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
TRICARE is the health care program for uniformed service members, retirees and their families. The conduct resulted in more than $180 million in fraudulent billings, including more than $50 million paid by federal health care programs. According to court documents, … Read More
DALLAS (CBSDFW.COM) – Two North Texas doctors were sentenced to a combined 23 years in federal prison for healthcare fraud Thursday, Dec. 2, federal officials said. According to the office of US Attorney for the Northern District of Texas Chad … Read More
A Mississippi man who oversaw two pharmacies in Walker County and a couple of other states has been sentenced to prison for health care fraud and ordered to pay more than $16 million in restitution. A federal judge in Birmingham … Read More
ATLANTA, GA – Attorney General Chris Carr today 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, 2021, … Read More
Similar programs in Texas were rejected. A top Senate Republican is worried about the future of a $1.8 billion Medicaid hospital financing program after the Centers for Medicare & Medicaid Services recently shot down similar funding proposals in Texas. “It … Read More
A federal judge is blocking President Biden’s coronavirus vaccination mandate for health care workers from taking effect nationwide next week. Louisiana Western District U.S. Judge Terry Doughty ruled Tuesday that the mandate’s constitutionality is questionable since it didn’t come from … Read More
SAN ANTONIO – This week, two San Antonio residents were sentenced for their roles in health care fraud schemes. Yesterday, Nancy Almaguer, 42, was sentenced to 18 months in prison and today Christopher Felix Montoya, 47, was sentenced to two … Read More
Washington — The U.S. House of Representatives passed the Build Back Better legislative package Nov. 19 without an expansion of dental benefits within the Medicare program. The legislation now moves to the Senate. In an Issues Alert email, ADA President … Read More
St. David’s Foundation provides mobile dental van for pediatric dentist in central Texas Sometimes a van can do so much more than just being a van. It can provide access to care. Help the underserved. Establish dental homes. That’s the … Read More
ADA Member Advantage-endorsed Compliancy Group among resources member dentists can use to follow federal rules To comply with the Health Insurance Portability and Accountability Act’s Security Rule, practices must continue to review, correct or modify and update security protections. The … Read More
POUGHKEEPSIE – Federal authorities have filed a civil fraud lawsuit against Maranatha Human Services, Inc., with an office in Poughkeepsie, and its chief executive officer, Henry Alfonso Coley, for falsely claiming that millions of dollars expended to benefit for-profit ventures … Read More
Medicaid is a government program that pays for healthcare for people with limited incomes. Some of these services are provided to people as they grow older. Medicaid pays for services that help people stay in their own homes. It also … Read More
MADISON, Wis. (WMTV) – A doctor from Edgerton has been sentenced to 54 months in prison for his role in a scheme to defraud Medicare, Timothy M. O’Shea, Acting United States Attorney for the Western District of Wisconsin announced Monday. … Read More
Damian Williams, the United States Attorney for the Southern District of New York, and Scott Lampert, the Special Agent in Charge of the New York Office of the U.S. Department of Health and Human Services, Office of Inspector General (“HHS-OIG”), … Read More
November 23, 2021 The Texas Medicaid Vendor Drug Program requests the OIG perform continuous audits of pharmacies enrolled in the program. If you are a Medicaid or CHIP provider and are notified to expect an audit by the OIG, here … Read More
On Friday, the Department of Justice announced a guilty plea from a licensed attorney in a case regarding falsified timesheets and medical claims made to Medicaid by the defendant while she was working as a home health aid from 2016 … Read More
HOUSTON – Two ophthalmologists and their eye clinic must pay millions of dollars for fraudulently billing Medicare in relation to the evaluation and treatment of glaucoma, announced Acting U.S. Attorney Jennifer B. Lowery. “Deliberately overcharging the government for medical services … Read More
(COLUMBIA, S.C.) – South Carolina Attorney General Alan Wilson announced that his office’s Medicaid Fraud Control Unit (SCMFCU) has arrested Rachel Nicole Summers, 37 years old, of Elgin, SC, for two counts of Obtaining Signature or Property by False Pretenses … Read More
The ADA Council on Dental Practice, ADA Member Advantage and BMO Harris Bank announced Nov. 15 the winners of the third annual Design Innovation Awards, which recognize excellence in dental facilities that seamlessly combine esthetics appeal, function and design. The … Read More
A Christmas tree in the city of Northville, MI has people turning heads for a second glance. At first glance it looks like a traditional Christmas tree covered in snow, but it’s not. It’s actually made of teeth! The person … Read More
A physician who owned and operated a heart institute in Florida was sentenced to seven years in prison for performing unnecessary surgical procedures and defrauding health insurance providers, the Justice Department said Nov. 18. Prosecutors said Moses deGraft-Johnson, MD, performed … Read More
A Tallahassee doctor has been sentenced to seven years in prison for his role in a $28 million health care fraud scheme. Moses deGraft-Johnson had pleaded guilty to all 58 counts against him in federal court back in Dec. 2020. … Read More
On November 8, 2021, the US Department of Health and Human Services (HHS) Office of Inspector General (OIG) issued an update to the Health Care Fraud Self-Disclosure Protocol (SDP). This update revises and renames the Provider Self-Disclosure Protocol last updated … Read More
Mr. Singer has more than 20 years’ experience at the Texas Attorney General’s office having spent the majority of his time in the Consumer Protection Division, including as Division Chief. Most recently, he served as part of the agency’s Executive … Read More
According to the National Health Care Anti-Fraud Association, $ 3.6 trillion has been spent on healthcare The United States in 2018, and that financial losses from healthcare fraud are in the tens of billions of dollars each year. Estimates put … Read More
The number of improper payments made under Medicare fee-for-service declined by $20.72 billion since 2014, according to new figures from the Biden administration. The Centers for Medicare & Medicaid Services (CMS) said the data, released Monday, are the result of … Read More
Two men were sentenced Nov. 5 for their roles in a fraud scheme against Medicare and the Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMPVA) after submitting at least $134 million in fraudulent claims, according to … Read More
ELGIN, S.C. (WACH) — An Elgin woman has been charged with medical fraud according to the Attorney General’s Medicaid Fraud Control Unit (SCMFCU). Rachel Nicole Summers, 37, has been charged with two counts of obtaining signature or property by false … Read More
WATSONTOWN, Pa. — A dentist is offering free dental services to all veterans on Friday, November 12. Carl Jenkins is a vet himself and now runs a dental practice in Watsontown, Northumberland County. This is the seventh year the doctor … Read More
