Texas high court says Xerox can't blame dentists in $2B Medicaid fraud case

The Texas Supreme Court on Friday ruled that Xerox alone is on the hook for a reported more than $2 billion worth of fraudulent Medicaid losses and damages that Texas is seeking to recover. The company, since renamed Conduent Business Services, had sought to share blame with dentists and orthodontists who performed the procedures.

The finding represents a significant blow to Xerox, which was responsible for pre-authorizing dental and orthodontic treatment for children between 2004 and 2012, when Medicaid spending on the procedures soared. The company had sought to share some of the cost with the providers, claiming they knowingly gamed the system.

The lawsuit is scheduled to go to trial next year.

The ruling is the latest development in a thicket of legal actions that aim to assign blame for hundreds of thousands of procedures that regulators say did not meet the criteria to be covered by Medicaid, the federal health program for poor people and children. As of last summer, the actions had generated millions of pages of documents; 50 state lawyers were working on it.

In addition to suing Xerox for failing to act as a reliable gatekeeper for prepayment requests, Texas also has sought to recover money from scores of dentists and orthodontists for what state inspectors say were procedures that were cosmetic rather than medically necessary, the standard to qualify for the government program. While dentists have prevailed in actions brought in administrative court, several lawsuits remain pending in district courts.

Read more: https://www.mystatesman.com/news/state--regional/texas-high-court-says-xerox-can-blame-dentists-medicaid-fraud-case/UI9wpIpLNMSrR4AFCPClgL/