State Office of Inspector General Drops Case Against Ortho Dentist: Texas Dentists for Medicaid Reform

HHSC-OIG motion to withdraw case against San Antonio orthodontic provider Dr. Diana Malone is a hopeful sign that Medicaid fraud enforcement agency is seeing the light on due process and provider rights

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There have been several administrative court decisions over the last year that have been extremely positive for Medicaid orthodontic providers which, to date, have been seemingly ignored by the Office of the Inspector General.

Austin, Tx (PRWEB) February 07, 2013

The Texas Office of the Inspector General (OIG), Health and Human Services Commission (HHSC) filed a motion to drop all claims against Diana Malone, DDS, of San Antonio, per the motion document filed February 5th. (HHSC-OIG Case P200803164). Per the filing, the motion comes as a result of a decision by HHSC administrative court Judge Susan Fekety last October that OIG claims at issue were to be limited to the dollar for dollar potential overpayment associated with 72 of Malone’s clients.

The OIG motion states that OIG withdraws the allegations of a potential dollar for dollar overpayment associated with the 72 clients.

“We are happy to see this occur,” says a relieved Dr. Scott Malone, Diana’s husband and business partner.

Malone’s lawyer, Tony Canales of the Corpus Christi firm Canales Simonson commented, “There have been several administrative court decisions over the last year that have been extremely positive for Medicaid orthodontic providers which, to date, have been seemingly ignored by the Office of the Inspector General. The withdrawing of this case is a hopeful sign for those providers that such court decisions are now being respected.”

Dr. Tara Rios, an executive of Texas Dentists for Medicaid Reform, is also positive about the development. “We are very concerned about Medicaid provider rights. These impact the security with which providers can practice their professions and deliver effective help to Medicaid patients. Due process is a cornerstone of these rights and we are happy to see at least a harbinger of change from OIG on this issue.”

For more information on the Malone case, please contact Tony Canales at Canales Simonson.