March 11, 2014 — Church Street Health Management (CSHM), which operates 70 Small Smiles dental clinics in 22 states and the District of Columbia, has been excluded from participation in the Medicaid and Medicare programs for a minimum of five … Read More
Enrollment in the Health Insurance Marketplace continued to rise in February to a five-month total of 4.2 million. As in January, the percent of young adults who selected a Marketplace plan was 3 percentage points higher than it was from … Read More
WASHINGTON — The share of Americans without health insurance is dropping to the lowest levels since President Barack Obama took office, but sign-ups under his health care law lag among Hispanics — a big pool of potential beneficiaries. With just … Read More
LUBBOCK, TX (KCBD) – A Lubbock dentist is voicing concerns about patient privacy and complaining about “Big Brother” after the FBI seized his patient records on Thursday morning. The FBI executed multiple search warrant around 8 a.m. Thursday at the … Read More
In a highly unusual move, a judge working for the Texas Health and Human Services Commission last week overturned findings of an outside judge — essentially changing a finding of innocence to one of guilt. The case is particularly unusual … Read More
March 5, 2014 — A Texas judge has upheld payment holds on Medicaid payments for Houston dental clinic Antoine Dental Center (ADC), citing credible evidence of Medicaid fraud. The clinics billed about $8.1 million for orthodontic services in less than … Read More
When Steve Aragon’s daughter invited him to speak to her students for career day, he wasn’t sure what he was going to say. He was lined up behind a judge, a SWAT team member and a zoologist. But when it … Read More
Attorney General Eric Holder and HHS Secretary Kathleen Sebelius today released the annual Health Care Fraud and Abuse Control (HCFAC) Program report showing that for every dollar spent on health care-related fraud and abuse investigations through this and other programs … Read More
HOUSTON—Augustine Ihenacho Nnadi, aka Austin, 60, of Houston, has been arrested for accepting a bribe in exchange for assistance in an ongoing health care fraud case, announced United States Attorney Kenneth Magidson. The FBI arrested Nnadi this morning shortly after … Read More
EDINBURG — Sitting at an old picnic table in front of a dilapidated house, María Díaz, a hotel housekeeper, tells stories of the rejection that comes with living in impoverished Texas colonias. The trash on her street is not picked … Read More
Dr. Chang Ho Lee, 68, of Palisades Park, N.J., pleaded guilty today to health care fraud and agreed to forfeit more than $3.4 million in fraud proceeds. Acting Assistant Attorney General Mythili Raman of the Justice Department’s Criminal Division, U.S. … Read More
Hundreds of North Texas Nigerian-Americans are caught up in the biggest home health care frauds ever uncovered by U.S. law enforcement. Federal indictments were issued in 2012 against those who allegedly profited the most from half a billion dollars in … Read More
BEAUMONT, Texas – A Center, Texas couple now living in Elgin, Texas, has pleaded guilty to federal violations in a health care fraud scheme in the Eastern District of Texas, announced U.S. Attorney John M. Bales today. Cathy Harvill, 57, … Read More
Medical device manufacturer EndoGastric Solutions Inc. has agreed to pay the government up to $5.25 million to resolve allegations that it violated the False Claims Act by misleading health care providers about how to bill federal health care programs for … Read More
CORPUS CHRISTI, TX—Dr. Roque Joel Ramirez, 49, of Robstown, has entered a plea of guilty to mail fraud in connection with his scheme to defraud Medicare and Medicaid through fraudulent billings, announced United States Attorney Kenneth Magidson and Texas Attorney … Read More
Gov. Rick Perry is encouraging University of Texas System regents to consider Health and Human Services Executive Commissioner Kyle Janek for the open job of chancellor, sources said Tuesday. Francisco Cigarroa, the current UT System chancellor, last week announced his … Read More
Citing shortfalls in Medicaid financing and billions in annual uncompensated care costs, the president and chief executive of the Texas Hospital Association said Friday that it was time for medical facilities to join together on a long-term strategy to compensate … Read More
AUSTIN — Attorney General Greg Abbott, who has said he supports the Americans with Disabilities Act, has tenaciously battled to block the courthouse door to disabled Texans who sue the state. In a series of legal cases in his three … Read More
In 2011, state regulators announced that they were taking a giant stride toward fighting blatant insurance fraud. They said they had identified nearly four dozen dentists and orthodontists who had ripped off taxpayers by billing Medicaid tens of millions of … Read More
Vulnerabilities in electronic health records systems are creating opportunities for fraud among healthcare providers and contractors working to achieve Meaningful Use attestation, says the Office of Inspector General. With CMS spending at least $18.8 billion through December on Meaningful Use electronic health … Read More
COLUMBIA, SC—United States Attorney Bill Nettles stated that R.L. Robinson-Taylor, age 46, of Cordova, South Carolina, was sentenced yesterday in federal court in Columbia for conspiracy to commit health care fraud, a violation of 18 U.S.C. § 1349. United States … Read More
ABILENE, TX—Dr. Tuan Truong, aka “Terry Truong,” of Abilene, a dentist who practiced pediatric dentistry at Kool Smiles in Abilene, was sentenced this afternoon by U.S. District Judge Jorge A. Solis to 18 months in federal prison. Truong pleaded guilty … Read More
More than 40 health and community groups launched a campaign Wednesday to raise awareness of the coverage gap created when Texas officials declined to expand Medicaid as part of the Affordable Care Act. Advocating that poor Texans should have greater … Read More
TYLER, TEXAS (KETK) — The former Chief Financial Officer for Dr. Tariq Mahmood’s Texas hospitals has been charged with health care fraud violations in the Eastern District of Texas, announced U.S. Attorney John M. Bales today. Joe White, 66, of … Read More
February 6, 2014 — Thousands of applications for orthodontic approvals under Medicaid were delayed after Texas employed a single dentist to review them. The understaffing led to dentists, not the private company reviewing the applications, being accused of fraud for … Read More
DALLAS (AP) U.S. Health and Human Services Secretary Kathleen Sebelius says Texas is losing $18 million a day in federal funding by not expanding Medicaid under the federal health-care overhaul. Sebelius spoke Friday at Paul Quinn College in south Dallas. … Read More
Due to its reluctance to expand Medicaid under the Affordable Care Act, Texas may see more than 3,000 deaths due to a lack of insurance, according to a new Health Affairs study. The study looked at the uninsured rates for … Read More
DALLAS (CN) – A healthcare administrator delayed thousands of orthodontic approvals under Medicaid by employing just one dentist to review Texas applications, such disastrous understaffing that dentists – but not the private company – were accused of fraud for working … Read More
When Gov. Rick Perry touts the Texas economic miracle, as he did recently at the World Economic Forum in Davos, Switzerland, he’s only telling half the story. True, the state enjoys low overall unemployment. Yes, Texas leads the nation in … Read More
January 30, 2014 — South Carolina health officials and dental providers are hopeful that state lawmakers will reinstate dental Medicaid coverage for low-income adults, saying the move will save emergency room (ER) costs and help people with painful oral infections … Read More
Today was a day filled with successes for Texas Attorney General Greg Abbott as a judge ruled the state may seize the Fundamentalist Church of Jesus Christ of Latter Day Saints compound where polygamist leader Warren Jeffs committed horrific crimes … Read More
SAN ANTONIO — The facts are pretty basic: About 1 million Texans — 115,000 in Bexar County — could be eligible for insurance coverage under the Affordable Care Act, but won’t be able to get it. Because they live in … Read More
Federal regulators moved today to block new home-health agencies from starting up in the Dallas and Houston areas. The reason, in a word: fraud.Specifically, the regulators said they wouldn’t let any new agencies bill Medicare, the federal health insurance program … Read More
The Justice Department’s Medicare Fraud Strike Force has set record numbers for health care prosecutions in Fiscal Year 2013, demonstrating the targeted and coordinated approach remains strong as the strike force enters its eighth year of fighting fraud against the … Read More
AUSTIN — Those hired to care for the state’s frailest citizens are leaving their positions in droves, a state report released Wednesday shows. Nurses for the disabled and Child Protective Services caseworkers were among the positions with the highest turnover … Read More
A federal grand jury has handed down additional charges against Dr. Tariq Mahmood, whose rural hospital chain collapsed last year amid reports of reckless care and alleged fraud. The Dallas businessman now faces seven counts of aggravated identity theft, according … Read More
The operator and director of nursing of a home health agency based in Richmond, Texas, was arrested yesterday for her alleged role in a Medicare fraud scheme and a conspiracy to structure bank withdrawals. The owner and operator of the … Read More
The Far North Dallas psychologist said he treated a single postal worker seven days a week, up to eight hours a day. A federal billing contractor responded by paying the therapist more than $1 million, court records say. Now Michael … Read More
The Texas Department of Insurance on Tuesday issued state regulations for health care “navigators,” the workers who assist people seeking health insurance in the federal marketplace created by the Affordable Care Act. The rules take into account some of the … Read More
January 17, 2014 — Idaho is considering restoring adult dental coverage in its Medicaid program after emergency room costs more than doubled following budget cuts and the elimination of nonemergency dental coverage. After the program was cut in 2011, dental-related … Read More
