeps Contract

The New York TimesFor nearly five years, a state contractor allowed workers with limited expertise to approve dental claims for Texas’ Medicaid program, the joint state-federal insurer. State spending on orthodontic services spiraled out of control; by 2012, federal and state auditors found that the contractor’s actions had opened the door for a “massive Medicaid fraud scheme” that cost taxpayers hundreds of millions of dollars.

More than two years later, Texas health officials have reeled in spending on Medicaid texas tribuneorthodontic services and pursued legal action against health care providers who billed for the services. But a Texas Tribune investigation found that while health officials have repeatedly raised concerns with the contractor, a Xerox subsidiary called the Texas Medicaid and Healthcare Partnership, they have not severed its multiyear contract worth hundreds of millions of dollars.

Critics accuse the state of dragging its feet because of the contractor’s political ties to Gov. Rick Perry, a claim the governor’s office says is not true.

Continue reading at New York Times

Read Texas Tribune Article Here - Company That OK's Unnecessary Braces Kept Its Contract


Related:

“Ho” Down in Texas – James W. Orr, DDS Testifies for Antoine Dental Center