By Theresa Pablos, DrBicuspid.com editor in chief The top 10 largest dental service organizations (DSOs) in the U.S. have grown considerably since we last updated our list in October 2019. Unlike private dental practices, the corporations do not appear to … Read More
The United States has intervened in six complaints alleging that members of the Kaiser Permanente consortium violated the False Claims Act by submitting inaccurate diagnosis codes for its Medicare Advantage Plan enrollees in order to receive higher reimbursements. The Kaiser … Read More
July 29, 2021. The United States Department of Justice this month settled four cases involving health care fraud for a total of $6 million. Whistleblowers received $504,000 for reporting fraud. An Ocala, Florida-based neurologist settled with the government regarding allegations … Read More
HOUSTON — A Houston man is facing up to five years in prison after being found guilty in a costly face mask scheme. Arael Doolittle, 56, pleaded guilty. He attempted to sell 50 million 3M N95 respirator masks to the … Read More
A second defendant has been sentenced for her role in a Texas conspiracy involving the theft of data from patients’ electronic health records that was then sold to support fraudulent claims for payment. Amanda Lowry of Sherman, Texas, was recently … Read More
Montgomery, Alabama – On July 23, 2021, a notice of dismissal was filed indicating that SpectraCare Health Systems, Inc. (“SpectraCare”) agreed to pay $1 million dollars to resolve a federal qui tam lawsuit alleging that it violated the False Claims … Read More
On June 17, 2021, the Supreme Court rejected another attempt to dismantle the Patient Protection and Affordable Care Act (“ACA”) in its highly-anticipated decision in Texas v. California. However, instead of ruling on the central issue in the case—whether the … Read More
WASHINGTON, D.C. – Congressman Steven Horsford (D-NV-04) and Congresswoman Robin Kelly (D-IL-02) have introduced the Medicare Dental Coverage Act, which would expand Medicare Part B to cover most dental services, including preventive dental care, routine dental treatments, and dentures. “Dental … Read More
People don’t become dentists to spend their time navigating the insurance claims process. They do it to take care of people. Unfortunately, the reality of dealing with insurance carriers and their varying claims policies can create headaches not only for … Read More
A Long Island lab is being asked to reimburse New Jersey’s Medicaid program almost all of the $25 million it was paid for drug testing work over nearly four years after a state watchdog agency found it vastly overcharged for … Read More
Two Texas companies have agreed to pay a combined $15.3 million to resolve allegations of kickbacks and other misconduct resulting in the submission of false claims to federal health US DOJcare programs. According to the settlement, Alliance Family of Companies … Read More
A Texas woman was sentenced Monday to 50 months in prison for defrauding the Virginia Medicaid program out of $2.8 million. “For over six years, the defendant stole over $2.8 million from the Virginia Medicaid program, using those funds to … Read More
NOTICE OF STAKEHOLDER MEETING August 11, 2021 The Board requests stakeholder input on the following topic related to possible rulemaking proceedings: Teledentistry, specifically implementation of Board rules in accordance with House Bill 2056 that was passed by the 87th Texas Legislature. … Read More
The past 18 months have tested everyone’s mettle. The biennial ADA Dentist Health and Well-Being Conference will feature sessions and speakers focused on building such resilience as well as sharing knowledge and solutions about the challenges dental professionals face in … Read More
HHS’ watchdog agency, the Office of Inspector General, recovered $3.1 billion in false and fraudulent claims in 2020, according to a July report. OIG won or negotiated more than $1.8 billion in judgments and settlements in 2020, which, combined with … Read More
FRANKFORT, Ky. (KT) – Kentucky will share in a $75 million multi-state settlement with Bristol-Myers Squibb Company, in a federal lawsuit that alleged the company overcharged state Medicaid programs for drugs. Under the settlement, the pharmaceutical manufacturer has agreed to … Read More
SACRAMENTO, Calif. — Akop Atoyan, 48, of Glendale, pleaded guilty today to one count of conspiracy to commit health care fraud and one count of conspiracy to pay and receive health care kickbacks, Acting U.S. Attorney Phillip A. Talbert announced. … Read More
Home health providers in the U.S. have paid at least $422.6 million to settle False Claims Act (FCA) allegations since 2012, according to a recently unveiled database from Nashville, Tennessee-based legal firm Bass, Berry & Sims. The total number of … Read More
The Dallas-area owners and operators of two durable medical equipment companies have been convicted on insurance fraud and money laundering charges, the U.S. Attorney’s Office for the Northern District of Texas reported. Federal officials said Leah Hagen, 49, and Michael … Read More
(RALEIGH) Attorney General Josh Stein reached two separate civil settlements with ProHealth Dental Inc. and Henry W. Davis, Jr., D.D.S. as part of Operation Root Canal, an ongoing effort to find and stop health care fraud among dental providers. The … Read More
BOSTON – A Lexington doctor and his wife, who works as his office manager, were charged today in a superseding indictment in connection with an international money laundering scheme involving importing illegal, misbranded drugs. Rahim Shafa, 64, was indicted on … Read More
NEWARK, N.J. – Two medical device manufacturers have agreed to pay $38.75 million to resolve allegations that they violated the False Claims Act for billing the Medicare program for defective rapid point-of-care testing devices, Acting U.S. Attorney Rachael A. Honig … Read More
Akron General Health System (AGHS), a hospital system in Ohio owned by the Cleveland Clinic Foundation, reached a civil settlement and agreed to pay $21 million for allegedly committing healthcare fraud by violating the False Claims Act. AGHS is accused … Read More
The U.S. Justice Dept. announced that Avanos Medical (NYSE:AVNS) agreed to pay more than $22 million to resolve a criminal charge related to fraudulent misbranding. Charges levied against the Alpharetta, Ga.-based medical device company relate to alleged fraudulent misbranding of … Read More
The former owner and operator of a Missouri assisted living community has paid a $150,000 settlement in a Medicaid fraud case for falsely billing services that were not provided. Brook Fears was charged with filing 148 false claims to MO … Read More
In Midland today, a federal judge sentenced 45-year-old James Clinton Fletcher, owner of now-defunct San Jan, LLC, to 15 years of imprisonment for defrauding investors out of more than $18 million through various fraudulent schemes. In addition to the prison … Read More
San Antonio – San Antonio’s doctor’s assistant pleads guilty to Medicaid and Medicare fraud and can face up to 20 years in prison. Christopher Felix Montoya, who owns the TPC Family Care and Medical Clinic in San Antonio and Laredo, … Read More
The owner and Chief Executive Officer of Spring Hill-based Crestar Labs, LLC was charged on Friday for his alleged role in a fraudulent Medicare billing scheme relating to genetic testing of the elderly and cancer patients. The criminal complaint was … Read More
Ventura dentist Homayoun Zadeh has agreed to plead guilty to filing a false tax return in connection with the national college admissions scandal, federal officials said Thursday. Zadeh, an associate professor at USC and internationally known periodontist, was accused of … Read More
MONROE, La. –A federal grand jury has returned an indictment charging Charlie L. Simpson, 48, of Downsville, who worked as Chief Operating Officer of United Home Care, Inc. (“United”) and Trinity Home Health Care, Inc. (“Trinity”),and Charles R. Gardner, 53, … Read More
Akron General Health System (AGHS), a regional hospital system based in Akron, Ohio, will pay $21.25 million to resolve allegations under the False Claims Act of improper relationships with certain referring physicians, resulting in the submission of false claims to … Read More
MORRIS COUNTY, NJ — Former dentist from Morris County Frederick Bailey admitted that he sold and dealt drugs, the U.S. Attorney’s Office for the District of New Jersey said. The 61-year-old Denville resident pleaded guilty to one count of conspiring … Read More
STATEWIDE — Florida is among 6 states that will receive a share of a $2-million dollars settlement from a French medical device manufacture accused of paying kickbacks to doctors. Medicrea International and its American affiliate Medicrea USA Inc. have agreed … Read More
NORFOLK, Va. (WAVY) — A Portsmouth man has been sentenced to two years in prison for defrauding Virginia Medicaid and submitting more than $188.000 in false claims. According to a Department of Justice news release, the false claims were made … Read More
A Connecticut primary care physician was ordered to pay nearly $15 million over allegations of an illegal billing scheme, the state’s attorney general said June 28. According to prosecutors, Ramil Mansourov, MD, billed Connecticut’s Medicaid program for medical treatment that … Read More
A former Henderson County social services caseworker was charged last week with stealing more than $80,000 by switching Medicaid assistance payments to her own bank account when a family became ineligible for the cash, according to arrest warrants. Ryan Marie … Read More
NORTH JERSEY — A Chester man pleaded guilty on Thursday to his involvement in a healthcare fraud operation, when he and another man from New York admitted to a federal judge they defrauded a union fund in excess of $4 … Read More
Earlier this year, the United States Department of Justice (DOJ) wrapped up sentencing in a $189 million Medicare fraud scam dating back roughly a decade. Bobby Rouse, Steven Houseworth, Jeffery Parsons, and David Edson were all members of the executive … Read More
BEAUMONT — From U.S. Attorney’s Office – A physician practicing in Beaumont has been sentenced to prison for federal health care fraud violations in the Eastern District of Texas, announced Acting U.S. Attorney Nicholas J. Ganjei today. Grigoriy T. Rodonaia, … Read More
EL PASO –El Paso Ear, Nose & Throat Associates (EPENT) has agreed to pay $750,000 to settle allegations that they violated the False Claims Act by billing Medicaid, Medicare and other federal healthcare programs by upcoding evaluation and management codes. … Read More
