HARTFORD, Conn. — A Connecticut-based physician and a slew of his businesses have been ordered to pay $4.2 million in damages for false claims for payment to Medicare and state Medicaid program for improper billing and unnecessary services. The state … Read More
In a development in what’s being billed as one of the largest healthcare fraud schemes ever, a federal grand jury yesterday convicted the owner of a laboratory that performs sophisticated genetic tests of bilking Medicare out of hundreds of millions … Read More
Texas’ system of home and community care for people with disabilities has been beset by crisis for years. Funds are scant. Demand for services vastly outweighs supply. Workers receive poverty wages. Delays in oversight mean facilities can go more than … Read More
Texas has the highest rate of children without medical insurance in the country. The number of kids without health coverage could go up in 2023 if the Texas legislature declines to expand Medicaid yet again. The state is one of … Read More
In April 2016, government auditors asked a Blue Cross Medicare Advantage health plan in Minnesota to turn over medical records of patients treated by a podiatry practice whose owner had been indicted for fraud. Medicare had paid the Blue Cross … Read More
The federal system meant to stop health care business owners and executives from repeatedly bilking government health programs fails to do so, a KHN investigation has found. That means people are once again tapping into Medicaid, Medicare, and other taxpayer-funded … Read More
AUSTIN (KXAN) – Valerie Bennett rarely goes to the doctor, and she’s never had diabetes. So, it came as a troubling surprise when she noticed hundreds of dollars in diabetic supplies billed to her Medicare account and supplemental insurance in … Read More
With only a few weeks left in the year, more than 100 healthcare organizations and advocacy groups are urging Congress to prevent cuts in Medicare payments. Congress is looking at a Jan. 1 deadline to avert the planned reductions. The … Read More
NEW YORK – New York Attorney General Letitia James today announced two agreements with White Glove Community Care, Inc. (White Glove), a Brooklyn-based home health agency, for causing false claims to be submitted to Medicaid and cheating employees out of … Read More
We did it! Better dental benefits were on the ballot in Massachusetts, and on Nov. 8, voters delivered a decisive victory with over 71% supporting Question 2. This landmark decision creates a first-in-the nation insurance reform that will change the … Read More
TOPEKA, Kan. (WIBW) – One Kansas woman and three Florida residents have been indicted in connection with a scheme to defraud Medicare, according to the United States Attorney’s Office District of Kansas. Court documents say that a federal grand jury … Read More
Federal authorities announced that a Florida man was charged for his role in conspiracies to pay illegal kickbacks and to commit health care fraud that caused at least $64 million in losses to federal health care benefit programs. According to … Read More
Three providers will pay out $22.5 million across two separate settlements to resolve false claims allegations in California, the Department of Justice (DOJ) announced. Dignity Health and two Tenet Healthcare subsidiaries will settle allegations that they violated both federal and … Read More
Dentists across the country are largely in favor of dental insurance reform, according to findings from the ADA Health Policy Institute’s Economic Outlook and Emerging Issues in Dentistry poll. More than 1,100 dentists responded to the November wave of the … Read More
A Raleigh CEO was sentenced Thursday to more than six and a half years in prison for health care fraud. According to the U.S. Department of Justice, Tanya Grant, 51, was investigated for a health care fraud scheme she carried … Read More
BOSTON–(BUSINESS WIRE)–The Oral Health Response Workgroup, a collection of leaders and organizations from across the dental industry, is calling on Congress to improve oral health equity and access by including extensive adult dental benefits in all state Medicaid programs. The … Read More
Two healthcare systems agree to pay federal, state governments more than $22 million in settlement deal. It’s a $22. 5 million settlement in a fraud case involving some major health care providers on the Central Coast. Federal prosecutors reached a … Read More
DALLAS – A former slave from Texas is being honored for being a trailblazer. Dr. Marcellus Clayton Cooper was enslaved on a farm in Dallas in 1862, before later becoming the state’s first Black dentist. He also co-founded Dallas’ first … Read More
MIAMI – Federal authorities arrested nine people Tuesday, accusing them of orchestrating a $37 million South Florida-based health care fraud scheme. For some of the suspects, the scheme was a family affair, prosecutors allege. According to the U.S. Department of … Read More
MERIDEN — A local woman has become the second Connecticut personal care assistant in six days to be charged with stealing thousands of dollars from Medicaid. Kenisha T. Swain, 43, of Meriden, followed her cousin, Deborah V. Swain, 52, of … Read More
A man, who along with his wife, was sentenced to 144 months in federal prison for a multi-million dollar Medicaid fraud scheme is claiming his attorney was ineffective for advising him his wife could be compelled to testify against him … Read More
A Texas married couple was sentenced today for a $1 million Medicare fraud scheme, including violations of the federal Anti-Kickback Statute. Lindell King, 53, of Missouri City, was sentenced to 60 months in prison. Ynedra Diggs, 45, also of Missouri … Read More
A major Texas hospital group shored up its push for legislative assistance with warnings that nearly 1 in 10 of the state’s hospitals are at risk of closure—roughly twice as many as during the run-up to the COVID-19 pandemic. Further, … Read More
Attorney General Kwame Raoul today announced the Attorney General’s office obtained a guilty plea in a case against a Cook County OB-GYN who fraudulently charged Illinois’ Medicaid program for services that were never provided. In a case being prosecuted by … Read More
DALLAS — A nonprofit organization will host a pop-up clinic this weekend offering free health services in Dallas. Remote Area Medical (RAM) is partnering with the UNT Health Science Center to bring a two-day clinic to the Kay Bailey Hutchison … Read More
New York’s top prosecutor accused the owners of a Rochester-area nursing home of stealing $18.6 million in government funds as residents at the understaffed facility suffered years of neglect, culminating in preventable COVID-19 deaths. Attorney General Letitia James on Tuesday … Read More
he world’s first journal focused on dentistry and tooth care, the American Journal of Dental Science, was published in 1839; seven years earlier, the London-based James Snell invented the first reclining chair specifically designed for dental work. Britain’s inaugural dental … Read More
GREENBELT, MD — A 70-year-old Silver Spring dentist was sentenced in federal court on Friday to 30 months in federal prison followed by three years of supervised release, according to court documents. He was also ordered to pay more that … Read More
Medicare Advantage, also known as Medicare Part C, is a popular form of health insurance coverage for U.S. adults age 65 and older. But picking the right plan can be complicated—nationwide, insurance providers offered a total of 4,064 different Medicare … Read More
A Plano dentist pleaded guilty to COVID-19 related fraud, a federal violation in the Eastern District of Texas. U.S. Attorney Brit Featherston made the announcement on November 18, and the Federal Bureau of Investigation is currently investigating the case. Forty-two-year-old … Read More
The ADA believes that requirements related to advanced explanation of benefits should be applicable to dental plans as they work in concert with good faith estimates for the benefit of both patients and providers. That was one of the key … Read More
TennCare officials say they’re on track to provide dental coverage to all members starting Jan. 1. The state’s Medicaid agency is one of the last in the country to cover dental work for adults. Tennessee had already expanded dental benefits … Read More
Edward Buford III, a Silver Spring dentist, was sentenced to 30 years in federal prison Friday in connection with a scheme to fraudulently obtain Medicaid funds by recruiting Medicaid beneficiaries through a payment of kickback and bribes. Buford, 70, also … Read More
MIAMI – A federal magistrate judge has unsealed an indictment charging Miami resident Julio Arsenio Rodriguez, 61, with running a money laundering operation involving millions of Medicare and Medicaid health care fraud proceeds. These proceeds stemmed from multiple clinics located … Read More
SHERMAN, Texas – A Plano, Texas, dentist has pleaded guilty to federal violations in the Eastern District of Texas, announced U.S. Attorney Brit Featherston today. Brian Bui, 42, of Plano, pleaded guilty to wire fraud before U.S. Magistrate Judge Christine … Read More
The Texas Medical Association filed its second lawsuit in less than a year against the US Department of Health and Human Services (HHS) last month over federal policies on surprise billing. The latest suit alleges that the recently released final … Read More
Two New York pharmacy owners who “exploited the Covid-19 emergency for their own financial gain,” pleaded guilty to an international scheme to submit fraudulent claims to Medicare for cancer medication, the Department of Justice (DOJ) announced Wednesday. Arkadiy Khaimov, 39, … Read More
In this edition of “What They’re Watching,” Stephanie Muth, former Texas Medicaid Director and currently a Principal at Stephanie Muth Consulting, says Medicaid redeterminations and addressing the social determinants are 2 of her top priorities. “One of the projects that … Read More
A Beverly Hills, California man was convicted on Tuesday in Federal court for his role in a $723,000 health care fraud and prescription drug diversion scheme at two pharmacies in Southern California, the U.S. Department of Justice said. Between 2016 … Read More
A Cary man has been sentenced to more than 12 years in prison for defrauding the North Carolina Medicaid system of more than $7 million in an elaborate scheme, the Department of Justice announced. Antonio Deon Fozard was sentenced Tuesday … Read More
