ALBUQUERQUE, N.M. (KRQE) – The state is going after an Albuquerque dentist, claiming he practiced on patients without a license. “When we have an individual that’s trying to play in the grey, what we tell them is that it needs … Read More
WASHINGTON – Bilal Ahmed, 47, of Potomac, Maryland, pled guilty on September 6, 2019, to a federal charge of health care fraud stemming from a scheme in which he and others caused the District of Columbia’s Medicaid program to be … Read More
Federal prosecutors in Texas announced Wednesday that 58 people had been charged in connection with assorted health care fraud schemes revolving around the illegal distribution of more than six million opioid pills. The Justice Department said that those charged include … Read More
Two Valley defendants have been sentenced in a health care fraud scheme that bilked Medicaid out of more than $850,000. A McAllen federal judge sent Everado Villareal to prison for 3 years and 4 months, while sentencing Delilah Rae Robles … Read More
Richmond and Burke county grand juries have returned eight indictments in a Medicaid fraud case involving suspects from across the country. A Richmond County grand jury Tuesday indicted Timothy Smith, Dylan Logsdon and Robert Garcia each on one count of … Read More
The owner of a now-defunct Elsa durable medical equipment business will serve more than three years in prison and ordered to pay back nearly $900,000 in restitution. U.S. District Judge Micaela Alvarez sentenced Everardo Villarreal to a 40-month prison sentence, … Read More
TYLER, Texas – A 62-year-old Longview, Texas man has pleaded guilty to federal violations in the Eastern District of Texas, announced U.S. Attorney Joseph D. Brown. Joseph Valdie Kimble pleaded guilty to health care fraud on Sep. 11, 2019, before … Read More
EDINBURG — Two men accused of defrauding Texas Medicaid nearly a decade ago entered not guilty pleas to charges of fraud Monday morning. Edinburg resident Osama Bachir Nahas, 64, faces four charges of Medicaid fraud while Pharr resident Gerardo Javier … Read More
HOUSTON, TX – A Houston, Texas-area hospital administrator was sentenced today for his role in a $16 million Medicare fraud scheme involving partial hospitalization programs. Assistant Attorney General Brian A. Benczkowski of the Justice Department’s Criminal Division, U.S. Attorney Ryan … Read More
A federal district judge sentenced a south Florida health care facility owner to 20 years in prison today after being found guilty in the largest health care fraud scheme charged by the U.S. Justice Department. The case involves a decades-long … Read More
BALTIMORE (AP) — The Maryland attorney general’s office says a woman has been convicted of felony Medicaid fraud after claiming that she was providing care for a client with developmental disabilities and autism when she was actually working elsewhere. Attorney … Read More
For the second year in a row, the number of Texans without health insurance increased, and fewer people enrolled in Medicaid. BY STACY FERNÁNDEZ The rate of Texans without health insurance rose for the second year in a row, making it … Read More
To protect their networks and bottom lines, health insurers don’t aggressively pursue widespread fraud, making it easy for scammers. Then they pass the costs off to you. Like most of us, William Murphy dreads calling health insurance companies. They route … Read More
(RALEIGH) Attorney General Josh Stein today announced that he has reached a $375,000 settlement with Santa Maria McKibbins, D.D.S., and her dental practice, Santa McKibbins Family Dentistry, to resolve allegations involving the submission of false claims to the North Carolina … Read More
A CMS rule expands its ability to revoke or deny providers’ position serving in federal networks in an effort to combat fraud in Medicare, Medicaid, and CHIP. “The provisions we are finalizing in this rule are necessary to address various … Read More
The owner and operator of a Buckhead-based healthcare company pleaded guilty to a $1.2 million Medicaid fraud scheme, authorities said Tuesday. Diandra Bankhead, 42, used her company, Elite Homecare, to submit thousands of fraudulent claims for Medicaid services that were … Read More
We estimated that Illinois did not recover unallowable MCO payments made on behalf of deceased beneficiaries during our audit period, totaling at least $4.6 million ($3.2 million Federal share). We confirmed that 80 of the 94 beneficiaries associated with the … Read More
The FBI on Thursday charged Bay Area health care professionals and the CEO of a home health care facility on allegations of Medicare fraud. The Department of Justice says the Medicare and Medicaid fraud case cost taxpayers more than $115 … Read More
TEXAS, USA — Texas Attorney General Ken Paxton announced that his office filed a civil Medicaid fraud lawsuit against two pharmaceutical companies for using the opioid drug, Duragesic. Pharmaceutical manufacturer Johnson & Johnson, and its subsidiary Janssen Pharmaceuticals, Inc. are … Read More
A Pharr man who has been entangled in allegations of defrauding Texas Medicaid was arrested again Thursday. Gerardo Javier Jackson, 51, is charged in an indictment issued Aug. 22 with a single count of Medicaid fraud. He’s accused, along with … Read More
Hundreds of dentist offices across the U.S. have been crippled by ransomware in the latest attack to target the healthcare industry. The attacks appear to have started as early as June 24 with some reports of ransomware affecting dentists in … Read More
Knoxville dentist Clarence “Buzz” Nabers had dental hygienists and dental assistants perform duties beyond their professional scope for four months in 2018 while he was short a dentist, according to a July state health professions board disciplinary action report. The … Read More
KEENE — A children’s dentist known as “Dr. Wully” is being accused of overusing nitrous oxide, hurting his patients by putting them in restraining devices, and performing unnecessary dental work. Blake Wullbrandt, who has an office in Keene and also … Read More
An Edinburg doctor was arrested and released Friday on a combined $400,000 in bonds on four charges of Medicaid fraud. A Hidalgo County grand jury on Thursday indicted 64-year-old Osama Bachir Nahas on accusations he defrauded Texas Medicaid from Jan. … Read More
A Keene-based pediatric dentist who was previously sanctioned for practicing while impaired faces new allegations of professional misconduct, including claims that he overused restraints and nitrous oxide, performed unnecessary dental work and did not fully obtain informed consent for some … Read More
The average University of Washington dental student graduates with a debt load of $255,000 – and that’s still $30,000 lower than the average in the U.S., which doubled between 1996 and 2016. The debt load of a public school dental … Read More
SWANSEA — Federal prosecutors are seeking $700,000 from a Swansea dentist whom they accuse of billing for procedures that he never performed. Dr. Yun Sup Kim, 48, of St. Louis, has been indicted in U.S. District Court in East St. … Read More
A 55-year-old Rockledge woman who Florida law enforcement authorities said bilked Medicaid out of $45,000 for in-home care not provided, was arrested Tuesday. Laura Leace, a participant in the Consumer Directed Care Plus program geared toward assisting people with disabilities, … Read More
Bridget Morlan called the number on her first-ever dental insurance card and held her breath. After more than 30 years of dealing with broken teeth, gum infections and toothaches that landed her in the emergency room dozens of times, the … Read More
SHERMAN OAKS—Two pharmacy owners from Sherman Oaks were found guilty for their participation in a $35 million health care and money laundering scheme on Tuesday, August 21 in federal court. During their scheme, Aleksandr Suris, 51 and Maxim Sverdlov, 44, … Read More
SPRINGFIELD — A Branson physician has blown the whistle on what he calls Medicare fraud at CoxHealth. In a lawsuit filed in 2017 and unsealed earlier this year, Dr. Charles Rasmussen accuses the hospital system and two other Missouri companies … Read More
A former auditor for Nebraska’s Medicaid office has been sentenced to 16 months in jail and ordered to pay nearly $277,000 in restitution after he pled guilty to benefit fraud. Craig Barnett became his father’s power of attorney in February … Read More
The Minnesota Department of Human Services (DHS) is intensifying pressure on two Indian bands to repay $25.3 million in Medicaid overpayments, despite mounting evidence that state officials were largely to blame for the billing error. In letters sent to the … Read More
Attorney Rusty Tucker: Whistleblower Grant Bachman’s Claims are Vindicated Dallas, August 14, 2019 – In a case alleging massive home health care fraud, today Judge Barbara Lynn, Chief Judge of the U.S. District Court for the Northern District of Texas, … Read More
Following a detailed account of how scam artists can easily gain access to health care cash, six Democratic senators this week sent a letter to federal regulators urging them to “close loopholes” that allow “bad actors” to commit fraud. The … Read More
EL CENTRO — A federal judge has granted a stay of forfeiture of assets of a local dentist pending the outcome of an ongoing criminal investigation. Back in April, the U.S. Attorney’s Office filed a civil complaint in U.S. District … Read More
A Texas federal judge dismissed a False Claims Act lawsuit alleging Dallas-based Baylor Scott & White Health overbilled Medicare by improperly upcoding claims, according to Law360. The whistleblower lawsuit, filed in 2017, alleges Baylor Scott & White Health submitted more … Read More
SHELTON — A Shelton man who is a Greenwich police officer was charged Wednesday after allegedly fraudulently billing Medicaid for work as a personal care assistant that he did not perform, according to the Connecticut Division of Criminal Justice. Michael … Read More
A potential class-action lawsuit filed this week alleges Florida did not properly determine whether Medicaid beneficiaries could continue qualifying for coverage after initially losing eligibility for the health-care program. The lawsuit was filed Wednesday in federal court in Jacksonville against … Read More
WASHINGTON — The ranking member of the U.S. Senate health committee has complained for months about the Trump administration’s failure to look into Medicaid contractors that have reaped big profits while sometimes failing to provide crucial patient services. So last … Read More
