As Medicare and Medicaid Turn 50, Use of Private Health Plans Surges 

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Enrollment in private insurance plans has soared as the government has tried control costs and improve care for Medicare and Medicaid beneficiaries. Source: As Medicare and Medicaid Turn 50, Use of Private Health Plans Surges - The New York Times … [Read more...]

Spending on dental care will grow 60% in next decade – Dr. Bicuspid

July 29, 2015 -- Spending for dental care will grow 60% during the next decade, according to a new report in Health Affairs. Spending for dental services was $97.3 billion in 2007 and is projected to grow from $114.5 billion in 2014 to $183.4 billion in 2024. This mirrors a projected growth in overall healthcare spending from $2.3 trillion in 2007 to $5.4 trillion in 2024. Source: Spending on … [Read more...]

Dentist’s Nightmare Over – Settles for $120,000 Withheld Medicaid Funds

Dr. Paul Dunn testifying before a legislative committee

The vicissitudes of Dr. Paul Dunn have been chronicled by TDMR over the last several years. Dunn first appeared on the scene when he came to Austin during the 2013 legislative session. "Credible allegation of fraud" payment hold, but told he hadn't committed fraud He had been placed earlier under a 100% “credible allegation of fraud” payment hold for his Medicaid orthodontic billings by then … [Read more...]

Austin Doctor Heads to Prison for Health Care Fraud

HOUSTON—Dr. Dennis B. Barson Jr., 42, has been ordered to federal prison following his convictions related to a conspiracy to defraud Medicare of $2.1 million in less than two months, announced U.S. Attorney Kenneth Magidson. A federal jury convicted Barson and his medical clinic administrator, Dario Juarez, 55, on Nov. 5, 2014, of all 20 counts charged. Co-defendant Edgar Shakbazyan entered a … [Read more...]

Owner of Detroit Home Health Care Companies Sentenced to 80 Months in Prison for Role in $12.6 Million Fraud Scheme

A Michigan resident was sentenced to 80 months in prison late yesterday for his leading role in a $12.6 million Medicare fraud and tax fraud scheme.  Eleven other individuals have been convicted in this case. Assistant Attorney General Leslie R. Caldwell of the Justice Department’s Criminal Division, U.S. Attorney Barbara L. McQuade of the Eastern District of Michigan, Special Agent in Charge … [Read more...]

Records show feds accused NM firms of overbilling Medicaid $16.7M

Newly released documents show the federal government attempted to collect $16.7 million from the state after alleging four New Mexico companies that provide in-home health care services didn’t comply with the rules for submitting Medicaid reimbursement claims. In June 2012, Gov. Susana Martinez’s administration defended the four home care providers against the Obama administration audits. Yet … [Read more...]

Dallas-area woman pleads guilty to $1.6M Medicaid fraud

A Dallas-area woman has pleaded guilty in a $1.6 million Medicaid scam over false claims using the names of legitimate counselors. Brenda Ward of Cedar Hill faces up to 10 years in federal prison and a $250,000 fine. Ward on Friday pleaded guilty to health care fraud. She's free pending sentencing later this year in Dallas. Read more here: … [Read more...]

MI healthcare CEO spends $500,000 in Medicaid funds on fortune teller 

The former CEO of Summit Point in Battle Creek is facing criminal charges for spending more than half a million dollars in public funds on a fortuneteller. Summit Pointe is a Community Mental Health Authority, contracted through the State, that provides mental health and behavioral health services to Medicaid consumers. 68-year-old Ervin Brinker was the CEO of Summit Pointe Mental Health … [Read more...]

Janek’s “Capricious” Decision in Antoine Dental Case Challenged in District Court

Kyle Janek

Last Wednesday, July 16, lawyers for Antoine Dental Centers of Houston again went to court. Going Travis County District Court This time they appeared before Travis County District Court to appeal the Medicaid payment hold final decision by former Health and Human Services Commission Executive Commissioner Kyle Janek that was issued back on May 7, 2014. Janek decision "capricious," … [Read more...]

Dental board aims to improve, but critics not impressed – WFAA

Patients who say they received bad treatment from dentists are speaking out about the lack of oversight by the Texas State Board of Dental Examiners. Four years ago, News 8 began revealing cases of patient recruiting, poor quality of care and neglect. While the board took action in some cases, the dentists involved still have their licenses. Source: Dental board aims to improve, but critics … [Read more...]

Investigation Reveals $60 Billion Lost in Medicare Fraud Video

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Government report concludes money sent to unchecked addresses and PO boxes. VIDEO Source: Investigation Reveals $60 Billion Lost in Medicare Fraud Video - ABC News … [Read more...]

NY Medicaid scammer draws 7-21 years in prison

NEW YORK (AP) >> The owner of a Brooklyn medical supply business was sentenced to up to 21 years in prison in a Medicaid fraud scheme. Source: Medicaid scammer draws 7-21 years in prison … [Read more...]