New HHS-OIG litigation team will tackle Medicare, Medicaid fraud cases 

The U.S. Department of Health and Human Services Office of Inspector General has created a new team of attorneys focused solely on litigation involving Medicare and Medicaid fraud. The new team was announced at the American Health Lawyers Association's annual meeting Tuesday, and aims to help fill an enforcement gap among attorneys handling civil penalty and exclusion cases, OIG officials said. … [Read more...]

Orange County Crackdown on Medicaid, Welfare Fraud 

Thirty people have been charged with Welfare Fraud for illegally obtaining over $324,000 in public assistance benefits administered through the Orange County Department of Social Services—mostly Medicaid.The enforcement action was the result of the collaborative efforts of the Orange County Department of Social Services Special Investigations Unit (SIU), the Sheriff’s Office and the District … [Read more...]

Not all states reporting required Medicaid data, HHS-OIG says

A number of states still do not report required quarterly data about services provided to Medicaid beneficiaries enrolled in managed care—information that's crucial to running Medicaid and protecting it from fraudsters, according to a study HHS' Office of Inspector General released Monday. States have gotten better in recent years at reporting encounter data—information detailing services … [Read more...]

New HHS OIG fraud unit to levy fines, exclusions—and target physicians 

The Office of the Inspector General at HHS announced Tuesday the creation of a new litigation team that will concentrate on identifying and fining Medicare and Medicaid fraud. The team's creation is intended to put further pressure on physicians, drugmakers and other healthcare organizations suspected of bilking the federal government. The team was created in March and will have around 10 … [Read more...]

Federal Leaders Question Administration’s Decision to Ease Fraud Reduction Targets in Medicaid Program

WASHINGTON, DC – House Energy and Commerce Committee Chairman Fred Upton (R-MI) and Oversight and Investigations Subcommittee Chairman Tim Murphy (R-PA) today sent a letter to Centers for Medicare and Medicaid Services Acting Administrator Andy Slavitt in their continued oversight of the Medicaid program. Upton and Murphy write, “Specifically, the committee is looking into why the Centers for … [Read more...]

HHSC Allegedly Paid Out $104 Million to 8,000 Medicaid Providers the Agency Suspected Of Fraud

Former HHSC Chief Counsel Jack Stick's $87 OIG Badges

Four firms provided “proof of concept” demonstrations of their Medicaid fraud detection software to the Texas Health and Human Services Commission and its Office of Inspector General back in 2011. These proof of concept projects allowed the firms to access Medicaid claims data to evaluate it for fund diversion to fraud. In the case of Reflective Medical (RMIS), as already reported in the … [Read more...]

New HHS-OIG litigation team focuses on civil money penalty and exclusion cases

On Tuesday, representatives from the United States Department of Health and Human Services Office of Inspector General (OIG) announced the creation of an OIG litigation team that will focus specifically on civil monetary penalties and exclusion cases. The announcement was made to attendees at the annual meeting of the American Health Lawyers Association (AHLA). Devoting a designated legal team … [Read more...]

San Antonio Seminar Helping Providers Understand Compliance and Enforcement Issues

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This past Friday at the Leon Valley Conference Center in San Antonio, Star Compliance Services and TDMR held our third healthcare compliance seminar, following our recent successful seminar in Houston and the earlier one held in February at Weslaco. Gregory Ewing and Dr. Juan D. Villarreal were once again the presenters and provided attendees the benefits of their knowledge and personal … [Read more...]

Walgreen settles Medicaid false billing case in New York

Walgreen Co will pay $2.55 million to settle charges by New York's attorney general that a pharmacy unit improperly billed Medicaid for costly drugs to treat hemophilia patients, without proof that it actually delivered the drugs to those patients. Attorney General Eric Schneiderman on Monday said his audit of Medicaid billings by Trinity HomeCare LLC found improper conduct and false billings … [Read more...]

NH Dental Practice Pays $13K Fine for Records Violation

Attorney General Joseph A. Foster announced on June 25, 2015, that the Medicaid Fraud Control Unit (MFCU) of the Department of Justice had reached a settlement with Dr. Eyad Almahayni, DMD, to resolve allegations about his dental practice, according to a press statement. It is alleged that Almahayni’s business submitted claims to Medicaid for dental services, between February 2008 and July … [Read more...]

Texas healthcare vendor lavished NY OMIG director with gifts, booze

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An investigation by state Inspector General Catherine Leahy Scott found that a former top official with the state Office of the Medicaid Inspector General improperly accepted gifts, including air travel and a job offer, from a Texas corporation that has a multimillion-dollar contract with New York. The searing report released Thursday accusedJoseph J. Flora, 56, a former OMIG director, of … [Read more...]

HHS OIG: McAllen a Medical Fraud Hotspot

The federal government is calling McAllen a hotspot for potential Medicare fraud and abuse. The Department of Health and Human Service Office of Inspector General released a report today detailing the growing problem. Source: HHS OIG: McAllen a Medical Fraud Hotspot … [Read more...]

Texas Dentists for Medicaid Reform

and Star Compliance Services

 are holding a healthcare compliance

seminar in:

Dallas, Friday, July 17