(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
(Reuters) – Managed care giant Centene Corp has agreed to pay $33.3 million to resolve claims that it overcharged Apple Health, Washington state’s Medicaid program, for pharmacy benefit management services, the latest in a string of similar settlements with states. … Read More
JOPLIN, Mo. — Joplin’s new dental school is still a year out from opening — but it’s already attracting attention and extra funding for future operations. It’s a grant – big bucks from the federal government aimed at improving dental … Read More
A San Diego dentist accused of performing substandard and unneeded dental work on children has apparently closed his practice. NBC 7 Investigates first reported about the state accusation filed against Dr. Khuong Nguyen in February. Several patients complained to the … Read More
The new academic year has kicked off, but several students have been on campus for most of the summer. From clinical outreach to scientific research, doctoral and dental hygiene students kept a full schedule. The Learning Enhancement for Achievement in … Read More
An OIG Fraud Detection Operation (FDO) focused on indicators for potential fraud, waste and abuse among durable medical equipment (DME) providers. DME includes products like shower/bath chairs, incontinence supplies, blood pressure monitors and enteral feeding supplies. The FDO selected four … Read More
(Reuters) – A county-managed health plan and three health care providers in Ventura County, California, have agreed to pay a total of $70.7 million to the state and the federal government to settle claims that they overbilled the state’s Medicaid … 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
A 59-year-old Houston woman has been sent to federal prison following her conviction of committing and conspiracy to commit health care fraud, announced U.S. Attorney Jennifer B. Lowery. Naomi Moore pleaded guilty April 7. Today, U.S. District Judge Charles Eskridge … Read More
One tool managed care organizations (MCOs) use to reduce fraud, waste and abuse (FWA) is a team of in-house investigators known as the special investigative units (SIUs). This team reviews all services provided under an MCO’s contract with Texas Medicaid. … Read More
Healthcare providers in New York want more due process protections when they are audited by the state’s Office of the Medicaid Inspector General, Spectrum News 1 reported Aug. 18. Dozens of healthcare and advocacy groups accused the office of using … Read More
Ideally, Scenic Bluffs Community Health Center would employ 13 full-time dentists. But right now, with only two full-time and three part-time dentists, the center is straining to fill surging demand. “At this point in time, we, like many other health … Read More
The state’s victory this year in finally getting lawmaker approval to provide nearly 85,000 adults on Medicaid basic dental benefits will be short-lived if it can’t find more dentists like Chris and Derek Blackwelder. The two are among the approximately … Read More
Over the next few weeks, the CUPHD Child and Teen Dental Clinic will be visiting Unit 4 and District 116 schools to provide free dental exams, cleanings, fluoride treatments, and dental sealants to students who need them. Students who are … Read More
Volunteer dentists and doctors are expanding their mobile services to underserved areas in the Willamette Valley. Two medical agencies — Kaiser Permanente Northwest and Medical Teams International — are partnering to provide mobile clinics in six Oregon counties and parts … Read More
