Resolved Texas FCA Action Through Pre-Trial Settlement

Defended a healthcare provider in a Texas Medicaid Fraud Prevention Act investigation arising from alleged improper billing practices in connection with managed care services. The team coordinated internal investigation, structured document production, and direct engagement with the Texas Attorney General's Civil Medicaid Fraud Division. The matter resolved through pre-suit settlement with no admission of liability and preserved Medicaid provider status.

Investigation and Production

The matter began with an investigative demand from the Texas Attorney General's Civil Medicaid Fraud Division. The demand sought documentation of the client's managed care billing practices over a multi-year period. The team coordinated internal investigation with the client's compliance and billing functions, reconstructed the documentary record, and managed phased production to the Attorney General's investigators. Internal investigation findings supported the position that the disputed billing practices reflected operational variation within the applicable Medicaid program rules rather than fraudulent conduct.

Pre-Suit Resolution

Engagement with the Attorney General's office during the investigative period produced an agreed framework for resolution before any civil action was filed. The settlement closed the investigation without admission of liability and preserved the client's Medicaid provider status. The agreed terms resolved the matter substantially below the State's potential exposure under TMFPA's treble damages and per-claim penalty framework. The matter closed without entering formal litigation.