State health commission investigative leader visits Rio Grande Valley

By Emily Sides

McAllen Monitor

EDINBURG — The new head of the state health agency’s investigative division visited with stakeholders in Hidalgo County Wednesday to learn about local healthcare issues and promote his vision.

Stuart Bowen Jr., inspector general for the Texas Health and Human Services Commission, took over Feb. 26 following his appointment by Gov. Greg Abbott and subsequent Senate confirmation.

“I consider it a great privilege that Gov. Abbott picked me in an important role for integrity of public health system,” Bowen said. “I’m committed to bringing transparency and accountability of tens of billions of dollars supporting the delivery of health and human services across the state.”

Bowen oversees the division of the commission that audits state and federal funds to uncover fraud, waste and abuse throughout the agency’s jurisdiction.

Legislators budgeted about $83.8 billion for fiscal years 2015-16 and 2016-17 for the five departments under the health commission’s umbrella, including the departments of aging and disability services and family and protective services. The commission is the state’s largest agency, Bowen said, adding about 56 percent of the commission’s budget comes from federal funding.

Former Gov. Rick Perry fired Bowen’s predecessor, Doug Wilson, in December amid a controversy of awarding a $110 million contract to 21 Century Technologies without putting the contract up for bid proposals, according to the Texas Tribune.

Government and private reports found the inspector general’s office had poor management practices, inconsistent case management and outcomes as well as poor communication between the division’s office and other commission programs as well as with healthcare providers, according to the inspector general’s quarterly report issued Sept. 21.

Bowen said his predecessor focused on investigations to the detriment of regulatory audits and internal performance. Bowen created a policy and external relations division in March. He is also encouraging more providers and patients to report suspected fraud, waste or abuse by calling (800) 436-6184 or reporting it on the division’s website.

“They know, and I need them to help me, so this is the beginning to partner with good providers to root out the bad ones,” Bowen said.

Bowen said he inherited about 1,800 cases of alleged fraud, waste or abuse allegations, of which he said have been cut down to half. The majority of the cases were more than three years old, he said. A case is considered backlogged if it wasn’t sufficiently investigated.

Bowen met with his division’s local office in Pharr, which has about 50 employees, including 32 investigators, he said, adding they discussed cases, policies and practices.

“It’s about vision, mission and values,” Bowen said. “My vision is to be the best in the country. I was telling my staff in Pharr that we’re going to succeed. Our values are professionalism, productivity and perseverance.”

Doctors Hospital at Renaissance board chairman Dr. Carlos Cardenas said he appreciated Bowen meeting with local doctors and hospital leaders, calling the meeting a breath of fresh air.

“This is the only sitting inspector general that I have in my memory — since I’ve been a doctor in the Rio Grande Valley for 20 years — that has ever visited the Valley and met with physicians who are in the trenches of serving patients,” Cardenas said. “I think he’s outperformed his predecessor by a mile.”

The Centers for Medicare and Medicaid Services approved the hospital’s request earlier this month to double its bed capacity to 1,102, meaning the hospital will be the largest in the Rio Grande Valley.

Cardenas said Bowen’s visit and his statewide efforts to reach stakeholders will be helpful as his office adopts a new law.

State legislators passed Senate Bill 207 this year, which defines policies for the inspector general’s office, including requiring shorter investigation times, being more restrictive on the office halting a provider’s payments if suspected of fraud and more.

“Like any piece of legislation of a regulatory body, oftentimes policies can be made in a vacuum,” Cardenas said. “And when you implement them, you may learn there are issues. If you don’t have communication with people affected by those policies, it’s difficult to discharge the duties of your office. His willingness to come and educate himself and learn about the people is quite positive.”