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
Republican Iowa Gov. Terry Branstad is defending the companies selected to manage the state’s $4.2 billion Medicaid program, despite reports that all four have been involved in high-priced fraud settlements, according to the Des Moines Register. Earlier this month, the … Read More
The chief operating officer of the Texas Health and Human Services Commission announced Monday that he will be stepping down to return to the private sector. John Scott, who has served in the role since January, was credited as the … Read More
Bryan Black is the new press officer for the Office of Communications. He joins HHSC following his service as the communications director at the Texas Department of Agriculture. During Black’s tenure at TDA, he transformed the department into a premier … Read More
AUSTIN – Texas Health and Human Services Executive Commissioner Chris Traylor today announced John Scott is stepping down as chief operating officer of The Health and Human Services Commission (HHSC). Scott joined HHSC in January, where he served as the … Read More
McALLEN — A Pharr woman pleaded guilty Friday for her role in connection with a federal healthcare insurance fraud scheme, prosecutors said. Martha Lidia Flores admitted to engaging in a kickback scheme of exchanging referrals of Medicare beneficiaries for money … Read More
Channel 8’s Byron Harris announced Friday that he’ll retire in October. Ed Bark posted a solid story Monday about the investigative reporter and his 40 years at the TV station. I’d like to go in a slightly different direction. Harris … Read More
Law360, New York (August 27, 2015, 2:12 PM ET) — A Texas federal judge recused himself Wednesday from a False Claims Act suit against a medical center, days after the defendants revealed his cousin could be a key witness. The … Read More
AUSTIN — A lawsuit that sought to block deep cuts in what Medicaid pays for disabled children and poor elderly Texans’ therapies has delayed the rate changes for a month but otherwise forced no change in the state’s plans. On … Read More
A Texas jury on Tuesday acquitted a former Cancer Prevention and Research Institute of Texas executive of a felony charge that he deceived the agency’s executive director and general counsel to get an $11.04 million grant approved for a pharmaceutical … Read More
A McAllen area doctor accused in June of filing fraudulent Medicare claims involving deceased patients faces new charges after he continued to file false claims, federal investigators said. Source: Doctor accused of filing claims for dead patients faces new charges … Read More
Another 100 Florida hospitals — 17 of which are in the Tampa Bay area — will be audited by the state to determine whether they’re receiving more in Medicaid payments than legally allowed, Gov. Rick Scott said Monday. They join … Read More
Empire State Home Care Services has agreed to pay $6 million as part of a settlement with the New York state attorney general to resolve allegations of improper Medicaid billing. Source: Brooklyn Medicaid Fraud Case Settled
On the streets of Managua, the shuttle bus wrapped in a giant ad for free health care stood out. “Medicare for people living abroad,” it proclaimed above the image of a cheerful older woman playing golf. But Medicare, the American … Read More
Los Angeles, California – The owner and operator of three medical clinics located in Los Angeles pleaded guilty today to submitting more than $4.5 million in fraudulent claims to Medicare. Assistant Attorney General Leslie R. Caldwell of the Justice Department’s … Read More
August 17, 2015 — California legislators took the first step in resolving oral health disparities by hiring the state’s first dental director, Jayanth Kumar, DDS, MPH. Dr. Kumar, who officially started the position on August 1, will create and implement a … Read More
