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
Comments on the story: “Don’t be so quick to dismiss Medicaid business” on the Dr. Bicuspid website.
Texas is again sinking to the bottom of the barrel on a national health care measure. The state ranks 38th in the nation – down from 29th five years ago – for failing to support emergency patients. That’s according to the latest report card … Read More
AUSTIN — Hospital officials, Democratic lawmakers and advocates for the poor complained Monday that the state’s proposed rule on health insurance “navigators” could cripple efforts to educate Texans about their coverage options.At a final hearing and in written comments submitted … Read More
January 3, 2014 — Since I began my first dental client consultancy for a corporate dental practice in Arizona (about two years before the publication of my article, “The emergence of the dental practice management company,” in the September 2009 … Read More
On January 1, the Affordable Care Act changed the rules states use to determine whether people can get most types of Medicaid or Children’s Health Insurance Program (CHIP) coverage. Here’s a list of some of the more significant changes: Medicaid … Read More
December 31, 2013 — A 57-year-old New Hampshire dentist indicted on 189 counts of Medicaid fraud faces up to 1,300 years in prison, according to a story in the Concord Monitor. Nicholas Marshall, DDS, who practices in Manchester, is accused … Read More
A smile is one of the first things people notice about you, and yet it was a thing Robina Rayamajhi would not allow herself to show. When she was a child, dental problems left untended in her native Nepal had … Read More
December 20, 2013 — Almost half a million Coloradans are expected to gain dental benefits under Medicaid by 2016, but they’ll have a hard time finding a dentist to treat them, according to a study by the Colorado Health Institute. … Read More
December 19, 2013 — United Health Foundation’s 2013 America’s Health Rankings report has ranked U.S. states according to their health and includes visits to the dentist in its data. The healthiest states have a higher concentration of dentists, and their … Read More
Supporters of the Affordable Care Act and its so-called navigators, who are charged with helping uninsured Texans sign up for health insurance coverage, on Friday criticized proposals for additional regulations of navigators during a Texas Department of Insurance hearing. Proposed … Read More
Debra Jean Velasquez, of Robstown, and Sylvia Salinas Ramirez, of Driscoll, have been ordered to prison in a scheme to defraud the Texas Medicaid program through fraudulent home health billings, announced United States Attorney Kenneth Magidson along with Texas Attorney … Read More
For Martha Blaine, the 10 Affordable Care Act “navigators” who meet clients daily on behalf of the Community Council of Greater Dallas blend in with the rest of her staff. “They are all employees,” said Blaine, the organization’s executive director. … Read More
Washington, DC – A Houston doctor has been arrested on charges related to her alleged participation in a $158 million Medicare fraud scheme involving false claims for mental health treatment.Acting Assistant Attorney General Mythili Raman of the Justice Department’s Criminal … Read More
