Medicare spent more than $30 million during the first half of 2012 on ambulance transports for patients that appear to be ghosts on paper, according to a new report released by the Office of Inspector General (OIG) Tuesday. The report revealed … Read More
With more large-scale, multi-million dollar fraud schemes surfacing across the country, enforcement officials are utilizing Medicare Fraud Strike Force teams to dismantle entire fraud operations. Source: Anatomy of a fraud bust: Collaboration creates efficiency
Hawaii’s Medicaid Fraud Control Unit is costing 10 times as much to operate as it is in exposing waste, fraud and abuse in the federal health care program for the poor and disadvantaged, according to a new report from the … Read More
A Lincoln pharmacist tearfully pleaded guilty Tuesday to health care fraud, admitting he bilked Nebraska’s Medicaid program of $14.4 million in what is believed to be the largest such fraud Source: Lincoln pharmacist pleads guilty to possibly state’s biggest Medicaid … Read More
Former Texas health official Jack Stick tried to persuade dozens of other states to buy Austin technology company 21CT’s Medicaid fraud detection system even as he privately complained that the results it produced for Texas were worth “a bucket of … Read More
Bureaucracy can be a real killer. An 87-year-old Brooklyn woman found that out when she got a letter from the city’s Bureau of Fraud Investigation saying her Medicaid has been cut off — because she is dead. “I couldn’t believe … Read More
The most successful Medicare Fraud Strike Force sent health care scammers scurrying all over the country — but hasn’t come close to running out of cases on its own turf. The Southern District of Florida accounted for 18 percent of health care … Read More
Jack Stick, a former state official at the center of a contracting scandal at the Texas Health and Human Services Commission, on Friday received a sentence of six days in jail and 90 days without a driver’s license for a … Read More
Attorney General Pam Bondi’s Medicaid fraud control unit and the Altamonte Springs Police Department said they arrested Orange County dentist Dr. Merys Downer-Garnette on Thursday. Downer-Garnetted is accused of billing double-billing for services not rendered, totaling more than $5,500 in … Read More
TYLER (KYTX) – Law enforcement officers in East Texas have arrested multiple individuals charged in a Medicare fraud scheme.A federal grand jury returned an 18-count indictment charging 12 individuals with Three Angels Home Heath, Inc., in a scheme to defraud … Read More
A Travis County judge has temporarily blocked the state from reducing funding for a Medicaid-backed therapy program for thousands of Texas kids with special needs, ruling on Tuesday that there was enough reason to believe the Texas Health and Human … Read More
WASHINGTON, D.C. — Three in four Americans (75%) last year perceived corruption as widespread in the country’s government. This figure is up from two in three in 2007 (67%) and 2009 (66%). Source: 75% in U.S. See Widespread Government Corruption Gallup
McALLEN—A 28-year-old ambulance company owner accused of submitting more than $1 million in fraudulent claims to Medicare and Medicaid was convicted Tuesday after pleading guilty before a federal court judge. Victor Lee Gonzalez, the owner of Vic’s Texas Transport Inc., … Read More
In the 1980s and 90s, driftnet fishing was a common technique used to catch salmon, tuna and other types of fish. It was an incredibly effective and efficient commercial fishing method. The nets, which were as long as 50 kilometers, … Read More
Former Texas health commission lawyer Jack Stick, found guilty Monday of driving while intoxicated, will be sentenced within the next two weeks, but no final date has been set, Travis County court officials said Tuesday. The former state representative and … Read More
AUSTIN – Texas officials are giving up on getting medical providers to repay hundreds of millions of dollars in Medicaid funding that the state for years has said was fraudulently billed for questionable dental and orthodontic procedures. After a series of … Read More
A Travis County jury on Monday convicted former state representative and Texas Health and Human Services general counsel Jack Stick of drunken driving, the latest chapter in year of problems for the former prosecutor and state lawmaker. Stick, 49, was … Read More
The top watchdog of Medicaid and other federal entitlement programs in Texas has identified more than $100 million in possible fraud and waste this fiscal year, according to the first report to the governor after years of public failures and … Read More
More than three years after he was originally arrested, Jack Stick, a former state representative and previous inspector general for the Texas Health and Human Services Commission, went on trial Friday for a drunk-driving charge he has fiercely contested in … Read More
If there is a poster child for dysfunction in Texas government, look no further than the agency Stuart Bowen inherited in January. The Office of Inspector General over the state’s sprawling health agency, charged with investigating Medicaid fraud and waste, … Read More
AUSTIN — Nearly three years after police pulled over a then-powerful Texas state official on suspicion of drunk driving, prosecutors are finally getting a chance to prove their case. Source: Controversial former state official’s drunk driving trial begins
Before Jack Stick resigned as chief counsel for the Texas Health and Human Services Commission amid one of the biggest political scandals in 2014, the former state representative was fighting a charge in Travis County court for driving while intoxicated. … Read More
Costs almost always spiral higher on big government projects because of “deception and mismanagement” by Congress, federal managers and contractors, according to scholars at the Cato Institute. “Cost overruns on large government projects are pervasive,” wrote Chris Edwards and Nicole … Read More
What’s the first thing that comes to mind when you think about Coca-Cola? Is it the dozens of executives who reside in the company’s corporate offices? Or do you think about polar bears?Unless you are one of those corporate executives, … Read More
On Sept. 11, 2015, the House Energy and Commerce Committee’s Health Subcommittee held a hearing, entitled “Strengthening Medicaid Program Integrity and Closing Loopholes,” to discuss six bills related to improving Medicaid program integrity and closing eligibility loopholes in the program. … Read More
An Albany judge dismissed an indictment against a nurse charged in a Medicaid fraud, saying there was no evidence she knew that the owners of the facility she managed had falsely certified its regulatory compliance. Gelena Deverman, 35, was charged … Read More
The University of Texas (UT) Health Science Center at San Antonio dedicated the Center for Oral Health Care & Research, the campus’s newest dental clinic, on September 10. Source: UT Health Science Center dedicates 2nd dental clinic – Dr. Biscupid
House Republicans are pushing a slew of bills that attempt to cut back on Medicaid fraud by reforming eligibility and closing loopholes that enable lottery winners to get coverage.But Democrats are concerned that some of the measures could have unintended … Read More
A federal appeals court has upheld a $4.7 million jury verdict against two former officials in the Medicaid fraud unit of the state Attorney General’s office who were accused of presenting false evidence to a grand jury. A unanimous panel … Read More
VANCOUVER, Wash. – A Vancouver dental office is accused of filing around $1 million in false and inflated Medicaid claims over the past five years, the state Attorney General’s office said.The civil lawsuit filed on Thursday alleges that doctors Liem … Read More
A three-year-old Washington state law that allows whistleblowers to bring Medicaid fraud lawsuits is working. That’s according to a review by legislative auditors that urges lawmakers to renew the law before it expires next year. Medicaid is a nearly $10 … Read More
Medicaid rate cuts for therapy providers, which state lawmakers authorized during the recent legislative session in an effort to control Medicaid spending, have prompted a lawsuit against the state by some providers and patients who question the data the state … Read More
The Texas Health and Human Services Commission made $377 million in Medicaid electronic health record incentive payments to hospitals in 2011 and 2012, but at least $12.5 million of that was made in violation of state and federal regulations, according … Read More
From March 2011 through September 2013, Washington failed to suspend Medicaid payments to 48 providers being investigated for credible allegations of fraud, according to a report from the Office of Inspector General. Source: OIG report: Washington needs better policies for suspending providers … Read More
At Texas Senior Medicare Patrol, program director Barbara McGinity regularly hears troubling stories from elderly victims targeted by medical scams. There was the 90-year-old San Antonio woman who wanted to buy a bedside commode and called a company advertising such … Read More
PHOENIX — A prosecutor says an executive who oversaw procurement for the Arizona Medicaid program may have skimmed more than $10 million through an elaborate scheme over the past nine years.A judge on Thursday ordered 63-year-old Michael Veit held on … Read More
Alarmed by the tens of billions of dollars in Medicare and Medicaid fraud and overpayments annually that are draining the federal health care system, the Obama administration has quietly stepped up its auditing and enforcement efforts to crack down on … Read More
Law360, New York (September 3, 2015, 10:12 AM ET) — Recent Office of the Inspector General physician guidance, personnel and budget increases, and a Third Circuit decision, all point to the same thing -— physicians who participate in Medicare and … Read More
The Health and Human Services Commission (HHSC) is asking for comments on a proposed new advisory committee structure. In response to Sunset legislation approved during the most recent legislative session, HHSC conducted a comprehensive analysis of 132 existing advisory committees. This … Read More
Cancer Care Group, P.C. agreed to settle potential violations of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) Privacy and Security Rules with the U.S. Department of Health and Human Services (HHS), Office for Civil Rights (OCR). Cancer … Read More
