The Obama administration’s efforts to crack down on bogus Medicare payments have ended up sweeping in too many “good actors” who get ensnared in a costly and tedious appeals process, House lawmakers said Tuesday. While tackling Medicare fraud is worthwhile, … Read More
The Texas Tech University System Board of Regents officially named state Sen. Robert Duncan, R-Lubbock, the sole finalist to be the system’s next chancellor in a press release issued Monday afternoon. Duncan is expected to start in his new position … Read More
Last week, Attorney General Greg Abbott filed a lawsuit against Xerox and its subsidiary, ACS Healthcare, alleging that the company had not properly vetted dentists’ pre-authorization requests to perform Medicaid orthdontic work on poor children, saddling taxpayers with hundreds of … Read More
Last year, state regulators accused Dallas-area dentist Everett Evans of bilking Medicaid out of millions of dollars by performing unnecessary procedures and billing for work he didn’t do. They froze more than $800,000 in pending payments to him from the … Read More
AUSTIN, Texas, May 9, 2014 /PRNewswire/ — The lawsuit filed today by the Texas Attorney General’s office regarding Xerox’s performance administering the state’s Medicaid orthodontic program is misdirected. Xerox will defend itself vigorously. We are also disappointed with the HHSC … Read More
The state of Texas on Friday moved against the contractor in charge of pre-authorizing controversial orthodontic and dental procedures, canceling a large contract with ACS Healthcare and suing the company and its corporate owner, Xerox Corp., to recover hundreds of … Read More
As the Texas Attorney General’s office on Friday announced it filed a lawsuit against state contractor Xerox, in an effort to reclaim hundreds of millions of dollars the company allegedly erroneously doled out for medically unnecessary Medicaid claims, the Health … Read More
AUSTIN — Attorney General Greg Abbott sued Xerox Corp. Friday over allegations that it let unscrupulous dentists put braces on thousands of poor children who didn’t meet the government’s strict criteria for the expensive work. Also Friday, the state’s Medicaid … Read More
AUSTIN – The Texas Attorney General’s Office today filed a civil lawsuit in state district court against Xerox Corporation and its wholly owned subsidiary, ACS Healthcare LLC. The State’s legal action seeks to recover fraudulent Medicaid payments for orthodontic and … Read More
Date: May 9, 2014 Contact: Stephanie Goodman, 512-424-6951 The Texas Health and Human Services Commission (HHSC) today notified Xerox Corp. that the state is terminating the company’s Medicaid claims administration contract for cause after Xerox staff approved thousands of requests for braces … Read More
San Antonio (CNN) — Clerks scheduling medical appointments for veterans were “cooking the books” at their bosses’ behest to hide the fact some had to wait weeks, if not months, for appointments, a VA scheduler in San Antonio said Thursday. … Read More
The New York Times has published Trib reporter Becca Aaronson’s article on TMHP. For nearly five years, a state contractor allowed workers with limited expertise to approve dental claims for Texas’ Medicaid program, the joint state-federal insurer. State spending on … Read More
ay 6, 2014 — Washington state is the leading provider of preventive dental care to children, with more than 54% of Medicaid-eligible preschoolers and younger children getting oral care, according to the U.S. Centers for Medicare and Medicaid Services. Some … Read More
May 1, 2014 — Chances are every six months an appointment shows up on your patient’s calendar that it is time for their biannual visit to the dentist. They didn’t make this appointment because they had an aching tooth or … Read More
by Becca Aaronson, The Texas Tribune May 2, 2014 Part two of two. For nearly five years, a state contractor allowed workers with limited expertise to approve dental claims for Texas’ Medicaid program, the joint state-federal insurer. State spending on … Read More
by Becca Aaronson, The Texas Tribune May 1, 2014 Part one of two. In 2010 and 2011, Antoine Dental was among Texas’ top-billing Medicaid providers for orthodontic services, collecting more than $1 million annually for putting braces on poor children. … Read More
by Becca Aaronson, The Texas Tribune May 2, 2014 Part two of two. For nearly five years, a state contractor allowed workers with limited expertise to approve dental claims for Texas’ Medicaid program, the joint state-federal insurer. State spending … Read More
HOUSTON—Jeffery Parsons, of Crockett, and David Edson, of Palm Harbor, Florida, have been charged in a 13-count indictment alleging a conspiracy to pay kickbacks to several area personal care home owners and patient advocates, announced United States Attorney Kenneth Magidson … Read More
HOUSTON – Yolanda Nowlin, 42, has been ordered to federal prison for 11 years following her multiple convictions in relation to a large health care fraud conspiracy, announced United States Attorney Kenneth Magidson. A federal jury in Houston convicted Nowlin … Read More
The Washington Times reported yesterday that ACS/Xerox is being sued in a class action by Nevada residents who purchased health insurance from the state health insurance exchange that was set up by the company. The state government contracted with ACS/Xerox … Read More
Even after Gov. Rick Perry stripped funding for the agency that prosecutes state public corruption cases, his emissaries worked to swap the resignation of embattled Travis County District Attorney Rosemary Lehmberg for restoration of the money, several sources told The … Read More
Two entities have paid the U.S. Department of Health and Human Services Office for Civil Rights (OCR) $1,975,220 collectively to resolve potential violations of the Health Insurance Portability and Accountability Act (HIPAA) Privacy and Security Rules. These major enforcement actions … Read More
A $48 million budget proposal from the Missouri House of Representatives would cover adult dental care for 300,000 Medicaid recipients. The Senate Appropriations Committee agreed to the additional $48 million in Medicaid spending last week, according to a report by … Read More
AUSTIN, Tex. — The last nine months of Rick Perry’s tenure as the longest-serving governor of Texas were supposed to be a political victory lap. Greg Abbott, the Republican state attorney general, and Wendy Davis, the Democratic state senator, both … Read More
Gov. Rick Perry, Florida Gov. Rick Scott and Louisiana Gov. Bobby Jindal today sent a letter urging President Barack Obama to take meaningful steps to strengthen and improve the Medicare Advantage program. The program, which offers an alternative health insurance … Read More
AUSTIN — A Texas judge was expected to seat a grand jury Monday in an investigation into whether Gov. Rick Perry abused his power by vetoing funding for public corruption prosecutors last year. Special State District Judge Bert Richardson was … Read More
WHY WE DID THIS STUDY OIG oversees the activities of all Medicaid Fraud Control Units (MFCUs or Units). As part of this oversight, OIG conducts periodic reviews of all Units and prepares public reports based on these reviews. The reviews … Read More
When Gov. Rick Perry announced last summer that he wouldn’t run for re-election, he said he was committed to spending his last 18 months in office working to create more jobs and opportunity in Texas. It’s a pledge he has … Read More
April 4, 2014 — The Indiana attorney general has filed Medicaid fraud and other criminal charges against three dentists and six others at a dental office in Anderson. The charges allege that Anderson Dental Center owner Sally Metzner, the dentists, … Read More
CSHM, which owns 54 Small Smiles dental clinics in the U.S., has agreed to sell the chain after the company was recently excluded from participating in the Medicaid and Medicare programs by the U.S. Department of Health and Human Services … Read More
Nothing about Texas Medicaid spending on dental or orthodontia. Medicaid Integrity Program Report for Fiscal Year 2013.
In April, we commemorate National Minority Health Month, a time to raise awareness about health disparities that persist among racial and ethnic minorities. This year’s theme – “Prevention is Power: Taking Action for Health Equity” – embodies the ambitious goal … Read More
by Terri Langford, The Texas Tribune April 3, 2014 A special prosecutor investigating whether Gov. Rick Perry abused his authority when he eliminated state funding of the Texas public integrity unit — which investigates government corruption and is housed in … Read More
Pharmaceutical manufacturer Teva Pharmaceuticals USA Inc. and a subsidiary, IVAX LLC, have agreed to pay the government and the state of Illinois $27.6 million for allegedly violating the False Claims Act by making payments to induce prescriptions of an anti-psychotic … Read More
DALLAS — Dr. Nicolas Alfonso Padron, 54, of Garland, Texas, was sentenced this morning by U.S. District Judge David C. Godbey to 57 months in federal prison and ordered to pay $9,484,111 in restitution to the Centers for Medicare and … Read More
DALLAS — Two Grand Prairie, Texas, men, convicted at trial in October 2013 on conspiracy and health care fraud charges related to their operation of A Medical House Calls, a physician house-call company in North Texas, were sentenced this morning … Read More
The Idaho Department of Health and Welfare (State agency) did not implement adequate information system general controls over its Medicaid claims processing system. We identified 19 reportable weaknesses, which we consolidated into 5 findings and grouped into access controls, configuration … Read More
The New Jersey Department of Human Services (State agency) generally claimed Federal reimbursement for Disproportionate Share Hospital (DSH) payments that did not exceed hospital-specific limits. DSH payments may not exceed hospitals’ uncompensated care costs for providing services to patients who … Read More
March 28, 2014 — Some 23 New York state general dentists and six orthodontists received $13.2 million in Medicaid payments in 2012 for services that appeared unnecessary or may not have been performed at all, according to a new report … Read More
With a high-profile legal settlement with Carousel Pediatrics, a children’s health provider, under its belt, the Texas Health and Human Services Commission’s Office of Inspector General says its ramped-up efforts to rein in Medicaid fraud have started to pay off. … Read More
