AUSTIN, Texas – On Wednesday, the Rio Grande Guardian reported on state Sen. Juan ‘Chuy’ Hinojosa’s concerns about the way the Texas Health and Human Services Commission Office of the Inspector General is treating healthcare providers.

Now, the McAllen Democrat has been named chairman of a workgroup that will study the inner workings of the OIG, review their practices and interaction with healthcare providers and recommend changes to the system used to investigate fraud in healthcare provider claims.

Hinojosa was appointed chairman of the workgroup by state Sen. Jane Nelson, chair of the Sunset Advisory Commission.

Hinojosa issued this statement about his appointment:

“I am alarmed by the reality of the current process through which the OIG prosecutes fraud cases. It appears that healthcare providers are accused of fraud, presumed guilty, and are not given an appropriate due process finding from the OIG. This process goes beyond a lack of due process or transparency, but infringes on a healthcare provider’s inherent rights. This is the opposite of our safeguarded justice system.”

Hinojosa said a recent Sunset Commission report “further confirms the many concerns” that have been expressed by healthcare providers and legislators in the last two years.

“Sunset recommends a complete overhaul of the current OIG office, practices, and policies. While I advocate for the prevention of fraud and abuse in our Medicaid system, the OIG and present structure is dysfunctional. This is not the type of system envisioned by the Legislature for due process,” Hinojosa said.

Hinojosa said he is “honored” to chair a workgroup to study such an important issue for healthcare providers statewide. “I thank Senator Jane Nelson for entrusting me with such an important task. I look forward to working with my colleagues in the Legislature, the OIG office, and stakeholders statewide to achieve a fair and transparent system of due process that our State can be proud of, and have an OIG that targets the healthcare providers that are defrauding our taxpayers and not those who commit clerical errors.”

The Sunset Advisory Commission is a 12 member legislative commission tasked with identifying and eliminating waste, duplication, and inefficiencies in government agencies. It is composed of five state senators, five state representatives, and two public members. The Commission reviews policies and programs of state agencies and recommends reforms, improvements, changes, dissolution of agencies, elimination of wasteful programs, and any other changes that are needed to ensure transparent, cost-effective, and productive state programs. Hinojosa and state Rep. Richard Raymond, D-Laredo, are the only two member of the commission from the border region.

Hinojosa said public participation is a key aspect of the Sunset Review process. The Commission seeks public input through hearings on every agency under Sunset review and recommends actions on each agency to the full Legislature in the next session.