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
Though the flurry of state PBM-focused legislation slowed down with the summer recess, there has still been plenty of noteworthy PBM news. This roundup focuses on state Medicaid enforcement activities involving Centene and provides a brief overview of recent legislative … Read More
As part of its commitment to uplifting underserved communities and expanding access to dental care, DentaQuest has continued its support of free health care services to individuals in need at Missions of Mercy and similar pop-up clinics across the United … Read More
Chicago, IL) — A suburban Chicago dentist was sentenced to two and a half years in federal prison last week for fraudulently obtaining $1.2 million in medical care loans for purported dental work that was never performed. Michael D. Egan, … Read More
A Leawood physician pleaded guilty Thursday in federal court for his role in a nationwide Medicare fraud scheme to pay kickbacks and bribes to doctors to sign off on expensive — and unneeded — prescriptions and medical equipment. Frederick Scott … Read More
DURHAM, N.C. (WNCN) – A Durham dentist has been sentenced to federal prison after pleading guilty to tax fraud, according to the U.S. Department of Justice. Santa Maria McKibbins will serve one year and a day in federal prison and … Read More
The Northwest Texas Healthcare System held a Friday morning service honoring its many veteran employees on the front lawn of its campus in Amarillo. The Randall County Sheriff’s Office Color Guard did the honors of presenting the colors for the … Read More
Volunteers from the dental and audiology programs at University of the Pacific stepped up to serve Bay Area military veterans in advance of Veterans Day by hosting a free health event in San Francisco. The November 10 event offered veterans … Read More
AURORA, Colo. — An Aurora woman is suspected of billing Medicaid for home health-care services that she didn’t provide over about 16 months, resulting in the theft of $372,150, the Colorado Attorney General’s Office said on Thursday. Dejane Reaniece Lattany, … Read More
The Supreme Court agreed Nov. 10 to hear the appeal of a Texas man convicted of health care fraud who argues that he was unjustly separately convicted under a federal aggravated identity theft law because a form he filed contained … Read More
On October 25, 2022, Melvin Lee Robison, 68, of Lake City, Colorado, was sentenced to serve 54 months in federal prison for illegal drug distribution and health care fraud, announced U.S. Attorney Robert J. Troester for the Western District of … Read More
Delta Dental of Colorado Foundation (DDCOF) announced nearly $11 million in grants to more than 40 organizations working to ensure all Coloradans have access to oral health care. The foundation awarded funds to organizations working within its three initiatives to … Read More
The state of Texas may have claimed more than $30 million in federal funds for Medicaid uncompensated care payments that didn’t actually meet federal and state requirements. As a result, the Lone Star State has agreed to refund some of … Read More
Open enrollment for health insurance on the Affordable Care Act marketplace began Nov. 1, and a trio of local political leaders joined staff at the Foundation Communities Prosper Center in South Austin to encourage Texans to get covered between now … Read More
Pulpdent Corporation is pleased to announce that 2022 marks 75 years as a leading company in the global dental industry. Building on a legacy of advances in dental research, Pulpdent is poised to maintain its position as a top manufacturer … Read More
The World Dental Congress is a flagship continuing-education event for FDI, and a unique opportunity for us to strengthen ties and foster collaboration within the global oral health community. Mark your calendars and take part in this event, where you … Read More
A Tinley Park dentist who collected more than $1 million in medical care loans for work he never performed will spend 2.5 years in federal prison, according to a report. Michael Egan, 58, of Orland Park, previously pleaded guilty to … Read More
JEFFERSON CITY — A federal judge has set a February sentencing date for a former state lawmaker convicted of conducting fraud at medical clinics in southwest Missouri. U.S. District Judge Brian C. Wimes set Feb. 28 to determine how long … Read More
Less busy practice schedules and lower patient demand are among the key findings in the latest wave of the ADA Health Policy Institute’s Economic Outlook and Emerging Issues in Dentistry poll. Most of the roughly 1,200 practicing dentists who responded … Read More
A former Connecticut resident who continued to defraud Medicaid even after she was charged with related offenses has been sentenced to three years in prison, according to the U.S. Department of Justice. Nicole Steiner, formerly known as Nicole Balkas, 33, … Read More
SNAP Benefits update has been announced in Texas, with Gov. Greg Abbott noting that the Texas Health and Human Services Commission is providing more than $334.5 million in Supplemental Nutrition Assistance emergency allotments. The emergency allotment for SNAP benefits in … Read More
Delta Dental Plan of New Hampshire is the firm recommended for a $34 million contract to deliver the first-ever dental benefit for 88,000 adults on Medicaid. If approved, the contract with a two-year extension could run through March 2026. The … Read More
GOLDTHWAITE, Texas (KWTX) – A Central Texas dentist born at the height of the Great Depression says genetics and a genuine love for his patients has kept him working nearly 70 years, five days a week, and he has no … Read More
ALBUQUERQUE, N.M. (KRQE) – Albuquerque dentist William Gardner, who had his license taken away for tax fraud, is accused of continuing to practice dentistry. Gardner pled guilty earlier this year after investigators say he submitted falsified x-rays to insurance carriers … Read More
WICHITA, Kan. (WIBW) – A Wichita woman has been ordered to pay back more than $15,000 after she used her dead care attendant’s information to continue to receive Medicaid benefits. Kansas Attorney General Derek Schmidt says that on Tuesday, Oct. … Read More
PUEBLO, CO — Attorney General Phil Weiser announced charges against a Pueblo woman on Thursday, October 28th. The Colorado Department of Law filed the charges for Medicaid fraud. 46-year-old Renee Fosano is accused of submitting Medicaid claims for reimbursement for … Read More
On Election Day, South Dakota voters will decide whether to expand Medicaid coverage. The move could extend health care benefits to an additional 42,500 low-income residents. Critics worry the estimate of eligible residents is low and that expanded Medicaid could … Read More
Today, the U.S. Department of Health and Human Services (HHS), through the Centers for Medicare & Medicaid Services (CMS), announced that more than half of all states have expanded access to 12 months of Medicaid and Children’s Health Insurance Program … Read More
A Texas physician could face up to 20 years in prison for pleading guilty to a charge related to kickbacks from Medicare fraud. Meanwhile, a New York physician will pay $900,000 to resolve civil claims for up-coding billings for medical … Read More
