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
The Friendly Dental Van brought smiles to a number of children living in the Wilson Housing Authority’s public housing communities by recently offering free checkups and cleanings to kids ages 5 through 18. The Friendly Dental Van program was founded … Read More
A new report released this morning shows that Texas has some of the lowest health care rankings in the nation. The report looks at each state’s health care in terms of access, affordability, and a series of health outcomes. Each … Read More
Two Kent dentists who conspired to avoid more than $460,000 in income taxes pleaded guilty Friday in U.S. District Court in Seattle to filing a false tax return. Dr. Mike Hsieh, 48, of Bellevue, and Dr. Christine Chen, 45, of … Read More
AUGUSTA, GA (WRDW/WAGT) — Bond was denied for the man accused of being the leader of an alleged Medicaid scam in the CSRA. The judge said Daniel Abshari, 33, was a “flight risk, a threat to witnesses and a threat … Read More
Among the thousands of people charged with Medicare fraud in Miami, only a handful would qualify as repeat offenders. Meet one of them, Vicente Gonzalez Acosta. A decade ago, Gonzalez pleaded guilty to helping a Miami-based network of HIV-therapy clinics … Read More
Health insurance coverage for tens of millions of Americans and hundreds of thousands of Minnesotans could be wiped away pending the outcome of a legal case heard by a federal appeals court on July 9. A total of 18 Republican-led … Read More
ALEXANDRIA, Va. (AP) — Just over 300,000 low-income Virginia adults have enrolled in the state’s expanded Medicaid program. Gov. Ralph Northam made the announcement Wednesday at a health center in Alexandria. State officials have previously estimated that roughly 400,000 adults … Read More
BRECKENRIDGE — Former Silverthorne dentist Bonifacio Guillena III, 42, of Greeley, has been sentenced to three years in prison after pleading guilty in January to possession with intent to distribute a controlled substance, a class 3 felony, according to a … Read More
RICHMOND, Va. (AP) — A blood-testing company filed for bankruptcy and says it’s cutting jobs because Medicare payments have been withheld over allegations of fraud. The Richmond Times-Dispatch reports True Health Diagnostics LLC filed for Chapter 11 bankruptcy protection this … Read More
Alabama-based Encompass Health Corporation (now HealthSouth Corp.) has agreed to pay $48 million to settle Medicare fraud allegations. According to prosecutors, Encompass’s Inpatient Rehabilitation Facilities (IRFs) falsified “disuse myopathy” diagnostics in order to maintain their standing as high-reimbursement Medicare-approved IRFs. … Read More
The federal government hit Medoc Health Services with a lawsuit alleging the Dallas-based pharmacy services provider filed hundreds of false claims and engaged in a kickback scheme worth millions of dollars. The complaint comes about a year after the FBI … Read More
SAN JUAN – Over 700 military, state, and county employee volunteers gave their time to serve the community during the 21st Annual Operation Lone Star in the Rio Grande Valley held July 22-26, 2019. OLS is a full-scale emergency exercise … Read More
The HHS inspector general could soon call on Florida to refund the federal government $436 million in Medicaid funds that were improperly paid to the country’s largest public hospital, according to a draft report obtained by POLITICO. The independent auditor’s … Read More
A former Warren dentist received a suspended prison sentence Tuesday for Medicaid fraud after making arrangements to pay about $136,032 in damages, restitution and fines within a week. John Steven Durmon, 60, had been charged with four counts of fraud … Read More
