A state worker who came under scrutiny during a high-profile contracting scandal last year has been paid more than $100,000 over the past 11 months without having to work a single day. Frianita Wilson — who earns $115,000 a year … Read More
November 17, 2015 — The Supreme Court of Texas has dismissed a petition that would have prevented practitioners from receiving Medicare funds when that provider is being investigated for fraud. In the November 13 dismissal, the state Supreme Court upheld … Read More
Amanda Barry, holding her son Dominic who she claims was among the dozens of children brutally treated by dentist Howard Schneider, smiled on Monday hoping the arrest of the former Jacksonville dentist meant he could not harm any more children. … Read More
November 12, 2015 — A U.S. federal court has ruled in favor of ClearCorrect in a case involving digital data, noting that the U.S. International Trade Commission (ITC) does not have authority over the data. The case has implications that … Read More
A federal jury on Thursday convicted a Bowie, Md., couple of orchestrating a multi-year campaign to defraud D.C. Medicaid of more than $80 million between 2009 and 2014, the largest local health-care fraud scheme ever prosecuted in the city. After a … Read More
State officials canceled their multimillion-dollar Medicaid contract with financially troubled TAPS Public Transit on Thursday and launched an investigation into the possibility of fraud. Sherman-based Texoma Area Paratransit System won the three-year contract in July 2014 to provide non-emergency medical … Read More
A Pharr woman has been sentenced for her role in a scheme to defraud the Medicare program, according to a news release from the Department of Justice. Martha Lidia Flores, 51, pled guilty to conspiring to commit health care fraud … Read More
Medicaid providers can now find their patients’ medical histories on YourTexasBenefitsCard.com. Medicaid Eligibility and Health Information Services added the Blue Button to the site in September. Once a provider or office staff receives a client’s consent, they can log in to … Read More
Republicans are openly feuding over whether to seek drastic changes to Medicare, Social Security and other entitlement programs, risking a potentially damaging intraparty battle ahead of the 2016 elections. The rift was exemplified this week by the GOP stars of … Read More
AUSTIN – Texas Health and Human Services Executive Commissioner Chris Traylor announced today Dr. John Hellerstedt is returning to the HHS system Jan. 1, this time as commissioner of the Texas Department of State Health Services.Hellerstedt, who last served the … Read More
In his first State of the State address to the Texas Legislature in early 2015, newly elected Gov. Greg Abbott challenged lawmakers to dedicate their unfolding 140-day session to ethics reform, asserting that “the most important commodity that we have … Read More
Texas could bring home $7 billion annually in federal dollars and cover more than a million uninsured U.S. adults today. Instead, Texans are stuck in the health care “coverage gap” — lacking the uninsured’s access to health insurance because they … Read More
November 6, 2015 — Adults enrolled in Medicaid may be living with unresolved dental problems, according to a new study. Almost half of the adults in the study who visited an emergency department (ED) for dental care did not visit … Read More
The federal government has warned Texas that it cannot block Medicaid participants from “qualified providers of their choice” or because of the provider’s “scope of practice.” In doing so, the U.S. Department of Health and Human Services has essentially put … Read More
SAN ANTONIO — The Texas health commission soon will begin a new project to fight waste, fraud and abuse in the state Medicaid program, a year after another anti-fraud effort fell apart in scandal. The “integrity initiative,” to be launched later … Read More
After more than a decade at the job, State Auditor John Keel plans to retire as of Jan. 4, his office confirmed Monday. “When I accepted my current job on Dec. 1, 2004, I expected to be here approximately 6 … Read More
The Health and Human Services Commission ruled Monday that it followed state contracting rules when it doled out a $68 million technology deal in September and that it doesn’t have to rebid the job. Deputy Executive Commissioner Ron Pigott dismissed … Read More
Gary Jessee, a 20-year veteran of state service, will be Texas’ new state Medicaid director, Health and Human Services Executive Commissioner Chris Traylor announced Oct. 30. Jessee, who has served three years as the Medicaid/CHIP Division’s chief deputy director for … Read More
When Lieutenant Governor Dan Patrick took to the mic on Texas Independence Day in March, he did so with the air of a man rallying his people before an alien invasion. “On March 2, 1836, a group of patriots gathered … Read More
HOUSTON—A Houston businessman has entered a guilty plea to engaging in a conspiracy to defraud Medicare of more than $6.6 million, announced U.S. Attorney Kenneth Magidson. At a hearing held today before U.S. District Kenneth Ellison, Robert Manning, 60, admitted … Read More
Texas officials are giving up on recovering most of the hundreds of millions of dollars spent on questionable Medicaid dental and orthodontic procedures. After years of an ongoing scandal over fraudulent billing and courtroom losses, the commission that oversees Medicaid … Read More
A House leader said Thursday that he plans to investigate the state’s oversight of a major technology contractor after Attorney General Ken Paxton alerted lawmakers to cost overruns in a contract. Earlier this week, Paxton aides informed GOP state leaders’ offices … Read More
Stuart Bowen, the inspector general of the Texas Health and Human Services Commission, told The Dallas Morning News that a whistleblower alleging Medicaid fraud at Texas Planned Parenthood clinics spurred the agency’s investigation. The Daily Signal previously reported that inspectors from the … Read More
The editorial board of the Austin American Statesman has called the decision by Texas “lawmakers and state officials” to investigate Planned Parenthood for Medicaid fraud part of a “witch hunt” that won’t stop until the health care provider “is completely dismantled … Read More
The Governor of the State of Texas said he hopes Planned Parenthood files legal action against their move to cut off Medicaid funding to the abortion biz so he can put their officials under oath. Newly-elected Governor Greg Abbot told … Read More
The Obama administration has warned state officials that pushing Planned Parenthood out of the state’s Medicaid program could put Texas at odds with federal law. Officials with the federal Centers for Medicare & Medicaid Services contacted the state Medicaid director on Tuesday … Read More
Texas health officials have asked an appeals court for permission to proceed with cutting payments to a therapy program for children with disabilities — the latest development in an ongoing lawsuit over the budget state lawmakers crafted this year. The … Read More
If Planned Parenthood has been billing Texas Medicaid for services it hasn’t been rendering, as Gov. Greg Abbott and state health officials suggested this week, it makes sense to cut off the money and go after the organization for whatever it stole. But … Read More
CARSON CITY — A dentist who overbilled Nevada’s Medicaid program by $285,000 has moved out of state and is under scrutiny by federal officials, the Legislative Commission was told Tuesday. Legislative auditors earlier this year found that the dentist, who … Read More
The top manager of the teacher’s pension fund received more than $2.2 million on top of his $504,000 a year salary. A lawyer making $153,000 a year at the General Land Office took home an extra $147,000. The Department of … Read More
Viju Mathew wanted to make sure that his wife could take care of their mentally disabled adult son and 4-year-old daughter, his lawyers say, so he agreed to plead guilty to federal health care fraud charges.But seven months later, his … Read More
A Santa Fe judge on Friday called a decision by Gov. Susana Martinez’s administration to withhold Medicaid funds from a behavioral health care agency “arbitrary, capricious or otherwise not in accordance with the law.” The decision by state First District … Read More
October 22, 2015 — The Indiana Attorney General’s Office has reached a settlement agreement on October 22 with Aspen Dental Management (ADMI), resolving allegations that the company used deceptive advertising and other unfair tactics to promote services at Aspen Dental-branded … Read More
The Obama administration just announced that fighting Medicaid fraud is going to be a “key priority” for the final year of the president’s term. That’s a tall order. Last year, the program lost more than $17 billion to fraud. That’s … Read More
As Congress stalls in its attempts to defund Planned Parenthood, a handful of states have succeeded in hitting the organization where it hurts. Texas announced Monday it will strip Planned Parenthood of its Medicaid funds after a 3-year video investigation captured … Read More
Advocates of Medicaid expansion in Texas often highlight our state’s record of the largest uninsured population in the nation, according to a recent U.S. Census Bureau report. Though the uninsured rate is falling, advocates say, it would fall even faster … Read More
In what may be the largest example of medicaid fraud in Nebraska’s history, investigators missed red flags that could’ve potentially saved millions. Now, the state wants to make sure it never happens again. Two weeks ago we told you about … Read More
EAST ST. LOUIS — A Brighton woman pleaded guilty Tuesday to engaging in a scheme to defraud a health care program. In a press release Wednesday, U.S. Attorney Stephen R. Wigginton said sentencing for Jessica A. Teets, 27, has been … Read More
PULASKI COUNTY (KATV) — A 32-year-old man from Desoto, Texas, was arrested for Medicaid fraud. Arkansas Attorney General Leslie Rutledge announced the arrest of DeAndre L. Taybore Tuesday by the Attorney General’s Medicaid Fraud Control Unit. He is accused of … Read More
BROOKLINE, Mass., Oct. 13, 2015 /PRNewswire/ — Bharani Padmanabhan MD PhD, a multiple sclerosis neurologist practicing in theBoston area who is called Dr. Bharani by patients and colleagues, filed a lawsuit in Federal court alleging massive violations of the Computer Fraud … Read More
