A relatively new Medicaid health homes program has caught the eye of a health-care watchdog, with a report expected by fiscal year 2019.The Health and Human Services Office of Inspector General will review an optional Medicaid benefit that creates health homes for beneficiaries with chronic health conditions. The new review was announced in a Sept. 15 update to the OIG’s work … [Read more...]
Medicaid Media
No license? No problem for rogue dentist in San Jose
SAN JOSE — He ignored a judge’s order, then the state Dental Board. Now, a former San Jose dentist, whose license has been revoked, is in trouble with Santa Clara County authorities for allegedly practicing anyway — and billing insurance companies for the prohibited work. Michael Marcus, 67, faces four counts of felony insurance fraud for allegedly defrauding two insurance … [Read more...]
Texas man sentenced for hacking Centerville Clinics computer system
A Texas man was sentenced Wednesday in federal court to 27 months in prison for hacking the computer system of a local health-care organization after he was fired from his job there. Chief U.S. District Court Judge Joy Flowers Conti imposed the sentence on Brandon A. Coughlin, 29, of Houston, after he pleaded guilty in June to charges of intentional damage to a protected … [Read more...]
North Texas Doctor Sentenced to Nearly 17 Years for Fraud
DALLAS (AP) — A North Texas physician must serve nearly 17 years in federal prison and repay $34 million in a health care services fraud case involving home visits. Dr. Noble U. Ezukanma of Fort Worth was sentenced Wednesday in Dallas. Prosecutors say the 57-year-old Ezukanma was part of a more than $50 million Medicare fraud scheme. The physician in March was convicted … [Read more...]
Avoiding health care fraud
STANDARD — As quickly as they’re detected and defeated — new, more complex scams take their place. Health care is a common target. To help residents avoid these swindles, the Putnam County Community Center in Standard recently held a program teaching how to detect and report these types of fraud. Presented on Aug. 17 by Amy Phillips, program coordinator for the Western … [Read more...]
5 in health care fraud case face charges in witness’ death
NEW ORLEANS — A Louisiana man convicted in a multi-million dollar health care fraud scheme in 2013 now faces federal charges — along with four other men — in the 2012 slaying of a witness in the case, federal prosecutors said Wednesday. Louis Age Jr., 68, his son Louis Age III, 47, and three others face multiple charges that include conspiracy to obstruct justice by murder … [Read more...]
Fewer Texans were uninsured in 2016, but state still has largest health coverage gap
More Texans are insured now than four years ago — but the state is still home to 4.5 million people without health coverage, the largest share in the country. A new United States Census Bureau report shows the percentage of uninsured Texans dropped from 22.1 percent in 2013 to 16.6 percent in 2016. Despite the drop, Texas still reported the highest uninsured rate of all 50 … [Read more...]
How healthcare providers can curb medical identity theft
Medical identity theft is on the rise. Medical records are a hot target for hackers because, according to the FBI, medical identities are valued at 20 to 50 times more than financial identities on the black market. Data breaches appear to be the leading cause of this growth, and the number of data breaches continues to grow. The number of healthcare organizations falling … [Read more...]
Medicaid agencies struggle to stop payments to healthcare providers accused of fraud
Medicaid agencies are having a difficult time imposing payment suspensions on providers against which there is credible allegation of fraud, according to a new government watchdog report. The report (PDF), from the Department of Health and Human Services’ Office of Inspector General, examined self-reported case data from both Medicaid agencies and Medicaid Fraud Control … [Read more...]
Woman ordered to repay more than $11,000 for Medicaid fraud
LAWRENCE, Kan. (KWCH) A Douglas County woman ordered to repay more than $11,000 to the Kansas Medicaid Program after pleading guilty to Medicaid fraud-related charges. Kansas Attorney General Derek Schmidt says 44-year-old Marquita Diane Hutcherson pleaded guilty in July in Douglas County District Court to one count of making a false claim to the Medicaid program, one count … [Read more...]
