NH Dentist Found Innocent of 45 Counts of Medicaid Fraud Amounting to $781

Texas Medicaid fraud

It appears other states besides Texas are having problems with their Medicaid fraud investigations. Jury found innocent Per a news report in the Concord Register, a New Hampshire orthodontist, after a two day trial, was found innocent of 45 counts of Medicaid fraud by a jury yesterday. Originally charged with 160 counts In December, the dentist had originally been charged with 160 … [Read more...]

UPDATE: “Cooked Books” Caused OIG to Settle for $39,000 in $16 Million Dental Medicaid Case

THHSC building

A Texas Health and Human Services Commission employee in the Office of the Inspector General was fired because he apparently "cooked the books" in OIG's case against Dr. Rachel Trueblood, according to a story published in the Austin American Statesman yesterday evening. UPDATE: HHSC termination letter to Brad Nelson, former senior actuary download Settlement offer sent one business day after … [Read more...]

NM lawmaker proposes bill to help providers appeal state fraud cases

Last year’s shake-up of behavioral health providers in New Mexico drew comparisons to the Salem witch trials and injustices perpetrated by rulers of the Roman Empire on Wednesday at a hearing where a state lawmaker unveiled proposed legislation that would guarantee due process to agencies suspected of Medicaid fraud. State Sen. Mary Kay Papen, D-Las Cruces, said Gov. Susana Martinez’s … [Read more...]

FBI raids Anchorage health care firm in Medicaid fraud investigation

ANCHORAGE - An Anchorage personal-care provider was raided by federal agents Tuesday night, as part of a joint investigation with state prosecutors into alleged Medicaid fraud at the facility. Kevin Donovan, assistant special agent in charge of the FBI’s Anchorage field office, confirmed that agents had seized documents and other materials from a medical care provider -- identified by state … [Read more...]

UPDATE: Federal Medicaid Audit Tags Texas for $30 Million


Another HHS-OIG audit about to be released of the Texas Medicaid program will cost Texas another $30 million, according to a story in this morning's Austin American Statesman.  The federal audit covers 2011 for non-emergency medical transportation services. The article reports that the Texas Health and Human Services Commission "improperly claimed Medicaid reimbursements in 70 out of the 90 … [Read more...]

Federal audit: Texas owes $30 million for improper Medicaid… | www.mystatesman.com

The federal government wants Texas to pay back more than $30 million for incorrectly claimed Medicaid reimbursements. An audit to be released Wednesday by the Office of Inspector General within the U.S. Department of Health and Human Services describes how Texas incorrectly claimed $30.3 million in fiscal year 2011 for non-emergency medical transportation services — private companies that … [Read more...]

UPDATED: HHSC Executive Compensation Figures Released

THHSC building

This past week HHSC released a report on executive compensation within HHSC.  (Staff Compensation) Per the report, the average base salary for non-executive staff on August 31, 2014 was $37,326. The following table is excerpted from the report to show only the salary increases from 2013 to 2014 . It should be noted that the Inspector General's salary has increased from $153,296 in 2010 … [Read more...]

Congressional Budget Office Report on How Initiatives to Reduce Fraud in Federal Health Care Programs Affect the Budget

Last Updated: Tuesday, 21 October 2014 06:10 Read Complete Document (pdf, 522.97 KB) October 20, 2014 - Observers often cite fraud as an important contributor to high health care spending, particularly in federal programs. This report describes how CBO estimates the budgetary effects of legislative proposals to reduce fraud in Medicare, Medicaid, and the Children’s Health Insurance Program … [Read more...]

President of Houston Hospital and Three Others Convicted in $158 Million Medicare Fraud Scheme

Washington, DC—(ENEWSPF)—October 20, 2014. A federal jury in Houston today convicted the president of Riverside General Hospital (Riverside), his son, and two others for their participation in a $158 million Medicare fraud scheme involving false claims for mental health treatment.  Ten defendants have now been convicted in connection with the Riverside fraud scheme. Assistant Attorney General … [Read more...]

Texas Medicaid “Low Hanging Fruit” – AG Lawsuit Against Yet Another Company

justice for texas medicaid providers

Two weeks ago, the Texas Office of the Attorney General quietly filed a lawsuit against yet another company associated with Texas Medicaid - the drug company AstroZeneca. Millions of dollars in excess reimbursements It accuses the company of defrauding the Texas Medicaid program with the off-label promotion of its drug Seroquel, claiming that the company's illegal conduct resulted in … [Read more...]


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