PITTSBURGH, PA – A South Hills pharmacist pleaded guilty in federal court to charges of obtaining controlled substances by fraud, misbranding of drugs, and health care fraud conspiracy, Acting United States Attorney Stephen R. Kaufman announced today. Timothy W. Forester, … Read More
FAYETTEVILLE – A Florida dentist, formerly of Arkansas, pleaded guilty today to one count of conspiracy to commit honest services fraud in a scheme with former Arkansas State Senator Jeremy Hutchinson that occurred between 2014 and 2016. U.S. District Judge … Read More
John Peter Smith Hospital agreed to pay $3.3 million to settle a case alleging it violated the False Claims Act by upcoding claims given to federal healthcare programs such as Medicare, TRICARE, and VA health benefits programs. The suit stems … Read More
ABINGDON, Va. – A Bristol, Tennessee man was sentenced today to three months of home confinement for conspiring with another man to pay and receive kickbacks. In addition to home confinement, he will pay $56,000 in monetary penalties and will … Read More
NEW YORK, Sept. 16, 2021 /PRNewswire/ — The United States Department of Justice (DOJ) has filed its complaint in intervention in a Constantine Cannon whistleblower’s lawsuit against Independent Health Association (IH), coding consultant subsidiary DxID LLC (DxID) and Betsy Gaffney, … Read More
An ophthalmologist in Rye, NY, has pleaded guilty in connection with a seven-year healthcare fraud scheme. Dr. Ameet Goyal falsely billed for millions of dollars of procedures he did not perform, according to a press release from the U.S. Attorney’s … Read More
After our last article about possible termination from a DMO’s network for filing a complaint with HHS before all company complaint procedures have been exhausted, we picked up online copies of the Medicaid Provider manuals for DentaQuest, MCNA and UnitedHealthcare … Read More
Dr. Janice Reardon, Chief Dental Officer of the Office of Inspector General, has been honored with the Lifetime Membership Award by the Texas Dental Association. The award recognizes her 30 years of continuous membership in the TDA. A graduate of … Read More
A major California-based health care system, Sutter Health, and several of its medical practice foundation affiliates have agreed to pay a total of $90 million to settle allegations that they violated the False Claims Act (“FCA”) by knowingly submitting inaccurate … Read More
EL PASO – An El Paso businesswoman and her nephew were arrested today on criminal charges for their alleged roles in committing health care fraud. According to court documents, Zenia Chavez, 45, and Raul Alejandro Fuentes, 23, of El Paso, … Read More
WASHINGTON — Former NFL players Clinton Portis, Tamarick Vanover and Robert McCune pleaded guilty for their roles in a nationwide health care fraud scheme and could face years in prison, the U.S. Department of Justice announced Tuesday. Portis, Vanover and … Read More
Indiana Attorney General Todd Rokita announced Wednesday that Indiana Medicaid has recovered $1.8 million as part of a $75 million national civil settlement resolving allegations that Bristol-Myers Squibb Co. overcharged state Medicaid programs for drugs. Of the $1.8 million, $746,780 goes directly … Read More
The U.S. Department of Justice (DOJ) has alleged that the University of Pittsburgh Medical Center in Pennsylvania (UPMC) and the head of cardiothoracic surgery, James Luketich, “fraudulently bill[ed] Medicare and Medicaid for complex surgeries,” according to court documents. The complaint … Read More
If you’re interested in issues surrounding the statewide operation of Medicaid managed care, you may want to apply to be a member of the State Medicaid Managed Care Advisory Committee. The Texas Health and Human Services Commission executive commissioner will … Read More
More than a year into the pandemic and all the government programs, funding, and relief that came along with it, the federal government is accelerating its pace of prosecution of fraud. Since the passing of the Coronavirus Aid, Relief, and … Read More
SUFFOLK COUNTY, NY — A former dentist from Long Island was convicted of Medicaid fraud and sentenced to prison, New York Attorney General Letitia James announced on Wednesday. Dawer Nadi, 63, submitted false Medicaid claims for dental services after his … Read More
n anticipation of the upcoming solicitation and resulting contract for STAR+PLUS, the Health and Human Services Commission (HHSC) is issuing this Request for Public Comment to seek information and comments regarding the proposed Best Value Criteria the agency will use … Read More
A new law will no longer require some Texas doctors to obtain approval for certain medical procedures, treatments or drugs. Physicians with a proven track record — who are approved 90% of the time for a service — will receive “gold … Read More
September 3, 2021 — The COVID-19 pandemic affected the income of all dentists in 2020, but female clinicians took a much bigger financial hit than their male colleagues, according to a webinar hosted by the ADA’s Health Policy Institute (HPI) on … Read More
The latest ADA Health Policy Institute (HPI) survey, conducted in August, included additional questions relating to staffing and found that recruitment challenges were becoming an issue in U.S. dental offices. For 40.1% of all respondents, filling vacant positions in the … Read More
WASHINGTON – The White House is trying to shorten projections from federal health officials that it could take several years for American seniors to benefit from Democrats’ push for free dental coverage, according to four people with knowledge of the … Read More
An Easley chiropractor’s string of businesses must pay $140 million in judgments after a federal whistleblower lawsuit that alleged the medical companies charged for unnecessary tests in exchange for kickbacks. The default judgments were awarded in U.S. District Court in … Read More
Leonel Palatnik, 42, co-owner of Dallas-based Panda Conservation Group, a medical lab company, pleaded guilty Aug. 31 for his role in a $73 million Medicare kickback conspiracy, according to a Justice Department news release. Mr. Palatnik paid kickbacks to a telehealth company … Read More
The largest healthcare system in Pennsylvania and one of its top physicians are being sued by the federal government for alleged healthcare fraud. UPMC, its chairman of cardiothoracic surgery and the University of Pittsburgh Physicians group are accused of billing … Read More
WASHINGTON — The U.S. House committee investigating the Jan. 6 attack on the Capitol has requested communications between Texas Attorney General Ken Paxton and Trump White House officials in the months leading up to the insurrection. The request was issued … Read More
A report detailing an internal investigation, released Tuesday by Texas Attorney General Ken Paxton’s office, concluded that Paxton committed no crimes in official actions related to friend and political donor Nate Paul, contradicting accusations made last year by top officials … Read More
A federal grand jury in St. Louis has indicted an Overland Park anesthesiologist on charges he conspired to defraud Medicare out of $26 million. The 25-count indictment of Dr. Scott Taggart Roethle alleges that telemedicine and marketing companies paid him … Read More
Tens of millions of older Americans who cannot afford dental care — with severe consequences for their overall health, what they eat and even when they smile — may soon get help as Democrats maneuver to add dental benefits to … Read More
RALEIGH, N.C. – A Morehead City woman was sentenced today to 30 months in federal prison, followed by three years of supervised release on a charge of Making Material False Statements Relating to Healthcare Matters, in violation of Title 18, … Read More
Tarrant County’s John Peter Smith Hospital (JPS) has agreed to pay more than $3.3 million to settle allegations that it violated the False Claims Act by upcoding certain claims submitted to federal healthcare programs, Acting U.S. Attorney Prerak Shah announced … Read More
A federal grand jury in New Orleans, Louisiana, returned an indictment today charging a Louisiana physician for his role in distributing over 1,200,000 doses of Schedule II controlled substances, including oxycodone and morphine, outside the scope of professional practice and … Read More
Mississippi Attorney General Lynn Fitch’s Medicaid Fraud Control Unit has had two successful sentencings in the past week, protecting vulnerable seniors and families who rely on Medicaid from fraud and in one of those cases the guilty party will serve … Read More
PORTLAND, Ore. (KTVZ) — A Bend resident and his residential care company have agreed to pay $2.9 million to settle federal and state allegations that the firm submitted false reimbursement claims to Oregon’s Medicaid program, federal prosecutors said Thursday. Kevin … Read More
Ghada Beydoun, DDS, was a member of Healthy Kids Dental, and fraudulently obtained taxpayer dollars by billing the program for services she never did on multiple occasions in 2017 and 2018, according to Nessel’s offce. Dr. Beydoun now faces 10 … Read More
Federal prosecutors have reached consent judgments with a company accused of fraud while providing mental health and substance abuse treatment services at community clinics throughout Delaware, authorities said Thursday. Connections Community Support Programs, which also is the former medical and … Read More
A federal grand jury in St. Louis has indicted an Overland Park anesthesiologist on charges he conspired to defraud Medicare out of $26 million. The 25-count indictment of Dr. Scott Taggart Roethle alleges that telemedicine and marketing companies paid him … Read More
Uber is now offering millions of Texans on Medicaid rides to and from non-emergency medical appointments. Uber Health, the company’s health care division, launched the service officially this week thanks to a law the company helped pass in the 2019 … Read More
DOWNEY — SuperCare Health, Inc., a Downey-based provider of home respiratory services and durable medical equipment, has agreed to pay $3,315,308 to resolve allegations that it defrauded public health care programs by billing for ventilator services that were not medically … Read More
After we published our article last week about the HHS complaint line and its email address, we received a few emails from dentists. Several were excited about the possibility of complaining to HHS about their DMO troubles, but one had … Read More
