When agencies that receive Medicaid reimbursements are accused of fraud, it can impact that provider as well as its patients for months at a time—regardless of whether any parties are ever found guilty.Four U.S. lawmakers recently introduced a bill meant … Read More
WILMINGTON, N.C. (WNCT) – Terry Lamont Speller, 38, was sentenced to 240 months in federal prison and three years of supervised release following his guilty plea to Medicaid fraud. The Winterville-native was also ordered to pay back the money he … Read More
A vast web of bribes, kickbacks, counterfeit hardware and a legislative loophole allowed one California spine surgeon to cash in on spinal fusion surgeries for which the state paid millions of dollars, according to an article by Los Angeles Magazine. … Read More
Back in 2012, I delved into a topic of utmost importance and surprising depth: children’s dental health. For years, many dentists chose not to treat Medicaid patients. From an economic point of view, it was really no surprise; providers willing … Read More
PIERRE, S.D. (AP) — A man accused of defrauding the South Dakota Medicaid program has been sentenced to two years of probation and ordered to pay back $990. Thirty-eight-year-old Tanka Bhujel pleaded guilty in state court to one count of … Read More
Commentary: U.S. Sens. Tom Udall and Martin Heinrich, and U.S. Reps. Ben Ray Luján and Michelle Lujan Grisham introduced the Medicaid Program Integrity Enhancement Act of 2016. The bill protects Medicaid patients by establishing clear guidelines that ensure that state agencies investigating … Read More
A former official with Arizona’s health care program for the poor pleaded guilty Tuesday to fraud and theft charges in a case in which he was accused of stealing millions in public money. Michael John Veit, the former chief procurement … Read More
Ohio Attorney General Mike DeWine said Thursday that Ohio’s Medicaid Fraud Control Unit ranks first in the nation for the number of convictions secured in fiscal year 2015, according to a statistical summary of Medicaid fraud control units in all … Read More
Xerox is on a list of 27 large and profitable companies that paid no income tax last year. A report in the USA Today lists Xerox as one of several profitable companies that reported negative income tax expenses in 2015. … Read More
Last year, the Medicaid program celebrated its golden anniversary. A lot has changed over the last 50 years. Originally created in 1965 as a joint federal-state program to provide health care coverage for low-income, vulnerable Americans, it is now the … Read More
On Jan. 6, Nevaeh Hall was running, playing and laughing at a Chuck E. Cheese indoor playground and game room.The next day, after a morning dental appointment, the 4 year old was in an ambulance en route to Texas Children’s … Read More
While Texas lawmakers are studying ways to reduce costs in the state’s Medicaid program for the poor and disabled, health insurance companies are making a business pitch. Health plans could save the state roughly $100 million per year, they say, … Read More
HOUSTON – The leader and four others charged in a $13 million Medicare and Medicaid health care fraud case have entered guilty pleas for their respective roles, announced U.S. Attorney Kenneth Magidson. Mkrtich “Mike” Yepremian, 58, of Houston, pleaded guilty … Read More
Republican presidential front-runner candidate Donald Trump on Wednesday unveiled proposals for reforming U.S. healthcare that included repealing Obamacare, allowing prescription drugs to be imported, and turning the Medicaid program for the poor into block grants to states. The plan also … Read More
Law360, Washington (March 2, 2016, 7:46 PM ET) — The U.S. House of Representatives on Wednesday unanimously passed a bill, with the backing of the White House, intended to ensure Medicaid providers terminated for fraud or quality issues in one … Read More
Six individuals, including two Dallas-area doctors, were charged in a superseding indictment that was unsealed today for their alleged participation in a $13.4 million health care fraud scheme involving fraudulent claims for home health services. Assistant Attorney General Leslie R. … Read More
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The Texas Supreme Court has given another shot to a former government lawyer who alleged he got fired after blowing the whistle that the state was illegally seeking reimbursement from some Medicaid recipients. F. Michael McMillen saw his employment lawsuit … Read More
DALLAS — Two North Texas men face health care-related fraud charges that prosecutors say cost a U.S. Defense Department agency $65 million. Richard Robert Cesario of Plano and John Paul Cooper of Southlake remained in custody pending a detention hearing … Read More
Updated: 3:00 p.m. Wednesday, Feb. 24, 2016 | Posted: 9:08 a.m. Wednesday, Feb. 24, 2016The state’s top criminal court on Wednesday threw out the remaining criminal charge against Rick Perry, sparing the former governor from trial and a potential prison sentence on … Read More
ATLANTA (WXIA) – Georgia State Senator Renee Unterman (R – 45th District, Sugar Hill/Buford) is chair of the Senate Health & Human Services Committee. She is also an executive with a health insurer that has a billion dollar a year … Read More
The emails between two people at the center of a no-bid state contract scandal are a window on how cozy associations can meld into influence — misused to the public’s detriment. An Express-News article by Brian M. Rosenthal of the … Read More
In the five years he served as U.S. Attorney for the Eastern District of Tennessee, Bill Killian oversaw dozens of healthcare fraud cases. By the time he resigned from his post Dec. 5, Killian’s district had collected more than $200 million … Read More
Ever since Texas Attorney General Ken Paxton was indicted last summer on three felony charges related to alleged financial fraud in his personal business dealings, he has said little about the matter save for an initial court appearance where he … Read More
They say you shouldn’t mess with Texas. Those submitting fraudulent claims to the state’s Medicaid program should heed that advice. According to new Medicaid Fraud Control Unit (MFCU) statistics and an interactive map released by the Office of Inspector General, the … Read More
Federal prosecutors have accused Cherie R. Dillon of health care fraud and aggravated identity theft tied to her Payette business, Dental Healthcare with Heart. They say Dillon, 60, performed dental procedures that could only be carried out by a dentist. … Read More
The Texas health commission finally has chosen a company to run a long-delayed massive data project, awarding it to the same firm whose tentative contract was canceled in 2014. The commission disclosed this week that it had decided to award … Read More
ALBUQUERQUE – Democrats with the state’s congressional delegation are calling for a federal investigation into the withholding of Medicaid payments from 15 nonprofits that provided behavioral health services to needy New Mexicans. In a letter sent Friday to U.S. Health and … Read More
Follow the link below to a map of the country. Click on a state and the MFCU data for that state will open. Source: 2015 Interactive Map of Expenditures | MFCU | Office of Inspector General | U.S. Department of … Read More
WHY WE DID THIS STUDY OIG oversees all State Medicaid Fraud Control Units (MFCUs or Units). As part of this oversight, OIG conducts periodic reviews of all Units and prepares public reports based on these reviews. The reviews assess Unit … Read More
A high-ranking official at the Texas Health and Human Services Commission is stepping down after he co-authored a controversial study that found fewer women accessed a Texas family planning program after Planned Parenthood was kicked out in 2013. Rick Allgeyer, the commission’s … Read More
JACKSON, Miss. (AP) — A 31-year-old Louisville woman is going to prison for Medicaid fraud. Attorney General Jim Hood, in a news release Tuesday, said Labeatris Estes pleaded guilty to two counts of Medicaid fraud before Rankin County Circuit Court … Read More
Under the Affordable Care Act, health-care providers must report and return Medicare or Medicaid overpayments within 60 days after an overpayment is identified, or the date a corresponding cost report is due, whichever is later. But it can be challenging … Read More
James R. Dye, 66, of Independence, Missouri waived his right to a grand jury and pleaded guilty before U.S. Magistrate Judge David P. Rush to a federal information that charges him with health care fraud. In his plea, Dye admitted … Read More
The state said Schneider billed Medicaid more hundreds of thousands of dollars for procedures he didn’t actually perform. The Office of the Attorney General Medicaid Fraud Control Unit interviewed them as a part of their investigation into the pediatric dentist … Read More
A man pleaded guilty Wednesday to Medicaid fraud after being charged with orchestrating a kickback scheme from his jail cell.David Epps, 44, who had been in the Monroe County Jail on an unrelated charge, was sentenced to six months, according to the … Read More
One of the least well-understood scandals of the Obama era is the effort to cripple the auditing system for Medicare payments, allowing sectors of the healthcare industry that helped get Obamacare passed into law to reap billions of dollars in … Read More
Travis County prosecutors are no longer leading a year-long criminal investigation into a controversial state technology deal that led to sweeping contracting reforms and have transferred the case to another law enforcement agency. Gregg Cox — chief of the Travis … Read More
AUSTIN — The Travis County District Attorney’s Office has transferred its investigation of a controversial no-bid contract to another law enforcement agency better able to handle the complicated case. Travis County Public Integrity Unit chief Gregg Cox disclosed the move … Read More
They met on an airplane in the spring of 2011 – the CEO of an Austin technology company and a Texas state official who found themselves seated next to each other and began talking about movies, and then work. Irene … Read More
