AUSTIN – The Texas Rangers have opened a criminal investigation into a recently fired state employee whose alleged falsification data could cost the state the chance to recoup millions of dollars from dentists and orthodontists of Medicaid fraud, officials confirmed … Read More
A Stillwater-based dental company has agreed to pay more than $5 million in civil claims stemming from allegations that it submitted false Medicaid claims. Ocean Dental PC, which operates 28 clinics in seven states, did not admit any liability in … Read More
In another setback for the state health agency charged with rooting out Medicaid fraud, an appeals court Thursday said almost $1.26 million was improperly withheld from a dental practice even after state regulators acknowledged that no fraud had taken place. … Read More
On October 22, 2014, the Department of Justice (DOJ) announced that DaVita Healthcare Partners, Inc. (DaVita), a provider of dialysis services, has agreed to pay the U.S. Government $350 million for allegedly violating several provisions of the False Claims Act … Read More
David Feinwachs was general counsel for the Minnesota Hospital Association. Until 2010 when he was fired. His firing ended a 30 year career with the hospital association. He was fired because he began asking questions about why the four HMOs … Read More
Oct 27 (Reuters) – The United States on Monday joined a lawsuit accusing New York City and Computer Sciences Corp of defrauding Medicaid into making millions of dollars of improper reimbursements by exploiting a computerized billing system that the company … Read More
A key legislator with oversight of the state’s Health and Human Services Commission has asked that agency’s Office of Inspector General to review all Medicaid fraud cases handled by an actuary who admitted recently to falsifying numbers on at least … Read More
It appears other states besides Texas are having problems with their Medicaid fraud investigations. Jury found innocent Per a news report in the Concord Register, a New Hampshire orthodontist, after a two day trial, was found innocent of 45 counts of … Read More
Last year’s shake-up of behavioral health providers in New Mexico drew comparisons to the Salem witch trials and injustices perpetrated by rulers of the Roman Empire on Wednesday at a hearing where a state lawmaker unveiled proposed legislation that would … Read More
ANCHORAGE – An Anchorage personal-care provider was raided by federal agents Tuesday night, as part of a joint investigation with state prosecutors into alleged Medicaid fraud at the facility. Kevin Donovan, assistant special agent in charge of the FBI’s Anchorage … Read More
The federal government wants Texas to pay back more than $30 million for incorrectly claimed Medicaid reimbursements. An audit to be released Wednesday by the Office of Inspector General within the U.S. Department of Health and Human Services describes how … Read More
Last Updated: Tuesday, 21 October 2014 06:10 Read Complete Document (pdf, 522.97 KB) October 20, 2014 – Observers often cite fraud as an important contributor to high health care spending, particularly in federal programs. This report describes how CBO estimates the … Read More
Washington, DC—(ENEWSPF)—October 20, 2014. A federal jury in Houston today convicted the president of Riverside General Hospital (Riverside), his son, and two others for their participation in a $158 million Medicare fraud scheme involving false claims for mental health treatment. … Read More
October 17, 2014 — The U.S. Federal Trade Commission (FTC) and Texas business groups are urging the rejection of new rules proposed by the state dental board regarding dental service organizations (DSOs), saying they would restrict dentists’ ability to contract … Read More
This summer, state regulators settled a Medicaid fraud case against an Austin dentist for literally pennies on the dollar. Although the Texas Health and Human Services Commission’s Office of Inspector General had initially accused Rachel Trueblood of bilking the government … Read More
AUSTIN—Texas Attorney General Greg Abbott has resolved an enforcement action against Ranbaxy, a generic drug manufacturer. The agreement resolves the State’s lawsuit under the Texas Medicaid Fraud Prevention Act (“TMFPA”) against Ranbaxy Pharmaceuticals, Inc., Ranbaxy Laboratories, Inc., Ranbaxy USA, Inc. … Read More
National medical billing company Medical Business Service (MBS) reached a settlement this week with the United States Attorney’s Office over allegations of defrauding the Medicare and Medicaid systems. The company has agreed to pay $1.95 million to rectify violations of … Read More
The Texas Attorney General has filed a lawsuit against AstraZeneca AZN.LN -0.93% that alleges the drug maker illegally marketed its Seroquel antipsychotic pill for unapproved uses, paid kickbacks to physician and state health officials, and subsequently caused the state Medicaid program … Read More
OKLAHOMA CITY — Oklahoma Attorney General Scott Pruitt has filed charges against a Yukon man for allegedly charging Medicaid recipients for counseling services he never provided. John Edward Karis has been arrested and faces four counts of Medicaid fraud and … Read More
A Florida managing member of a shell company pleaded guilty today in federal court in Tampa, Florida, for his role in a multi-million dollar health care fraud and money laundering scheme. Assistant Attorney General Leslie R. Caldwell of the Justice … Read More
The St. Mary’s University Mu Psi Chapter of the Pi Sigma Alpha National Political Science Honor Society is holding The Texas Medicaid Fraud Issue Forum on Wednesday, November 5th, 2014 in San Antonio. The purpose of the forum is to … Read More
October 13, 2014 — Last week, three Federal Trade Commission (FTC) staff members responded to an invitation for public comments on two rules proposed by the Texas State Board of Dental Examiners with a letter addressed to Simone Salloum, assistant … Read More
Extendicare Health Services Inc. (Extendicare) and its subsidiary Progressive Step Corporation (ProStep) have agreed to pay $38 million to the United States and eight states to resolve allegations that Extendicare billed Medicare and Medicaid for materially substandard nursing services that … Read More
A former certified home health aide in Passaic County was indicted on 175 counts of Medicaid fraud for submitting $87,616 in phony billing records, acting Attorney General John J. Hoffman announced today. Vladimir Faerman, 66, of Hawthorne, is the sixth … Read More
TALLAHASSEE – Attorney General Pam Bondi’s Medicaid Fraud Control Unit and the St. Lucie County Sheriff’s Office have arrested Claudia Laurenceau, 43, for defrauding the Medicaid program. According to the investigation, Laurenceau was responsible for assisting developmentally disabled Medicaid recipients … Read More
(AP) — The state reports saving more than $2 billion and recovering $879 million last year from spending on the Medicaid program that pays for health care for low-income New Yorkers. The Office of the Medicaid Inspector reports three-year recoveries … Read More
Summary Some of the New York State Department of Health’s (Health Department) claims for Federal Medicaid reimbursement for supported employment services did not comply with certain Federal and State requirements. On the basis of our sample results, we estimated that … Read More
In August, House Ways and Means Subcommittee on Health Chairman Kevin Brady (R-TX) introduced a bill, Protecting Integrity in Medicare Act of 2014, designed to help Medicare drug plans reduce fraud. More than 16,000 people die annually from abusing pain relievers, … Read More
SANTA FE, N.M. — A Santa Fe-based behavioral health company says it felt forced by Gov. Susana Martinez’s administration to agree to pay a $4 million settlement to the state to resolve Medicaid fraud allegations in order to stay in … Read More
ORANGE COUNTY — An Orange County man is facing serious charges alleging that he practiced as a Medicaid provider without having a medical license in the state of Florida. In an affidavit released by the Orange County Clerk’s Office, Liranzo … Read More
AUSTIN – The top health official in Texas has decided to appoint a special assistant to review the state’s Medicaid anti-fraud program after an audit found it is so poorly run that it may be better for taxpayers if it … Read More
DANVILLE — An elderly father was placed in a special program to expunge a charge of Medicaid fraud while his son will spend at least two months in jail. Montour County Judge Gary Norton allowed David L. Albertson, 75, of … Read More
The Tucson woman who earned nearly $6 million as the whistleblower who uncovered overbilling at the Carondelet Health Network is launching her own effort to prevent health-care fraud.“Providers are turning their heads, not wanting to hear about fraud, waste and … Read More
The government agency charged with rooting out medical fraud and waste is poorly managed, occasionally is unfair to those it investigates and has failed to do an effective job identifying and recovering money lost to medical fraud, according to a … Read More
by Becca Aaronson, The Texas Tribune In a blistering 225-page report on the Texas Health and Human Services Commission, the Texas Sunset Advisory Commission recommended that the state’s health and human services system undergo a massive overhaul. The Sunset Commission, which reviews the … Read More
The government agency charged with rooting out medical fraud and waste is poorly managed, occasionally is unfair to those it investigates and has failed to do an effective job identifying and recovering money lost to medical fraud, according to a … Read More
The Colorado Department of Health Care Policy & Financing (State agency) claimed $4.1 million ($2.5 million Federal share) in unallowable Medicaid nursing facility supplemental payments for State fiscal years (FY) 2010 and 2011. For these two FYs, the State agency … Read More
A Florida managing member of a shell company pleaded guilty today in federal court in Tampa for his role in a multi-million dollar health care fraud and money laundering scheme. Assistant Attorney General Leslie R. Caldwell of the Justice Department’s … Read More
Jack Stick could find out this month whether he will stand trial on a two-year-old drunk driving arrest. After a Thursday pretrial hearing, County Court-at-Law Judge Nancy Hohengarten said she will rule before an Oct. 21 hearing whether to admit … Read More
A Detroit federal jury convicted the operator of an adult day care center and two home health care company owners in a $29 million Medicare fraud scheme, The Detroit Free Press reported on Thursday. Felicar Williams, 51, Abdul Malik Al-Jumail, … Read More
