Medicaid Fraud Settlement Worries Health Providers

With a high-profile legal settlement with Carousel Pediatrics, a children’s health provider, under its belt, the Texas Health and Human Services Commission’s Office of Inspector General says its ramped-up efforts to rein in Medicaid fraud have started to pay off. But for health providers who treat the state’s poorest patients, the Carousel case has raised questions about how the inspector general’s office distinguishes fraudulent intent from human error.

“Carousel’s lesson is to make sure to read each and every regulation,” said Dan Gattis, a former state lawmaker and Carousel Pediatrics’ lawyer, “and assume that somebody ...

Full Story

Comment Policy

The Texas Tribune is pleased to provide the opportunity for you to share your observations about this story. We encourage lively debate on the issues of the day, but we ask that you refrain from using profanity or other offensive speech, engaging in personal attacks or name-calling, posting advertising, or wandering away from the topic at hand. To comment, you must be a registered user of the Tribune, and your user name will be displayed. Thanks for taking time to offer your thoughts.

You must be logged in to leave a comment. Login | Sign-Up