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
INDIANAPOLIS – Community Health Network, Inc. (Community), a healthcare network headquartered in Indianapolis, Indiana, has agreed to pay the United States $345 million to resolve allegations that it violated the False Claims Act by knowingly submitting claims to Medicare for … Read More
(WKBN) – A Chardon doctor’s license to practice medicine has been revoked by the Ohio Medical Board. The revocation is tied to a February 2023 federal healthcare fraud conviction against Steven J. Arnold. The board ruled in its December 2023 … Read More
The Washington Dental Quality Assurance Commission and Shawn Keller, DDS, agreed to restrictions of his dental license. The commission claims that between 2018 and 2020, Dr. Keller provided substandard dental care to multiple patients and was unable to produce adequate … Read More
Dentists who received funds during the sixth phase of the Provider Relief Fund from July 1, 2022 to Dec. 31, 2022 must submit a report on the use of those funds in the PRF Reporting Portal by 11:59 p.m. ET … Read More
Two dental practices have filed a class-action lawsuit against Align Technology, alleging the company engaged in anticompetitive conduct, according to a Jan. 2 news release from the U.S. District Court for the Northern District of California. Here are six things … Read More
Washington, D.C., had the highest number of dentists per capita out of any state in 2022, with 111.64 dentists per 100,000 individuals, according to data collected by the American Dental Association. The number of dentists per capita for the U.S. … Read More
Robert Leon Smith III: The Central Figure in a $60M Fraud Robert Leon Smith III, a 48-year-old man from Archer, Texas, has been charged in a massive healthcare fraud and kickback scheme, totaling $60 million. Smith allegedly owned a network … Read More
Amrish Patel, 61, an Indian American resident of Monroe Township, New Jersey, has been arrested for allegedly stealing more than $1 million intended for doctors who provided medical care to injured workers in New York. Patel, who provided billing services … Read More
Since April, states across the country have been kicking people off Medicaid, and no state has kicked off more people than Texas. We’re at 1.7 million. And counting. Some of this is right-sizing. Medicaid is health insurance for low-income households, … Read More
Several DSOs have begun offering discounted treatment opportunities for former patients of the now-defunct SmileDirectClub. SmileDirectClub announced Dec. 8 it would be shutting down its global operations immediately after efforts to recapitalize the business failed. The company said it was … Read More
A Florida woman has been sentenced to 20 years in prison for one of the most elaborate fraud schemes in recent history. According to the Department of Justice, 45-year-old nurse practitioner Elizabeth Hernandez masterminded a fraudulent operation worth over $192 … Read More
