Starting today, Medicaid patients in Texas have 12 months of postpartum coverage. Texas lawmakers passed a postpartum extension, bringing coverage from two months to twelve months, at the end of the last legislative session. The state submitted the extension to … Read More
The health-care industry led the way as a record 543 False Claims Act settlements and judgments were reported in fiscal year 2023. More than $1.8 billion of the $2.68 billion total involved matters related to managed care providers, hospitals, pharmacies, … Read More
SmileCon will be the place to be when it rolls into the Big Easy later this year with engaging learning experiences, the latest dental technology and lots of fun. The meeting will take place Oct. 17-19 at the New Orleans … Read More
The Nebraska Department of Health and Human Services (DHHS) is under scrutiny after a revealing audit by State Auditor Mike Foley uncovered significant suspected fraud and financial abuse within its Medicaid-funded personal assistance services program. Instances of questionable billings have … Read More
In a significant blow to healthcare fraud, Nathanael Thompson, 45, owner of four Ohio pharmacies, and Sanam Ahmad, 34, the operations manager, were convicted on February 27 for masterminding a scheme that defrauded Medicaid of $2.3 million. The duo exploited … Read More
A Feb. 21 cyber attack affecting Change Healthcare, one of the largest health care technology companies in the United States, is impacting dental, medical and pharmaceutical organizations. The cyber event is preventing some pharmacies from processing prescriptions and some dentists … Read More
A Filipino American doctor from Queens, New York is facing charges for allegedly pocketing cash kickbacks and unnecessary Medicare claims amounting to $20.7 million. According to the federal grand jury in New Jersey, Dr. Alexander Baldonado, 68, engaged in a … Read More
An Atlanta woman found herself in hot water after attempting to use a CPN (credit privacy number) to finance an expensive dental procedure. What began as a routine visit to the dentist quickly escalated into a legal ordeal that ended … Read More
Appointment cancellations and financial distress have become a constant at Bethesda Pediatrics, a nonprofit medical clinic in East Texas that is heavily dependent on Medicaid, the health insurance program for the poor. On a recent Monday, the mother of a … Read More
A woman in Pennsylvania is accused of making nearly $270,000 stealing dental products like teeth whitening kits from her employer and selling them on an online shopping site, according to multiple news reports. Kathy Lucarino, 50, who worked at Bright … Read More
DuPage County Health Department will offer free dental screenings as part of the American Dental Association’s “Give Kids A Smile Day.” Kids can get dental screenings at no cost when the DuPage County Health Department takes part in the American … Read More
During remarks to False Claims Act (FCA) practitioners on February 22 in Washington, DC, and in an accompanying press release, Department of Justice (DOJ) Principal Deputy Assistant Attorney General Brian Boynton announced that recoveries from FCA settlements and judgments in … Read More
Philip Esformes, a recipient of clemency from former President Donald Trump, pleaded guilty to health care fraud on Thursday, marking the resolution of a lengthy legal battle initiated by the Justice Department. Esformes entered a guilty plea to one count … Read More
Attorney General Tim Griffin issued the following statement announcing two promotions in his office: “Today I have promoted Ryan Owsley to be the new Chief Deputy Attorney General for my office and have named Greg McKay as the new Chief … Read More
NORTH HAVEN, CT (WFSB) – A woman from North Haven stole more than $145,705 by submitting fake Medicaid claims, according to state criminal justice officials. Evgjeni Baca, 41, was arrested by inspectors from the Medicaid Fraud Control Unit in the … Read More
The nationwide lack of dental hygienists is forcing patients in Virginia to have to wait as long as 14 months for a routine cleaning, according to a Feb. 22 report by WWBT. A major factor causing the shortage in Virginia … Read More
Together, the ADA accomplished much in 2023, from advancing legislation and scientific research to delivering new resources to help dentists thrive. “Each day, as a united ADA Tripartite, we assemble the building blocks of creating healthier communities, while also supporting … Read More
NEWARK – A Florida man was charged in an indictment unsealed this week for his role in a Medicare fraud scheme that involved a partnership with two co-conspirators from Monmouth County and caused $97 million in losses, the U.S. Attorney’s … Read More
Previously Health Equity Heroes, the awards recognize individuals and organizations improving health care access for high-need communities WELLESLEY, Mass., Feb. 22, 2024 /PRNewswire/ — DentaQuest, part of Sun Life U.S., today begins this year’s search for forward-thinking individuals or organizations … Read More
In 2017, a hospital operator set out to build a rural health care empire with the help of a Philadelphia-area consultant. The consultant, Jim Biden, had no experience running hospitals. But he did understand the federal government and had ties … Read More
A massive $110 million sham has landed a telemedicine tycoon in the hot seat with the feds. Steven Richardson, a 40-year-old from Parkland, Florida, is the big fish who’s agreed to plead guilty to a single count of conspiracy to … Read More
A U.S. jury convicted a manager for his role in a $6 million bribery scheme in which marketers were paid to refer Medicaid-insured children to the Texas dental practice where he was employed, according to the U.S. Department of Justice … Read More
U.S. Attorney for the District of Maine Darcie McElwee announced Wednesday that her office collected a total of $24.4 million from civil and criminal actions during fiscal year 2023. Nearly all of the $23 million collected by the Maine U.S. … Read More
Seven durable medical equipment companies cost the Medicare system $2 billion in payments, the National Association of ACOs (NAACOS) told the federal government in recent months. But it’s unclear just how problematic that will be for accountable care organizations. The … Read More
New Yorkers with zero healthcare experience are allowed to care for their elderly or disabled relatives and friends — potentially earning more than $43,000 a year — under a $6 billion Medicaid program that’s been rife for fraud, abuse and … Read More
A 19-year-old TikTok user took DIY beauty to the extreme by attempting to perfect her smile using nothing but a nail file. Her at-home dentistry escapade prompted some viewers to admit to doing the same, according to a story recently … Read More
Duane Morris Takeaways: On February 6, 2024, in In Re Delta Dental Antitrust Litigation, No. 1:19-CV-06734, MDL No. 2931 (N.D. Ill. Feb. 6, 2024). roughly 240,000 dentists and dental practices sought class certification in the U.S. District Court for the … Read More
In 2022, the inspector general of the Department of Health and Human Services published areportwarning thatMedicare’s payment rates for urinary catheters were too high. The report stated that lowering the costs for these products could save Medicare millions.But despite this … Read More
The ADA thanked two members of the U.S. Senate for introducing S 3597, the Promoting Dental Health Act, which would reauthorize the oral health promotion and disease prevention activities of the Centers for Disease Control and Prevention through 2028. ADA … Read More
The Santa Clara County (Calif.) Superior Court this week sentenced the last of 15 defendants convicted of running a massive statewide insurance scam in which they set up a telemarketing company to push overpriced and unneeded prescriptions and medical devices … Read More
Some significant changes are coming for Wisconsin. Wisconsin lawmakers passed a health care package that will address the ongoing workforce shortage issues afflicting dentistry. Gov. Tony Evers signed the bills into law Jan. 31. The Wisconsin Dental Association supported several … Read More
The Affordable Care Act’s (ACA) Medicaid expansion expanded Medicaid coverage to nearly all adults with incomes up to 138% of the Federal Poverty Level ($20,783 for an individual in 2024) and provided states with an enhanced federal matching rate (FMAP) … Read More
The House Committee on Energy and Commerce chair is asking the Government Accountability Office to study the state of consolidation and vertical integration in the dental and vision benefits industries. The request is the result of ongoing advocacy by the … Read More
Atlanta, GA, Feb. 06, 2024 (GLOBE NEWSWIRE) — Benevis, a leading dental healthcare and orthodontics delivery organization committed to providing quality care to underserved communities, announced today a call to action for primary care physicians and clinicians across the care … Read More
OIG auditors found a behavioral health services provider double-billed the state for telemedicine visits and improperly submitted claims for facility fees that were not provided. The improper payments totaled $45,412 for errors uncovered during the audited period, from June 2021 … Read More
COCKE COUNTY – An investigation by special agents with the Tennessee Bureau of Investigation Medicaid Fraud Control Division has resulted in the indictment and arrest of a Newport man. In September 2023, TBI received information from the Department of Intellectual … Read More
World Oral Health Day is March 20, and the FDI World Dental Federation will begin a three-year campaign to shed light on the multifaceted aspects of oral health under the unifying theme of “A Happy Mouth Is …” In the … Read More
Sun Life U.S. is relaunching its grant program in 2024 as the Sun Life Health Access grant program, aligning with the company’s commitment to broadening access to care for underserved communities. Initially launched in 2016 as Team Up Against Diabetes, … Read More
The U.S. District Court for the Northern District of California issued a default judgment against a practice and a dentist who unlawfully withdrew more than $85,000 of employees’ retirement funds, preventing the workers from accessing their savings. On January 2, … Read More
States now have a template they can use to change the way dental insurance works. The National Council of Insurance Legislators said Wednesday that its Health Insurance & Long Term Care Insurance Issues Committee has approved a model act that … Read More
