More than a dozen years ago, Texas healthcare administrators hired Xerox to help determine when patients' dental and orthodontic care qualified for Medicaid coverage. Xerox was supposed to hire dental professionals and specialists to review claims, according to My Statesman.
However, Xerox did not hire medical experts. Instead, Xerox hired employees with no dental background who accepted requests not covered by Medicaid. Now taxpayers may owe the federal government $133 million.
Here are six things to know:
1. In 2004, Texas Health and Human Services Commission hired Texas Medicaid and Healthcare Partnership to manage Medicaid claims. Xerox later purchased the company.
2. Approval rates for dental and orthodontic requests for Medicaid-covered procedures reached 90 percent at one point, with the fastest clerk approving 200 requests a day.
3. A state auditor found Xerox asked for additional funding to hire dental professionals the state administrators allegedly refused.
4. Xerox was fired in 2014 and could potentially be banned from doing Medicaid related business with the federal government for 10 years if found guilty of fraud. Xerox is arguing that state regulators were aware of how it was operating, with reports of rubber stamping preauthorization requests as early as 2007.
5. The U.S. Department of Health and Human Services concluded in 2014 that while Xerox clerks approved Medicaid procedures without a meaningful review, it was Texas administrators who are to blame.
6. Now state officials are suing Xerox for fraud in order to repay the bill from the federal government.
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However, Xerox did not hire medical experts. Instead, Xerox hired employees with no dental background who accepted requests not covered by Medicaid. Now taxpayers may owe the federal government $133 million.
Here are six things to know:
1. In 2004, Texas Health and Human Services Commission hired Texas Medicaid and Healthcare Partnership to manage Medicaid claims. Xerox later purchased the company.
2. Approval rates for dental and orthodontic requests for Medicaid-covered procedures reached 90 percent at one point, with the fastest clerk approving 200 requests a day.
3. A state auditor found Xerox asked for additional funding to hire dental professionals the state administrators allegedly refused.
4. Xerox was fired in 2014 and could potentially be banned from doing Medicaid related business with the federal government for 10 years if found guilty of fraud. Xerox is arguing that state regulators were aware of how it was operating, with reports of rubber stamping preauthorization requests as early as 2007.
5. The U.S. Department of Health and Human Services concluded in 2014 that while Xerox clerks approved Medicaid procedures without a meaningful review, it was Texas administrators who are to blame.
6. Now state officials are suing Xerox for fraud in order to repay the bill from the federal government.
More articles on dental:
Aetna Dental partners with Brighter: 5 key points
Henry Schein launches community service program: 5 insights
5 top Latin American countries for high quality care at low cost