Texas court finds Xerox at fault for $2B in Medicaid fraud scheme — Dentists not liable


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The Texas Supreme Court found Xerox, now known as Conduent Business Services, at fault for a six-year long Medicaid scheme totaling $2 billion in fraud, according to My Statesman.

Here are five things to know:

1. To brace for the blowback of paying Texas' Medicaid program back $2 billion in losses and damages on top of the fraudulent billing, Xerox claimed dentists and orthodontists were at fault for the procedures performed.

The company alleged the dentists knowingly performed the medically unnecessary procedures and were aware of the Xerox's blind system of accepting Medicaid claims. The court ruled, however, dentists and orthodontists were not at fault.

2. Along with seeking restitution payments, Texas is suing Xerox for not acting as a reliable source for pre-payment requests. Between 2004 and 2012, investigators allege Xerox pre-authorized dental and orthodontic treatment for children. Many of the treatments were later deemed cosmetic, not covered by Medicaid.

3. The Inspector General of the HHS became aware of the Medicaid scheme and concluded Texas owed the federal government $133 million for the unnecessary procedures. According to previous court documents, Texas was suing Xerox for $1 billion; however, more recent filings in the U.S. Securities and Exchange Commission found the state is seeking more than $2 billion in "treble damages and civil penalties per illegal acts for almost two hundred thousand purported illegal acts," My Statesman reports.

4. Xerox also alleged Texas health regulators were at fault for knowingly allowing Xerox's pre-authorization process to go on for so long. The company says regulators became aware of the issues years before the federal government intervened.

5. The company's "rubber stamp" policy allowed the fastest clerks to process 200 applications a day, with each claim taking around two minutes. Xerox employees said those who did not meet certain quotas were reprimanded.

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