A second whistleblower has been fired from the Texas attorney general’s office after reporting his boss, Texas Attorney General Ken Paxton, to law enforcement for crimes including bribery and abuse of office, according to a former senior official with the … Read More
There are no indications that audits of healthcare entities by government payers are slowing down – if anything, the ramping up of audit operations that was hinted at a short while ago has indeed materialized. Commercial payers are moving just … Read More
Four more Texas health care executives are charged in a multimillion-dollar billing scheme that already has resulted in a guilty plea from the CEO of a Texas hospital. A federal grand jury has indicted Steven Berglund, Aaron Cerpanya, Adam Gardner … Read More
SAN ANTONIO – Two people have been charged in connection with a health care fraud scheme by a federal grand jury in San Antonio, according to the U.S. Attorney’s Office for the Western District of Texas. Officials said authorities arrested … Read More
The Office of Inspector General recovered nearly $121 million this quarter, capping off a record year for the OIG. For the fiscal year, recoveries were more than $503 million, the most ever collected in a single year. In addition, we … Read More
Indiana Attorney General Curtis Hill said Wednesday that the sentencing of a Fort Wayne woman demonstrates the seriousness with which authorities view the crime of health care fraud in connection with the Medicaid program. After pleading guilty to health care … Read More
In a case that could provide a cautionary tale for clinical laboratories, a federal whistleblower lawsuit alleges that Cigna, through its HealthSpring subsidiary, “received billions in overpayments from the federal government” in a scheme involving the insurer’s Medicare Advantage plans. … Read More
In his first interview since top aides accused him of official misconduct, Texas Attorney General Ken Paxton said he was about to place his second in command, Jeff Mateer, on investigative leave before Mateer quit on Oct. 2. Paxton, speaking … Read More
Two Ocean Springs men are facing up to 10 years in prison and $250,000 fines after admitting Wednesday they accepted kickbacks in an $18 million healthcare fraud scheme involving prescription compound pain creams. Dempsey Bryan Levi and Jeffrey Wayne Rollins … Read More
COLUMBIA, S.C. (October 9, 2020)—In what is the third in a nationwide series of telemedicine fraud prosecutions, more than 40 people in South Carolina and Georgia are being charged. The charges add up to hundreds of millions in fraudulent billings. … Read More
A Manchester dentist and his dental clinics and dental imaging facility have agreed to pay $300,000 to settle claims that they violated the the federal and state False Claims Acts, U.S. Attorney for Connecticut John H. Durham announced Thursday. Abbas … Read More
Top aides of Texas Attorney General Ken Paxton have asked federal law enforcement authorities to investigate allegations of improper influence, abuse of office, bribery and other potential crimes against the state’s top lawyer. In a one-page letter to the state … Read More
A civil war inside Texas Attorney General Ken Paxton’s office intensified Thursday when top lieutenants for the second time — and in greater detail — accused Paxton of giving improper preferential treatment to an Austin developer who was under federal … Read More
Five senior officials in the Texas Attorney General’s Office accused their boss, Ken Paxton, on Wednesday of subverting his office to serve the financial interests of a political donor, according to an email obtained by The Texas Tribune. The aides … Read More
SAVANNAH, GA: The third in a nationwide series of telemedicine fraud prosecutions includes cases in the Southern District of Georgia identifying more than $1.5 billion in fraudulent billings to government healthcare insurance programs. The takedown – dubbed Operation Rubber Stamp, … Read More
AUSTIN, Texas — As people work from home or manage more stressors because of the coronavirus pandemic, their dental hygiene might be taking a hit. Dentists nationwide have noted seeing an increase in dental issues since reopening their offices in … Read More
LAREDO, Texas – A South Texas doctor has agreed to pay $3,234,900.50 to resolve allegations he fraudulently submitted claims to the Medicare program for medically unnecessary tests and procedures, announced U.S. Attorney Ryan K. Patrick. Dr. David Mora is an … Read More
The Department of Health and Human Services Office of Inspector General, along with our state and federal law enforcement partners, participated in a health care fraud takedown in September 2020. More than 345 defendants in 51 judicial districts were charged … Read More
The Department of Justice on Wednesday charged 345 people, including doctors, nurses and other medical professionals, across 51 federal districts in what the agency is calling the largest healthcare fraud takedown in history. The charges are in connection to cases … Read More
On Thursday, Oct. 1, Abbas Mohammadi, the owner of Columbia Dental, P.C., Maxillofacial Imaging in Manchester, and Columbia Oral, agreed to pay $300,000 to resolve allegations that the companies violated the federal and state False Claims Act, the U.S. Attorney’s … Read More
BAKERSFIELD, Calif. (KGET) — A woman who worked as a dental assistant was sentenced Thursday to time served in county jail and five years’ probation after pleading no contest to falsifying insurance claims for procedures that were not performed. Alma … Read More
HOUSTON – The U.S. Department of Justice announced a historic nationwide enforcement takedown Wednesday involving 345 charged defended across 51 federal districts, according to a press release. The investigation alleges more than 100 doctors, nurses and other licensed medical professionals … Read More
Lakeway (Texas) Regional Medical Center and its former managers agreed to pay more than $16.4 million to resolve two separate False Claims Act lawsuits, the U.S. Justice Department said Sept. 28. The medical center will pay $13.6 million and co-defendants … Read More
HARLINGEN — A partnership between Dentists Who Care and Valley Baptist Legacy Foundation continues. Executive Director Jacqueline Flores announced in a press release that Valley Baptist Legacy Foundation contributed $50,000 to the Dentists Who Care SMILE Voucher Program. “They are … Read More
NEW YORK – Attorney General Letitia James today announced that her office reached an agreement to settle kickback claims against Novartis Pharmaceuticals Corporation (Novartis) and delivered $22.7 million to New York. The agreement resolves allegations that Novartis paid kickbacks to … Read More
Gov. Kay Ivey has allocated $35 million from Alabama’s federal coronavirus relief money to set up a grant program to help doctors, dentists, clinics, ambulance services, and other health care and emergency response providers affected by the COVID-19 pandemic. The … Read More
MADISON, Wis. – Attorney General Josh Kaul announced today that Wisconsin has joined the United States to settle allegations against Novartis Pharmaceuticals Corporation (“Novartis”) by reaching an agreement in principle along with twenty-seven other states and the District of Columbia. … Read More
At the September 11, 2020 board meeting of the Texas State Board of Dental Examiners (Board), Board staff was directed to initiate possible rulemakings for the topic below. This stakeholder meeting will convene on October 5, 2020 via Zoom. The … Read More
A physician in Florida has pleaded guilty to conspiracy to commit healthcare fraud and faces a maximum of 10 years in federal prison, the Department of Justice announced Sept. 18. Richard Davidson, MD, admitted that he and his conspirators established … Read More
A physician in Berwyn, Pa., has agreed to pay $1.26 million to resolve False Claims Act allegations, the Department of Justice announced Sept. 18. The settlement resolves allegations that Thomas Whalen, DO, submitted false claims to federal health plans for … Read More
(CNN)A former dentist who was filmed extracting a patient’s tooth while standing on a hoverboard has been sentenced to 12 years in jail, according to a statement from the Alaska Department of Law. Seth Lookhart, 35, was convicted on 46 … Read More
FRAUD ALERT Some stakeholders have received fraudulent calls or emails purporting to be from The Texas State Board of Dental Examiners (TSBDE). If you suspect any telephone call or correspondence from our agency is fraudulent, please notify us by emailing licensinghelp@tsbde.texas.gov. … Read More
A Passaic County physical therapist who was being investigated by federal agents Thursday morning allegedly ran a healthcare scam that filed fraudulent Medicare and Medicaid claims, according to a federal indictment. Since January 2019, Dr. Mahmoud Elsanaa, who lives in … Read More
Harlingen, Texas (KVEO)—A brother and sister accused of healthcare fraud pleaded guilty on Thursday in federal court. According to court records, Krystal Lee Ybarra and her brother Julian Ybarra Jr. pleaded guilty to one count of healthcare fraud. Court records … Read More
Harlingen, Texas (KVEO)—Dr. Jorge Zamora-Quezada, an Edinburg based doctor convicted of healthcare fraud, is requesting that a date be set for his sentencing. According to court records, Quezada’s attorneys filed a motion on Sept. 3 requesting a sentencing hearing. The … Read More
Gov. Greg Abbott and other top leaders are talking about trimming the state’s budget, including in health care and education. Meanwhile, the state’s main doctor group, the Texas Medical Association, is asking Abbott — again — to accept federal Medicaid … Read More
The person in charge of providing health care for low-income Americans spent several million dollars on taxpayer money on furthering her own career, a congressional investigation has found. Seema Verma, the administrator of the Centers for Medicare and Medicaid Services … Read More
Acting United States Attorney Alexander C. Van Hook announced that Shreveport Prosthetics, Inc. (“SPI”) has agreed to pay $1.6 million, plus interest, to the federal government to resolve allegations that it violated the False Claims Act for false supplier billings … Read More
WHEELING, W.Va. — Wheeling Hospital, Inc. has agreed to pay the United States a total of $50,000,000 to resolve claims that it violated the False Claims Act by knowingly submitting claims to the Medicare program that resulted from violations of … Read More
AUSTIN, Texas — When Dr. Zachary Sussman went to Physicians Premier ER in Austin for a COVID-19 antibody test, he assumed he would get a freebie because he was a doctor for the chain. Instead, the free-standing emergency room charged … Read More
