Another Legal Win for Medicaid Dentist: Appeals Court Tells OIG To Return Payment Hold Monies

Court room

The 3rd Texas Court of Appeals has agreed with a Travis County District Court judge and has issued a ruling that the Office of the Inspector General should return over $1.2 million in withheld Medicaid funds to Harlingen Family Dentistry.  TDMR received a copy of the decision this morning and the Austin American Statesman has already published the story. Appeal over a year old Back in … [Read more...]

Court: State improperly held Medicaid money | www.statesman.com

In another setback for the state health agency charged with rooting out Medicaid fraud, an appeals court Thursday said almost $1.26 million was improperly withheld from a dental practice even after state regulators acknowledged that no fraud had taken place. The 3rd Court of Appeals ordered the money to be paid to the practice, ruling that the state Health and Human Services Commission was … [Read more...]

DaVita Healthcare Partners to Pay $350 Million to U.S. Government for Allegedly Violating the Anti-Kickback Statue under the False Claims Act | The National Law Review

On October 22, 2014, the Department of Justice (DOJ) announced that DaVita Healthcare Partners, Inc. (DaVita), a provider of dialysis services, has agreed to pay the U.S. Government $350 million for allegedly violating several provisions of the False Claims Act (FCA) — including persuading physicians or physician groups to refer their dialysis patients to DaVita by offering kickbacks for each … [Read more...]

Former Minnesota Hospital Association General Counsel Offered $150,000 in Hush Money

David Feinwachs was general counsel for the Minnesota Hospital Association. Until 2010 when he was fired. His firing ended a 30 year career with the hospital association. He was fired because he began asking questions about why the four HMOs in Minnesota were making so much money off the state’s Medicaid program. When he was fired, he was offered $150,000 to remain silent. He … [Read more...]

The Saga Goes On: Jack Stick’s Next Hearing in December

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No news is no news. Per the online case search at the website of the Travis County Clerk, Jack Stick has another hearing date on his DWI - December 9th. … [Read more...]

U.S. sues NYC, Computer Sciences over Medicaid reimbursements | Reuters

Oct 27 (Reuters) - The United States on Monday joined a lawsuit accusing New York City and Computer Sciences Corp of defrauding Medicaid into making millions of dollars of improper reimbursements by exploiting a computerized billing system that the company designed. According to the complaint filed in U.S. District Court in Manhattan, the defendants took advantage of the system's automatic … [Read more...]

Legislator seeks info on state fraud inspector’s falsified work

A key legislator with oversight of the state’s Health and Human Services Commission has asked that agency’s Office of Inspector General to review all Medicaid fraud cases handled by an actuary who admitted recently to falsifying numbers on at least one of the cases. State Rep. Richard Peña Raymond, D-Laredo, said the request was in response to an American-Statesman article last week revealing … [Read more...]

Rep. Raymond Asks For Review of All Medicaid Cases Handled by Fired OIG Actuary

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The Austin American Statesman reported this morning that Rep. Richard Peña Raymond, D-Laredo, has requested that the Texas Health and Human Services Commission Office of Inspector General review all Medicaid cases that were worked on by the now-terminated actuary that admitted to falsifying records in the case of Dr. Rachel Trueblood. OIG settled Trueblood's initial $16 million dollar … [Read more...]

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...]

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