Back in 2017, the City of Pittsburgh gave Arlinda Moriarty a special proclamation for “Arlinda Moriarty Day” in honor of her work as owner of Moriarty Consultants, a home healthcare company. No one who gave her that recognition knew she … Read More
On September 13, 2022, the Texas Health and Human Services Commission awarded a six-year STAR Health Medicaid managed care organization (MCO) contract to the incumbent Superior HealthPlan (Superior). STAR Health is a specialized Medicaid managed care plan for children and … Read More
ST. LOUIS – A St. Charles woman will spend nearly five years in federal prison for her role in fraud schemes involving Missouri’s Medicaid program and the Paycheck Protection Program (PPP). Prosecutors with the U.S. Attorney’s Office of the Eastern … Read More
NASHVILLE, Tenn. (WTVF) — On Saturday, hundreds of Nashvillians made their way to Meharry Medical College to get dental work done for free. It’s been over 2 years since the HBCU hosted “Oral Health Day” due to COVID-19. Meharry School … Read More
BOSTON, Sept. 22, 2022 (GLOBE NEWSWIRE) — DentaQuest, one of the nation’s largest and most experienced Medicaid dental benefits administrators, today announced its new engagement with Partners Health Plan (PHP) to increase access to oral health care and improve outcomes … Read More
Irvine, California, Sept. 23, 2022 (GLOBE NEWSWIRE) — The Pacific Dental Services® (PDS) Foundation is proud to announce that 17 students from eight states were awarded a total of $70,000 as the Dr. Carolyn Ghazal Dental Assistant Scholarship recipients for … Read More
When the Medicaid waiver system was put in place in Texas four decades ago, it was supposed to help stop the abuse of disabled residents in group homes. Instead, it’s left a trail of blood and abuse thanks to a … Read More
When Nevaeh Hall was 4 years old, she was sedated so she could get a baby root canal and a crown placed on one of her teeth, according to her family’s attorney. Once the sedatives had taken effect, she was … Read More
Two Kenyan nurses who defrauded the US government of $100 million (Sh230 billion) through healthcare fraud would have steered clear of trouble had they not continued with a scheme hatched by the husband of one of them, who was apprehended … Read More
n order to end an inquiry into whether Centene Corp.’s business operations violated Texas’ Medicaid fraud prevention law, the company will pay $165.6 million to the state. With the signing of the deal, Texas becomes Centene’s 12th state to settle … Read More
KANSAS CITY, Mo. — A doctor admitted in federal court on Wednesday that he certified products and tests for thousands of Medicare and Medicaid patients in Missouri whom he never met. Oluwatobi Alabi Yerokun, 36, of Washington D.C., pleaded guilty … Read More
Texas had the nation’s highest uninsured rate in 2021, with 18% compared to the national average of 8.6%, according to the US Census Bureau’s American Community Survey (ACS). Data released last week showed that nearly 12% of children and a … Read More
The Massachusetts Dental Society and American Dental Association are urging dental providers and the voters of Massachusetts to support a November ballot initiative that will require dental insurance carriers to spend at least 83% of premium dollars on patient care … Read More
A federal jury convicted a Michigan man today for his role in devising and executing a $1.8 million scheme to defraud Medicare by billing for services under another doctor’s name after Medicare revoked his privileges to participate in the program. … Read More
(Reuters) – A Florida businessman has agreed to pay $128 million after pleading guilty to three separate schemes to defraud federal health insurance programs, federal prosecutors announced Thursday. Daniel Hurt, 58, agreed to pay $97 million in restitution and $31 … Read More
A former Oregon dentist filed dozens of fraudulent loan and grant applications, in some instances using fictitious restaurant businesses, to steal nearly $11.5 million in COVID-19 relief funds, prosecutors said. Salwan Adjaj, 43, pleaded guilty on Tuesday, Sept. 13, to … Read More
There’s healthcare on the family plan, then there’s healthcare fraud on the family plan, which is what a federal indictment says a Boca Raton area mother and her Plantation daughter were running out of their Sunrise pharmacy. The 18-count indictment … Read More
Elderwood, a Buffalo based chain of senior care companies, has agreed to pay $950,000 to settle a civil suit that accuses the chain of filing fraudulent claims for Medicare and Medicaid payments over a six-year period, U.S. Attorney Trini E. … Read More
HOUSTON — Two Houston men both employed in dentistry were arrested for their roles in a healthcare fraud scheme totaling almost $7 million in false charges, officials said. Ifeanyi Ndubisi Ozoh and Rene Fernandez Gaviola of Houston both worked at … Read More
Improved licensure portability for dentists and dental hygienists is closer than ever, as the American Dental Association continues to work with other agencies to make it a reality. “Licensure is a process all dentists must go through at least once … Read More
A 49-year-old man from Brownsville, Fernando Mendez, was charged for his role in a scheme to defraud Medicaid by using a suspended medical license, a press release from the U.S. Department of Justice Southern District of Texas said. Mendez was … Read More
COLORADO SPRINGS — Attorney General Phil Weiser announced that Colorado will receive more than $1 million after a settlement with Essilor, an optical lens company. Essilor paid providers kickbacks to refer patients to their company resulting in the submission of … Read More
WASHINGTON — A federal judge in Texas ruled Wednesday that the Affordable Care Act’s process for determining what kinds of preventive care must be fully covered by private health insurance is unconstitutional, ramping up yet another legal battle over the … Read More
Which Texas dental school will win the first-ever SmileCon Dental Olympics trophy? This year, for the first time, dental students will compete in a series of games during SmileCon. Students from four dental schools — Texas A&M University, UT Health … Read More
CHARLESTON, W.Va. – United States Attorney Will Thompson and the U.S. Department of Health and Human Services-Office of Inspector General (HHS-OIG) announced today that Dr. Craig M. Morgan and Eye Consultants of Huntington Inc. have paid $907,074.64 to resolve allegations … Read More
The Biden-Harris Administration proposed a new CMS rule Aug. 31 to overhaul the enrollment processes for Medicaid, the Children’s Health Insurance Program, and Basic Health Programs. If finalized, the rule would streamline applications and standardize eligibility and enrollment policies nationwide. … Read More
Health care giant Centene will pay $19 million to Washington state to resolve a longstanding allegation that the company overcharged the state’s Medicaid program for its pharmacy benefit services. The resolution is the second-largest Medicaid fraud recovery for the state, … Read More
The ADA has suggestions for how the Centers for Medicare & Medicaid Services can improve Medicare Advantage plans and their dental benefits, the Association said in an Aug. 31 response to the agency’s request for information. Medicare Advantage plans, sometimes … Read More
A doctor in Texas was convicted this week of defrauding Tricare in a scheme that involved luring patients into taking unnecessary medical tests in exchange for gift cards. Sekhar Rao, 51, who was the medical director of an outpatient toxicology … Read More
Maranatha Human Services Inc., a Poughkeepsie nonprofit that provides housing and rehabilitation services to people with developmental disabilities, has agreed to pay New York and the federal government at least $850,000 for Medicaid fraud and then shut down operations. U.S. … Read More
A Florida lab owner has been charged with over $50 million in health care fraud related to fraudulent genetic cancer screening tests, Attorney for the United States Lee M. Cortes Jr. announced today. Daniel Hurt, 48, Fort Lauderdale, Florida, is … Read More
Thirteen defendants involved in the $27 million Novus healthcare fraud have been sentenced to a combined 84 years in federal prison, announced U.S. Attorney for the Northern District of Texas Chad E. Meacham. According to plea papers and evidence presented … Read More
Dentists say bureaucratic issues are forcing children and adults with disabilities across the nation to unnecessarily wait six to 12 months for care, but a fix could soon be on the way. Three leading dental groups wrote to the Centers … Read More
An investigation by the Texas Attorney General’s Medicaid Fraud Control Unit, the FBI, Department of Health and Human Services – Office of the Inspector General, and Customs and Border Protection has led to charges being brought against two Houstonians for … Read More
HOUSTON – An operator and manager at a dental clinic have been charged for their roles in a health care fraud scheme involving $6 million in claims to Medicaid, announced U.S. Attorney Jennifer B. Lowery. Authorities took Ifeanyi Ndubisi Ozoh, … Read More
The health system operated by Ventura County, California, and three health care providers will pay $70.7 million to settle allegations they defrauded California’s expanded Medicaid program. The U.S. Department of Justice (DOJ) and the California Attorney General’s Office announced the … Read More
Roughly 15 million people could lose Medicaid coverage when the COVID-19 public health emergency ends, and only a small percentage are likely to obtain coverage on the Affordable Care Act exchanges, according to a new report from the Department of … Read More
BEAVERTON, Ore. (KPTV) – After two years of a pandemic, many people are looking to freshen up their smile with a teeth cleaning but dentist offices are having trouble keeping up with the demand. Dr. Hai Pham is a pediatric … Read More
PHILADELPHIA, PA — United States Attorney Jacqueline C. Romero this week announced a $16.4 million civil settlement with Essilor International, Essilor of America, Inc., Essilor Laboratories of America, Inc., and Essilor Instruments USA (collectively, “Essilor”), headquartered in Dallas, Texas, to … Read More
