Former Deputy Attorney General John Scott Leaving the Texas Health and Human Services Commission, Returning to Private Sector

AUSTIN – Texas Health and Human Services Executive Commissioner Chris Traylor today announced John Scott is stepping down as chief operating officer of The Health and Human Services Commission (HHSC). Scott joined HHSC in January, where he served as the chief architect behind the agency's internal ethics and contracting reform. He will return to the private sector, where he is known as one of the … [Read more...]

South Texas woman pleads guilty in healthcare fraud scheme

McALLEN — A Pharr woman pleaded guilty Friday for her role in connection with a federal healthcare insurance fraud scheme, prosecutors said. Martha Lidia Flores admitted to engaging in a kickback scheme of exchanging referrals of Medicare beneficiaries for money from Nov. 15, 2010, to July 9, 2012, according to her indictment. Pharr woman pleads guilty in healthcare fraud scheme - The Monitor … [Read more...]

A Less Than Warm Adieu to Byron Harris | D Magazine

Byron_Harris

Channel 8’s Byron Harris announced Friday that he’ll retire in October. Ed Bark posted a solid story Monday about the investigative reporter and his 40 years at the TV station. I’d like to go in a slightly different direction. Harris won a ton of awards. I’m told he did a lot of great work (aside from thatsloppy stuff about Medicaid-funded orthodontics for which Politifact called him out). The … [Read more...]

Texas Judge Exits Med Center False Claims Act Suit Over Witness 

Law360, New York (August 27, 2015, 2:12 PM ET) -- A Texas federal judge recused himself Wednesday from a False Claims Act suit against a medical center, days after the defendants revealed his cousin could be a key witness. The case was reassigned after McAllen Medical Center's lawyers said Monday that U.S. District Chief Judge Ricardo H. Hinojosa’s first cousin’s son, Mario Garza Jr., will … [Read more...]

Texas sticks by plans to deeply cut Medicaid therapy rates 

AUSTIN — A lawsuit that sought to block deep cuts in what Medicaid pays for disabled children and poor elderly Texans’ therapies has delayed the rate changes for a month but otherwise forced no change in the state’s plans. On Wednesday morning, owners of several home health agencies who had challenged the reductions rejoiced after a Health and Human Services Commission lawyer announced in court … [Read more...]

Texas Jury Acquits Cancer Agency Exec In $11M Grant Row

A Texas jury on Tuesday acquitted a former Cancer Prevention and Research Institute of Texas executive of a felony charge that he deceived the agency’s executive director and general counsel to get an $11.04 million grant approved for a pharmaceutical company. Source: Texas Jury Acquits Cancer Agency Exec In $11M Grant Row - Law360 … [Read more...]

McAllen doctor accused of filing claims for dead patients faces new charges 

A McAllen area doctor accused in June of filing fraudulent Medicare claims involving deceased patients faces new charges after he continued to file false claims, federal investigators said. Source: Doctor accused of filing claims for dead patients faces new charges - The Monitor: Local News … [Read more...]

Florida expands program to audit hospitals, citing concerns about Medicaid Fraud

Another 100 Florida hospitals — 17 of which are in the Tampa Bay area — will be audited by the state to determine whether they're receiving more in Medicaid payments than legally allowed, Gov. Rick Scott said Monday. They join 29 hospitals already being audited for failing to provide information about their Medicaid contracts to the state Agency for Health Care Administration before Aug. … [Read more...]

HHSC Updating THSteps Diagnostic Dental Services Policy and Wants Feedback from Dentists

children health insurance program

  The Health and Human Services Commission has just put online proposed changes to the THSteps Diagnostic Dental Services Policy and is requesting stakeholder feedback on the changes. The updated policy will require the use of a professionally developed and approved caries risk assessment (CRA) tool.  Per the document, "one of the CRA codes must be appended to dental oral examination … [Read more...]

NY Medicaid Fraud Case Settled without Admission of Guilt

Empire State Home Care Services has agreed to pay $6 million as part of a settlement with the New York state attorney general to resolve allegations of improper Medicaid billing. Source: Brooklyn Medicaid Fraud Case Settled … [Read more...]

Medicare Fraud Is Committed Well Beyond U.S. Borders – Bloomberg

On the streets of Managua, the shuttle bus wrapped in a giant ad for free health care stood out. “Medicare for people living abroad,” it proclaimed above the image of a cheerful older woman playing golf. But Medicare, the American public health insurance program for the elderly and disabled, isn’t available in Nicaragua or anywhere outside the U.S., except in emergency circumstances. The clinic … [Read more...]

Owner of Three Los Angeles Medical Clinics Pleads Guilty to $4.5 Million Medicare Fraud Scheme

Los Angeles, California - The owner and operator of three medical clinics located in Los Angeles pleaded guilty today to submitting more than $4.5 million in fraudulent claims to Medicare. Assistant Attorney General Leslie R. Caldwell of the Justice Department’s Criminal Division, U.S. Attorney Eileen M. Decker of the Central District of California, Acting Special Agent in Charge Steve Ryan of … [Read more...]

tdmr_logo

Are you subscribed to TDMR News Alerts?

Get the latest news from TDMR. Just provide your email address.
  • This field is for validation purposes and should be left unchanged.