Whistleblowers don’t have to suffer a bite from a radioactive spider to detect and report fraudsters. Two home healthcare companies in two different states recently settled with both the Department of Justice and those states for submitting false claims to … Read More
ROBESON COUNTY, N.C. (WBTW) — A Robeson County pharmacy operator pleaded guilty Thursday to conspiracy to commit Medicare fraud, according to a release from the United States Attorney’s Office. While employed at Townsend’s Pharmacy in Red Springs between 2006 and … Read More
A physician who owns pain management clinics and surgery centers in Middlesex and Union counties, as well as in New York, has agreed to pay $7.4 million to settle a whistleblower lawsuit that alleged Medicare billing fraud. The whistleblower case, … Read More
Damian Williams, the United States Attorney for the Southern District of New York, Michael J. Driscoll, Assistant Director-in-Charge of the New York Office of the Federal Bureau of Investigation (“FBI”), Miriam E. Rocah, the Westchester County District Attorney, Kevin P. … Read More
Documents filed in U.S. District Court are shedding some light on why Federal investigators searched the California Palms Addiction Recovery Campus in Austintown last October, seizing $600,000 from its bank accounts. A complaint filed on Tuesday by the U.S. Attorney … Read More
Dental insurance provides coverages only for dental health or oral health of a person and reimburses any kind of dental costs incurred by patients. Primarily, preferred provider organizations (PPO), dental health maintenance organizations (DHMO), and indemnity plans are some of … Read More
DEL RIO – A Carrizo Springs doctor pleaded guilty today to charges he ran a “pill-mill” by providing patients with unlawful prescriptions. According to court documents, Dr. Alfonso Luevano, 52, admitted that he conducted appointments with patients that did not … Read More
NACOGDOCHES, Texas (KTRE) – One Nacogdoches dentist went through years of training to obtain a credential from the American Board of Implantology that only 609 other dentists in the world have earned. Dr. Steven Puffer obtained his board certified implant … Read More
LITTLE ROCK, Ark. – Arkansas Attorney General Leslie Rutledge announced Tuesday that Empower Healthcare Solutions, LLC will pay Medicaid almost $8 million in civil penalties and additional reconciliation payments. According to Rutledge, the false claims settlement was based on a … Read More
ALBUQUERQUE, N.M. — William Gardner has been protesting his revocation for years, but he’s not supposed to be seeing patients in the meantime. A new filing in a criminal case against him says he’s doing just that. Gardner’s website touts … Read More
Texas Attorney General Ken Paxton has asked the Texas Supreme Court to toss out a whistleblower lawsuit by four former officials who say they were improperly fired after accusing Paxton of accepting bribes and taking other improper acts. Paxton told … Read More
LONG BEACH, Calif.–(BUSINESS WIRE)–Molina Healthcare, Inc. (NYSE: MOH) (the “Company”) today announced that its acquisition of Cigna’s Texas Medicaid contracts closed on January 1, 2022. As of November 30, 2021, Cigna’s Texas Medicaid business served approximately 50,000 members. About Molina … Read More
One of the downsides to many dental insurance policies? Waiting periods. For context: A waiting period is the amount of time the insured person must subscribe to a dental insurance policy before their benefits begin. But not to worry: There … Read More
Market Introduction The global dental insurance market held a market value of USD 169.8 Billion in 2020 and is forecasted to reach USD 306.4 Billion by the year 2027. The market is anticipated to register a CAGR of 8.8% during … Read More
AUSTIN – Jordan Dixon has been named the Texas Health and Human Services Commission’s Chief Policy and Regulatory Officer. Dixon will oversee five divisions of HHSC that are responsible for licensing and regulating long-term care, acute care, and child care … Read More
ANDOVER TOWNSHIP, NJ — An ex-owner of a Sussex County nursing home where bodies were stacked in a makeshift morgue after COVID swept through it, is being sought in Arkansas for tax evasion and a $3.6 million Medicaid fraud. That … Read More
January 27, 2022 – 9:00 am Online Meetings. The Texas Health and Human Services Commission (HHSC) will conduct stakeholder engagement meetings on January 27, 2022, to receive comments on Medicaid and Title XX payment rates that can be addressed at … Read More
A Killeen-based pain clinic and surgery center Thursday denied allegations brought against it in a civil lawsuit that said the medical providers engaged in fraudulent overbilling, instead saying that the settlement that was reached recently is a result of overpayments … Read More
Certain Medicaid and CHIP services may soon be delivered using telemedicine, telehealth, and audio-only methods on an ongoing basis. This includes services that have been made available through telemedicine, telehealth, and audio-only methods during the COVID-19 public health emergency (PHE) … Read More
AUSTIN — As he celebrated an early-round win challenging one of just-inaugurated President Joe Biden’s dozen or more executive orders and policy changes on immigration earlier this year, Texas Attorney General Ken Paxton claimed to have made a big discovery: … Read More
United States Dental Insurance Market report focused on the comprehensive analysis of current and future prospects of the United States Dental Insurance industry. This report is a consolidation of primary and secondary research, which provides market size, share, dynamics, and … Read More
From providing health coverage for 48.4 million people as the largest payer in the country to reaching 127 million individuals through health services and provider solutions, here are 20 things to know about UnitedHealth Group. Company Basics 1. Minnetonka, Minn.-based … Read More
DentaQuest announced an investment in organizations that advance and promote diversity, equity, and inclusion in oral health care. With this investment, DentaQuest is supporting efforts to break down barriers to accessing oral health care. DentaQuest is contributing a total of $65,000 to five organizations … Read More
A Georgia woman has pleaded guilty to defrauding the state’s Medicaid program. Nourolzaman Tucker, the owner of a hospice care center in Snellville, was sentenced to five years probation and ordered to pay more than $5.6 million in restitution, Attorney … Read More
A California physician was found guilty by a federal jury Dec. 16 of scheming to defraud health insurers by submitting fraudulent claims, according to the Justice Department. Julian Omidi, MD, whose medical license was revoked in 2009, was found guilty … Read More
Texas Attorney General Ken Paxton has won another case against the Biden administration, this time over healthcare worker vaccination mandates. Texas was granted a preliminary injunction, blocking the administration from imposing vaccine mandates on the employees of Medicaid and Medicare … Read More
WEST LINN, Ore. (West Linn Tidings) — The U.S. Attorney’s Office has charged a 43-year-old West Linn man with fraudulently obtaining nearly $8 million in COVID-19 relief funds and using the money for personal expenses. Salwan Adjaj, who practiced endodontics … Read More
Dr. David Bellamah, a vascular surgeon with offices in Missoula and Kalispell, without admitting liability, will pay $3.7 million to the federal government to settle violations of the False Claims Act, alleging that he performed unnecessary surgeries and then submitted … Read More
A federal grand jury in Houston returned a superseding indictment, which was unsealed today, charging four additional individuals for fraudulently obtaining and laundering millions of dollars in forgivable Paycheck Protection Program (PPP) loans guaranteed by the Small Business Administration (SBA) … Read More
A Philadelphia retail pharmacy and its owner have agreed to jointly pay $1 million to resolve allegations they violated the False Claims Act by billing Medicare for prescriptions that were not actually dispensed. The settlement, which did not include any … Read More
GIBSON CITY, Ill. (WAND) – A local hospital will pay about $292,000 to resolve allegations claiming it failed to return overpayments it received. Prosecutors said Gibson Area Hospital in Gibson City took in these overpayments between March 9, 2014 and … Read More
WASHINGTON, D.C. – U.S. Sen. Ted Cruz (R-Texas) today sent a bicameral letter with members of the Texas delegation to the Biden administration expressing concerns regarding the Disproportionate Share Hospital Payments (DSH) and Uncompensated Care Pool (UCP) provisions in the … Read More
CONCORD, N.H. (AP) — A New Hampshire woman has been accused of submitting Medicaid claims for mileage reimbursement in connection with medical appointments that didn’t happen. The Ossipee woman was arrested Tuesday and charged with theft by deception, false claims … Read More
The pandemic telehealth boom will be supported by $23 million of research money from the Patient-Centered Outcomes Research Institute, but in Florida, the technology is showing vulnerability to fraud and abuse. Meanwhile, in Maryland, a cybersecurity attack took down the … Read More
During the fourth quarter of fiscal year 2021, the OIG settled cases in multiple healthcare categories, beginning the process of recovering funds for the state of Texas. The OIG Litigation team works collaboratively with providers looking to resolve pending cases, … Read More
MIAMI–(BUSINESS WIRE)–United Dental Corporation (UDC), whose Dental Partnership Organization (DPO) model has had a 98% retention rate in Australia, New Zealand and Canada, today announced a series of executive appointments to support its growth and M&A initiatives in 2022 and beyond. … Read More
By Melissa Busch, DrBicuspid.com associate editor December 6, 2021 — Henry Schein has agreed to pay $500,000 to settle a case in which the wholesale distributor allegedly improperly distributed hundreds of thousands of painkillers to dentists and other doctors despite … Read More
TAMPA, Fla. (CW44 News At 10)– Joshua Maywalt (40, Tampa) has pleaded guilty to four counts of healthcare fraud, four counts of aggravated identity theft, one count of filing a false federal income tax return, and two counts of failing … Read More
ATLANTA — Attorney General Chris Carr announced that Brenda Copeland has pleaded guilty in Houston County Superior Court to two felony counts of Medicaid Fraud. Superior Court Judge Edward D. Lukemire accepted the plea on Nov. 30 and sentenced the … Read More
Flower Mound, Texas – Flower Mound Hospital Partners LLC (Flower Mound Hospital), a partially physician-owned hospital in Flower Mound, Texas, has agreed to pay $18.2 million to resolve allegations that it violated the False Claims Act by knowingly submitting claims … Read More
