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Tuesday, March 25, 2014

TMA HELPS CLINIC REACH SETTLEMENT ON MEDICAID ALLEGATIONS

What began as a $22 million Medicaid fraud case against the Austin-based Carousel Clinic has ended as an agreement for the clinic to pay the state $3.75 million for alleged errors in billing. The clinic focuses almost exclusively on serving the poorest children in the Austin area. Following the initial fraud allegations, Carousel Clinic was dying a slow death as the state ordered a hold on its Medicaid payments. Through our Patient-Physician Advocacy Committee, TMA reviewed the medical records and facts in the case. Our support helped to substantially reduce the settlement amount. The case also served as evidence in our push last year to convince the Texas Legislature to grant better due-process protections to physicians facing Medicaid fraud allegations.

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