A Maryland-based firm, Aledade Inc., renowned for managing the largest independent network of primary care medical practices in the United States, is facing serious allegations of Medicare fraud. The accusations stem from a whistleblower lawsuit claiming that the company manipulated … Read More
PHOENIX — An Arizona orthodontist and his wife were recently indicted for their roles in attempting to embezzle $73,000 from a dental practice. Dr. Andrew L. Kassman and Laurie Ann Kassman, of Tucson, were indicted for conspiracy to commit wire … Read More
After claiming she was a victim of dental insurance fraud, a patient says her insurance company is making her pay for it. In recent headlines, TikToker Alberta (@alberta.nyc) says she was a victim of dental insurance fraud by her own … Read More
Lawmakers in Minnesota have introduced legislation to create a $20 million grant appropriation designated for dental hygiene and dental assisting programs. Senate File 4155 and House File 4375 will allow institutions to improve programs, train more hygienists and assistants, and … Read More
Massachusetts Attorney General Andrea Campbell is announcing that a Barnstable County grand jury has returned indictments against a Falmouth dentist and dental practice. Dr. Marcus Swann and his practice, Direct Pay Dental, are each charged with Medicaid False Claims and … Read More
The phones at many dental offices across North Carolina have been ringing repeatedly in recent months with requests for oral health care from newly enrolled Medicaid recipients. The state’s expansion of Medicaid benefits to nearly 600,000 low-income residents on Dec. … Read More
A Madison County doctor pleaded guilty to a federal healthcare fraud charge for falsely documenting services provided to nursing home patients in order to collect reimbursement from Medicare. According to court documents, Dr. Phillip J. Greene, 59, of Edwardsville, was … Read More
MT. PLEASANT, Sanpete County — The three top administrators involved with a substance abuse treatment center in Utah are accused of defrauding Medicaid out of nearly $13 million. Lillian Kaye Simiskey, 40, was charged Friday in 3rd District Court with … Read More
BOSTON, March 5, 2024 /PRNewswire/ — Overjet, the world-leader in dental AI, today announced a $53.2 million Series C round: the largest investment ever in artificial intelligence for dentistry. The historic round was led by March Capital, with participation from … Read More
The owner of a dental practice in North Haven received a suspended prison sentence Monday in a Medicaid fraud case, state officials announced. Christian O’Connor, 54, appeared in Superior Court in Hartford before Judge David Gold and was sentenced to … Read More
McALLEN, Texas — A federal jury has convicted a Texas doctor and a clinic employee on charges of healthcare fraud, conspiracy, and receiving illegal kickbacks. The verdict came after the pair ordered unnecessary lab tests and prescriptions, according to U.S. … Read More
North Carolina’s recent Medicaid expansion has significantly increased access to dental care for nearly 600,000 low-income residents, leading to an overwhelming demand for services in dental practices across the state. However, the surge in patient volume highlights a critical issue: … Read More
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
