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
SAN DIEGO – Imperial County dentist Javad Aghaloo, 50, Indio, was sentenced in federal court Jan. 26, to 37 months in prison for defrauding Medicare and covering it up. His former billing manager, Melissa Rosas, 42, Calexico, was sentenced to … Read More
BOSTON, Feb. 1, 2024 /PRNewswire/ — DentaQuest, part of Sun Life U.S., today announced a $25,000 contribution to the University of Oklahoma College of Dentistry. The donation is supporting the college’s Indigent Care Fund, which helps provide dental care for … Read More
The Texas Supreme Court seemed inclined to send a $16 million Medicaid fraud judgment back to a trial court rather than let the judgment against Dr. Richard Malouf stand. Malouf, who founded All Smiles Dental Center, billed the state hundreds … Read More
AUSTIN, Texas — A former Austin Dental Practice owner is sentenced to 36 months in federal prison after being convicted of wire fraud. In addition to prison time, 49-year-old Clinton Finch Herzog, of Pearland, has been ordered to pay $2,182,760.63 … Read More
CHICAGO, Jan. 30, 2024 – The National Council of Insurance Legislators (NCOIL) recently adopted model legislation (PDF) for a medical loss ratio (MLR) in dentistry, with language agreed to by the American Dental Association (ADA) and the National Association of … Read More
The Texas Supreme Court has temporarily halted depositions that were scheduled to begin Thursday in the whistleblower case against Attorney General Ken Paxton. The all-GOP court issued an order Tuesday blocking the depositions and giving the parties until Feb. 29 … Read More
A dentist who continued to do tooth extractions and implants after the dental board in Arizona barred him from doing them due to a patient dying after dental surgery has agreed to stop practicing, according to a story published on … Read More
Dental societies in nine states have introduced legislation in 2024 to implement a dental loss ratio. So far, societies in Illinois, Nebraska, New York, Oklahoma, Pennsylvania, Rhode Island, Virginia, Washington and West Virginia have introduced legislation, according to a Jan. … Read More
A pediatric dentist in Texas was sentenced on January 25 in U.S. court to 30 years in prison for reportedly using social media to coerce minors into recording sexual activity for him, according to the U.S. Department of Justice. Abiel … Read More
This year is shaping up to be a big one for legislation related to dental loss ratios. In 2024, nine state dental societies have already introduced legislation for dental loss ratios, which refers to the insurance premium revenue that is … Read More
HOUSTON, Texas — A 68-year-old man has admitted to orchestrating a $6 million Medicaid fraud scheme, according to U.S. Attorney Alamdar S. Hamdani. Rene Gaviola, of Houston, Texas, was the operator of Floss Family Dental Care clinic, where he submitted … Read More
SAN DIEGO (KYMA, KECY) – The U.S. Attorney’s Office said Javad Aghaloo, an Imperial County dentist, was sentenced in federal court on Friday to 37 months in prison for defrauding Medicare and then covering it up. Melissa Rosas, who was … Read More
36-year-old Ray Anthony Shoulders, of Fort Worth, Texas, was convicted on Monday on all counts of conspiracy to commit health care fraud and 12 counts of healthcare fraud, following less than an hour of jury deliberation. He awaits sentencing. U.S. … Read More
An alleged Medicaid fraud scheme in Killeen has led to two residents each being indicted on a felony theft charge. Karen Lea Bradley, 55, and Jason William McCaffery, 49, were indicted on Wednesday by a Bell County grand jury on … Read More
WILMINGTON, N.C. (WECT) – Former New Hanover County social worker Felicia Moore Jones pleaded guilty Wednesday, Jan. 24, to conspiring to defraud NC Medicaid. Per U.S. Attorney Michael Easley, over $400,000 in fraudulent billing took place as a result of … Read More
School districts across the state are facing financial challenges for the upcoming school year, and now Texas schools are confronted with a combined over $300 million loss in Medicaid reimbursements for the 2024-2025 school year. The Texas Health and Human … Read More
This week, the Office of the Attorney General (“OAG”) filed a motion to reconsider and a motion to enter judgment in litigation pertaining to an employment dispute with four former staff members. These filings challenged the judge’s ruling that depositions … Read More
This might not be something on the tip of your tongue in everyday conversation, but it’s important — especially when it comes to thinking about overall health. Your mouth is where the digestive process begins. It also is a key … Read More
Recently, OIG auditors found a managed care pharmacy based in Houston had dispensed prescriptions to Medicaid clients with errors in records, printed instructions and medication strength. Bemaj Pharmacy was found to comply with requirements to provide the correct medication in … Read More
A Miami woman has been left with severe brain damage after a botched dental surgery in Texas left her hospitalized after an alleged fentanyl overdose. The woman, Maria Lugo Querales, nearly died from the 2022 incident and now lives in … Read More
The increased adoption of medical loss ratio in the dental industry will have a major impact on dental insurance companies, DSOs and patients in 2024, according to two DSO executives. These two leaders in the dental industry recently connected with … Read More
Columbus LTACH, operating as Silver Lake Hospital, a long-term care hospital in Newark, New Jersey, along with certain investors, have agreed to a $30.6 million settlement to resolve accusations of healthcare fraud. U.S. Attorney Philip R. Sellinger announced the settlement, … Read More
Texas Insider Report: AUSTIN, Texas – Texas Attorney General Ken Paxton has announced that, in fiscal year 2023, the Office of the Attorney General (“OAG”) recovered more than $200 million from entities and individuals who defrauded the Texas Medicaid system … Read More
A former dentist has pleaded guilty to wire fraud for continuing to take people’s money and treat them after her license was revoked. Diane Meyer, 63, formerly of the 5700 block of Cass Avenue in Westmont, accepted a sentence of … Read More
Asante Health System, a large health system serving southern Oregon and northern California, and one of its cardiothoracic surgeons have agreed to pay $430,000 to settle allegations they submitted false claims to multiple government-funded health insurance programs. According to the … Read More
AmeriHealth and its owners, Ryan and Alban Hatch, have agreed to a $2 million judgment against them to resolve health care fraud allegations brought by the U.S. Department of Justice. The business has offices throughout eastern Idaho, including in Idaho … Read More
WELLESLEY, Mass., Jan. 17, 2024 /PRNewswire/ — Sun Life U.S. has been named one of TIME Magazine’s Best Employers for Future Leaders, and globally one of Forbes’ World’s Top Companies for Women in 2023. The recognitions add to several others … Read More
WASHINGTON – U.S. Senate Majority Whip Dick Durbin (D-IL) and U.S. Senator Roger Marshall, M.D. (R-KS) today introduced new bipartisan legislation, the Promoting Dental Health Act, to reauthorize funding the Centers for Disease Control and Prevention’s (CDC) Oral Health program … Read More
WASHINGTON – U.S. Senate Majority Whip Dick Durbin (D-IL) today took to the Senate floor to deliver a speech on his new bipartisan legislation with U.S. Senator Roger Marshall, M.D. (R-KS) to reauthorize funding for the Centers for Disease Control … Read More
BOSTON, Jan. 16, 2024 /PRNewswire/ — DentaQuest, part of Sun Life U.S. and the nation’s second-largest dental benefits provider by membership, today announced a $20,000 contribution to Louisiana State University (LSU) Health Sciences Center to support solutions designed to bring … Read More
ATLANTA–(BUSINESS WIRE)–Benevis, a leading dental healthcare and orthodontics delivery organization committed to providing quality care to underserved communities, announces the release of its Price of Poor Oral Health white paper to shed light on the profound economic consequences and escalating … Read More
At nearly 50, Dr. Mouhab Rizkallah is a husband and father who runs a successful orthodontic practice out of Sommerville, Massachusetts. He also happens to be forging a legacy as a tenacious advocate for the less fortunate, and a steward, … Read More
National Children’s Dental Health Month observances began with a one-day event in Cleveland and a one-week celebration in Akron, Ohio, in February 1941. Since then, the concept has snowballed into a nationwide program, bringing together thousands of dedicated professionals, health … Read More
SmileDirectClub is facing a class-action lawsuit that alleges the company violated the WARN Act when it laid off its employees during its shutdown. SmileDirectClub announced it would be shutting down its global operations immediately Dec. 8 after efforts to recapitalize … Read More
Morristown, NJ – In a major healthcare fraud case, RDx Bioscience Inc., a Kenilworth-based clinical laboratory, along with its owner and CEO, Eric Leykin, have consented to a $13.25 million settlement over accusations of illegal kickbacks and unnecessary medical testing. … Read More
TRENTON – A Kenilworth, New Jersey-based lab and its owner/CEO agreed to pay $2.93 million to NJ Medicaid, the Office of the State Comptroller (OSC) announced today. Eric Leykin, CEO/owner of RDx Bioscience, agreed to pay $2.93 million to New … Read More
More than $730 million in Medicaid-related and health-care fraud was recovered from entities and individuals who defrauded the Texas Medicaid system or were accused of doing so in fiscal year 2023, according to a newly released joint investigative report. A … Read More
Georgia Gov. Brian Kemp recently proposed putting $178 million toward construction of a dental school at Georgia Southern University in Statesboro, Atlanta News First reported Jan. 10. Gov. Kemp delivered the proposal during the state’s annual Eggs and Issues Breakfast, … Read More
Dental practices that meet certain requirements can begin providing information on both the practice and its “beneficial owners. The Corporate Transparency Act, enacted by Congress in 2021, intends to combat the use of businesses as money-laundering operations. It requires certain … Read More
