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Texas’ Medicaid Fraud Unit Suffers Mass Exodus Under Ken Paxton

Under Ken Paxton, the Civil Medicaid Fraud Unit, a Texas’ elite team of lawyers that have brought more than $1 billion to the state’s fund, is falling apart.

A new investigation by ProPublica and the Texas Tribune highlights that, under Paxton, the team’s leader was forced out last year, and since then, two-thirds of the attorneys have left the unit, leaving it at its smallest size in a decade.

The goal of the Civil Medicaid Fraud Unit was to stop fraud and abuse in the Medicaid system by some of the largest pharmaceutical companies in the world. In just over two decades, the team helped recover $2.6 billion. Of that, $1 billion went to the state fund that also pays for services such as education and health care.

Paxton even praised the team last fall and has benefited from fees from cases handled by the unit.

“Our Civil Medicaid Fraud Division has done an outstanding job holding these pharmaceutical companies accountable,” Paxton stated in a November news release about a lawsuit the team had filed against Pfizer Inc. and Tris Pharma Inc. The suit accused the pharmaceutical giants of giving an ADHD drug to children in Texas Medicaid, despite it failing quality control tests.

Paxton’s office benefited from fees from cases handled by the division. In fiscal year 2023, the division collected more than $14 million in fees, and in 2022, it collected more in attorney fees than all other attorney general divisions combined.

The division has had a strong reputation in the AG’s office since it was created in 1999 when John Cornyn, now a U.S. senator, was Texas AG. It even flourished during Gov. Greg Abbott’s tenure as AG. However, ever since Paxton was elected to a second term in 2008, the number of attorneys in the Civil Medicaid Fraud Division, and most recently, in 2023 the numbers dropped dramatically.

Nearly two-thirds of the attorneys who were on the team a year ago have left. Last January, the department had 31 attorneys, and this year they started with 19.

The decline in the number of attorneys in the division follows the departure of its beloved chief, Raymond Winter, in 2022. A former attorney in the division told ProPublica and The Texas Tribune that higher-ups told Winter that if he didn’t resign or take a demotion, he would be fired. David Maxwell JR, one of the whistleblowers in Paxton’s impeachment, told Texas House investigators that Paxton targeted Winter.

Maxwell had been the attorney general’s director of criminal enforcement, and when Paxton fired him and gave him a general discharge, he challenged the evaluation. The attorney general’s office asked Winter to defend Paxton’s decision, but Winter declined.

“He refused, and so they fired him,” Maxwell said.

After Winters left, more lawyers followed. In January 2023, six attorneys resigned, three of them on the same day, followed by four more in February. More departures followed in the months that followed. After Paxton’s acquittal, three more attorneys resigned.

The last resigned on January 17.

“Paxton has totally devastated the agency with good people that he’s gotten rid of because the criteria to get hired in the executive level is to plead your allegiance to him, not to the agency or not to the law,” Maxwell said.

These departures could harm the Division’s capacity to detect Medicaid waste.

Another former Civil Medicaid Fraud attorney said it could take more than a decade to rebuild the unit, because so much experience and institutional knowledge were lost.

“As a Texas citizen who happens to know more about the shady things that pharmaceutical companies and other entities do because of my job, I do feel less safe as a citizen knowing that CMF is not what it used to be and does not have the ability to hold those entities accountable in the way that they were,” she said.

Paxton’s agency has struggled in recent years. ProPublica and the Tribune reported on Paxton’s refusal to defend state agencies in court, and the Associated Press reported that the agency has decided to drop human trafficking and child sexual assault cases because investigators lost track of a victim.

Staff
Staff
Written by RA News staff.

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