Owner of Los Angeles Medical Supply Company Sentenced to Seven Years in Prison in $3.3 Million Medicare Fraud Scheme

The former owner of a Los Angeles-based medical supply company was sentenced today to seven years in prison for his role in a fraud scheme that resulted in $3.3 million in fraudulent claims to Medicare. Assistant Attorney General Leslie R. Caldwell of the Justice Department’s Criminal Division, Acting U.S. Attorney Stephanie Yonekura of the Central District of California, Special Agent in … [Read more...]

Florida dentist allegedly pulled kids’ teeth needlessly to get millions in Medicaid benefits

Florida pediatric dentist Dr. Howard Schneider is being sued by nearly 50 patients for allegedly extracting kids’ teeth for no reason, and in some cases hitting or choking them.Brandi Motley took to her 6-year-old daughter, Bri’el, to Schneider to have one tooth pulled. On the day of surgery in December 2014, Motley said she was not allowed to accompany her daughter, so she sat in the waiting room … [Read more...]

Indiana dental clinic employee given suspended sentence

ANDERSON — A former employee at the Anderson Dental Clinic was given a one-year suspended prison sentence Tuesday for her role in issuing a prescription using the name of a dentist who had left the practice. Deborah Davis, 56, was the last of nine people initially charged in a Medicaid fraud investigation to reach a plea agreement.The charges all stem from an investigation that ended last … [Read more...]

63 year old NY woman pleads guilty to submitting phony time sheets to Medicaid

Attorney General Eric Schneiderman announced Wednesday arraignment, guilty plea and sentencing of Patricia Power, 63, of 4883 Rushmore Road, Farmington. Power pleaded guilty for petit larceny based upon criminal charges filed by Schneiderman’s office. The mother of a disabled adult from Farmington, Power submitted phony time sheets to Medicaid for personal care work that her daughters did not … [Read more...]

The Medicaid Fraud Control Units: Fiscal Year 2014 Report 

The Department of Health and Human Services (HHS) Office of Inspector General (HHS-OIG) has released its Fiscal Year (FY) 2014 Annual Report (Report) on the performance of the Medicaid Fraud Control Units (MFCUs) (OEI-06-15-00010, April 2015). Although the MFCUs reported another strong year in civil recoveries, criminal recoveries were significantly lower than last year, when the MFCUs reported … [Read more...]

Medicaid Fraud Control Units Fiscal Year 2014 Annual Report Report 

WHY WE DID THIS STUDY The Department of Health and Human Services (HHS) OIG is the designated Federal agency that oversees State Medicaid Fraud Control Units (MFCUs or Units or Unit). This MFCU Fiscal Year (FY) 2014 Annual Report highlights statistical achievements from the investigations and prosecutions conducted by the 50 MFCUs nationwide. The report also explores issues that affect Medicaid … [Read more...]

CMS To Update Managed Care For First Time In Decade

Law360, New York (May 26, 2015, 7:36 PM ET) -- The Centers for Medicare and Medicaid Services put forth a proposal Tuesday that would update the way managed care organizations are regulated for the first time in a decade in order to align the service with the experience provided by the private marketplace and Medicare Advantage plans. Source: CMS To Update Managed Care For First Time In Decade … [Read more...]

Assistant U.S. Attorney General identifies fraud trends, targets healthcare executives

Federal prosecutors are moving fraud enforcement into the C-suite, according to Assistant Attorney General Leslie R. Caldwell. Just as the Department of Justice has pursued charges at against executives for financial fraud, healthcare executives will be held accountable for fraud schemes that occur under their watch. Source: Assistant U.S. Attorney General identifies fraud trends, targets … [Read more...]

Alabama dentist arrested for Medicaid fraud 

MOBILE, AL (WALA) - Alabama Attorney General Luther Strange arrested Mobile dentist, William Gerard Eastburn, on one count of filing false claims with the Alabama Medicaid Agency and one count of first-degree theft of property. The Attorney General's Medicaid Fraud Control Unit presented evidence to the May 2015 term of the Montgomery County grand jury, resulting in an indictment dated May 15 … [Read more...]

On health-care fraud, the little guys in Florida get jail; big guys get deals 

In March, Attorney General Pam Bondi announced she had nailed someone for Medicaid fraud. The culprit was a 49-year-old home-health worker from dirt-poor Gadsden County, accused of bilking the state out of $13,000. For her crime, Melissa Letica Simmons was ordered to spend six months behind bars — and repay all the money she stole from taxpayers. Six months. For $13,000. A few years … [Read more...]

Editorial: Contact Obama administration to stop plan to privatize Medicaid

Medicaid provides health insurance to about 500,000 Iowans. For decades, the government program has been operated by the state, which is not beholden to shareholders. Spending has been held down by reducing fraud, paying lower reimbursements to providers and giving seniors alternatives to expensive nursing homes. On average, the annual cost to insure an Iowan with Medicaid is significantly less … [Read more...]

Fired auditors say Medicaid errors remain issue at New York Health Department 

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The auditors worked in a non-descript, three-story brick building near a warehouse district in Menands, a couple miles north of the state Capitol.Their surroundings were ordinary, including hand-me-down state government furnishings. But their job was a crucial one: auditing the eligibility rates for recipients of New York's $22 billion-a-year Medicaid program. Source: Fired auditors say … [Read more...]

Medicaid Compliance Seminars

Texas Dentists for Medicaid Reform

and Star Compliance Services

now have healthcare compliance

seminars scheduled in:

Houston, Friday, June 12

San Antonio, Friday June 26

Dallas, Friday, July 17