Health care law saves consumers money, provides more resources to states

Consumers saved $1 billion in 2013 and states receive more funding to continue to scrutinize rate hikes Health and Human Services Secretary Sylvia M. Burwell today released a new report showing that in 2013 alone, consumers benefitted from $1 billion in savings from lower than originally requested health insurance rates. This includes $290 million in savings for individuals and families, and … [Read more...]

USDOJ: Medicaid Provider And Wife Convicted Of Health Care Fraud

NORFOLK, Va. – W. Wayne Perry, Jr., 55, and his wife, Angela Perry, 52, formerly of Suffolk, Va., were convicted after a three-week trial late yesterday afternoon by a federal jury of one count of conspiracy to commit health care fraud, four counts of health care fraud, eight counts of false statements relating to health care matters, one count of alteration of records and four counts of … [Read more...]

Dentist Tells His Story – “Medicaid for Braces is Over”

ortho case

TDMR received the following from a Texas Medicaid dentist who wishes to tell his story about his history with the HLD scoring system and the current state of Medicaid for orthodontia. He asked to remain anonymous. When I began working with the Medicaid program about 22 years ago, National Heritage Insurance Company (NHIC) was employed by HHSC to administer it for the dentists in Texas. Since … [Read more...]

In Health Care, Organizers Find Issue to Spur Hispanics | The Texas Tribune

by Alexa Ura, The Texas Tribune SAN ANTONIO — When Armando Rodriguez opened the front door of his home here on the city’s west side, Chris Ornelas of the Texas Organizing Project met him with one question.  “What are some of the biggest concerns you have in your life right now?” Ornelas asked in Spanish.  Health care, Rodriguez replied, and whether his family could afford it.  The … [Read more...]

There Needs to be a Difference Between Fraud and an Error


On September 3rd, Rachel Hammond of the Texas Association for Homecare and Hospice testified before the House Human Services Committee on SB 1803 and due process rights for Medicaid providers. Hammond gave examples of difficulties that their members were having with OIG investigations.  One point she made was that there needs to be a differentiation made between fraud and an error.  For … [Read more...]

$500,000 Spent on Hearings Worthless if HHSC Can Just Overturn the Decision


Dr. Behzad Nazari of Houston testified before the House Human Services Committee on September 3rd on SB 1803 and due process rights for Medicaid providers. Nazari's Antoine Dental clinics was put under a 100% payment hold for their Medicaid orthodontic billings and went to a payment hold hearing at the State Office of Administrative Hearings in 2013. The hearing lasted four days before two … [Read more...]

Area Chiropractor Pleads Guilty to Health Care Fraud In Scheme Involving Billings to D.C. Medicaid Program

WASHINGTON – Lewis J. Levine, 57, a chiropractor who practiced in Southeast Washington, pled guilty today to a federal charge of health care fraud for his role in a scheme involving fraudulent claims to the District of Columbia Medicaid program. The guilty plea was announced by U.S. Attorney Ronald C. Machen Jr.; Andrew G. McCabe, Assistant Director in Charge of the FBI’s Washington Field … [Read more...]

New York City Employee Pleads Guilty In Manhattan Federal Court To Million-Dollar Medicaid Fraud

Preet Bharara, United States Attorney for the Southern District of New York, announced today that AKIM MURRAY, an employee of the Medicaid Reimbursement Unit of the New York City Human Resources Administration “HRA”, pled guilty before U.S. District Judge Richard M. Berman to a Medicaid fraud scheme in which MURRAY, whose job involved issuing reimbursements for Medicaid-eligible expenses, … [Read more...]

OIG SNAP Fraud Strategies Report Required by Senate Bill 8

OIG SNAP Fraud Strategies Report Required by Senate Bill 8 is published by HHSC. This PDF file is available here:   … [Read more...]

HHS awards more than $295 million in Affordable Care Act funds to increase access to primary care at health centers

Funding creates an estimated 4,750 new jobs; Helps newly insured access care Health and Human Services Secretary Sylvia M. Burwell announced today $295 million in Affordable Care Act funding to 1,195 health centers in every U.S. State, the District of Columbia, Puerto Rico, the U.S. Virgin Islands, and the Pacific Basin to expand primary care services. Today’s awards enable  health centers to … [Read more...]


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