HARRISBURG — Pennsylvania Auditor General Eugene DePasquale is launching random audits of private contractors hired by the state to provide care for people covered by the state’s Medicaid program. There are about 2.75 million people covered by Medicaid in Pennsylvania, … Read More
Katherine Edmundson didn’t know her 7-year-old son was off Medicaid until she took him to the dentist for his annual cleaning in February. An employee at the front desk told her that his coverage was invalid and that her son … Read More
In the early 2000s Terry Mitchell’s dentist retired. For a while, Mitchell, an electrician in his 50s, stopped seeking dental care altogether. But when one of his wisdom teeth began to ache, he started looking for someone new. An acquaintance … Read More
The Supreme Court of Iowa ruled in favor of appellee Robert F. Colwell, DDS, over the Iowa Department of Human Services in the Supreme Court of Iowa, No. 18-0464, on February 8, 2019, in a case that addressed the way … Read More
Cleburne resident Sparrow Joe on Monday said she and her husband, Raymond Luther, were surprised to receive packages of medical equipment they never requested and later outraged by the response they received from others. In a turn that appears possibly … Read More
One of the largest healthcare fraud schemes investigated by the FBI and HHS and prosecuted by the Department of Justice resulted in $1.2 billion in losses and charges against 24 executives of telemedicine and durable medical equipment (DME) companies. Officials … Read More
Two people arrested on health care fraud charges are expected to appear in court. Everardo Villarreal and Delilah Rae Robles were partners in a medical supply company in Elsa. They’re accused of submitting fraudulent payment claims of more than $850,000 … Read More
Conduent said a “noisy resignation” letter from a disgruntled board member was part of a takeover attempt by Carl Icahn that was aimed at replacing current chairman William Parrett. Board member Michael Nevin resigned immediately from the IT service provider’s … Read More
The U.S. Department of Health and Human Services Office of Inspector General is alerting the public about a fraud scheme involving orthotic braces and other medical equipment. Scammers are offering Medicare beneficiaries orthotic braces that are supposedly free to them … Read More
A federal jury found a South Florida health care facility owner guilty today for his role in the largest health care fraud scheme ever charged by the Justice Department, involving over $1.3 billion in fraudulent claims to Medicare and Medicaid … Read More
HOUSTON – An appeals court will allow a liability lawsuit to move forward against a dentist who is accused of failing to properly diagnose and treat a patient. According to the April 2 filing at the Texas 14th Court of … Read More
Federal prosecutors on Tuesday said they dismantled one of the largest health care fraud schemes ever investigated by the FBI, charging 24 people in a $1.2 billion alleged scam involving telemedicine and durable medical equipment companies. As part of the … Read More
Imagine suddenly losing your health care coverage over some undelivered paperwork. Recent reports suggest this is happening to thousands of Texas’ poorest children, jeopardizing their ability to get basic medical care and yanking away a ladder proven to help families … Read More
Last October, Texas education officials told lawmakers they would likely owe the federal government $33 million for illegally decreasing funding for kids with disabilities. They reassured them it was a fraction — just 3% — of their federal special education … Read More
HARTFORD — Connecticut Attorney General William Tong on Thursday announced a $252,913 settlement with New Haven dentist Robert Sorrentino to resolve allegations that he violated the False Claims Act by submitting false claims for oral surgery and maxillofacial services to … Read More
AUSTIN — About 50,000 Texas children are losing Medicaid coverage each year because their families fail to quickly send proof to the state they are still poor enough to qualify, state data show. Yet one in three children kicked off … Read More
Philip Esformes, an obsessive businessman who built an empire of healthcare facilities in Miami-Dade, was found guilty Friday of over 20 charges, including bribery and paying kickbacks, in a scheme to generate streams of patients for both his businesses. The … Read More
PROVIDENCE, R.I. (WPRI) – More than 1,000 dead Rhode Islanders received over $11 million in Medicaid benefits last year, according to a financial audit reviewed by the Target 12 investigators. It’s one of the findings in the state’s 443-page annual … Read More
Bristol-Myers Squibb Co. didn’t demonstrate that a federal court erred in allowing a whistleblower to proceed with claims that the company engaged in Medicaid fraud under the False Claims Act. Ronald J. Streck adequately pled the falsity and knowledge elements … Read More
PUEBLO COUNTY, Colo. – A Pueblo County couple is facing theft charges after they defrauded the Colorado Medicaid program out of hundreds of thousands of dollars, according to the Colorado Attorney General’s Office. The office said Frank Palcic and Melanie … Read More
Sylvia Hernandez Kauffman, the first woman in state history to be named Inspector General for Texas Health and Human Services, was born and raised in Brownsville. Her reappointment to the office, by Gov. Greg Abbott, was confirmed by the Senate … Read More
Attorney General Bob Ferguson recently announced that CareOne Dental Corporation and its owners will pay $1 million over allegations they repeatedly billed Medicaid for non-covered services and for services the company didn’t provide, the second-largest resolution of an in-state Medicaid … Read More
Medicare made more than $23 billion in improper payments in 2017 due to insufficient documentation, according to a new Government Accountability Office report. The GAO also found in its review that Medicaid paid out more than $4 billion for services … Read More
Efforts in several states to require Medicaid recipients to work, study, volunteer or search for a job have stalled amid court challenges and questions from lawmakers, but the Trump Administration vowed to continue approving similar work requirements. A federal judge … Read More
The Office of the Inspector General (OIG) is making good on its long-held promise to ramp up oversight of home- and community-based services, requesting an extra $10 million in its fiscal year 2020 budget to tackle fraud, waste and abuse … Read More
BATON ROUGE — Five Louisiana Medicaid recipients, including a St. Martinville man, have been arrested on charges related to welfare fraud after investigations by the Louisiana Bureau of Investigation, the Louisiana Department of Health and the Louisiana Legislative Auditor’s Office. … Read More
A Long Island chiropractor pleaded guilty on Friday to stealing more than $2 million from health insurance companies through a fraud scheme. Raymond R. Pellegrino, 50, who currently lives in McKinney, Texas, pleaded guilty to health care fraud. He is … Read More
After a morning session on Wednesday, the government rested its case against Forest Park Medical Center. They allege that the for-profit, physician-owned medical center located near Forest Lane and Central Expressway conducted a bribery scheme where it sent payments to … Read More
A federal judge heard legal challenges Thursday to a Trump Administration policy that allows states to implement work requirements in order for residents to qualify for Medicaid. U.S. District Judge James Boasberg heard oral arguments in two separate cases challenging … Read More
McALLEN — One of two men accused of playing roles in a Medicare fraud scheme was sentenced Wednesday, court records show. U.S. District Judge Micaela Alvarez sentenced Palmview resident Ivar Cantu Maldonado, 47, to a 56-month prison term more than … Read More
MOUNT VERNON, Mo. — A Mount Vernon dentist pleaded guilty Wednesday to Medicaid fraud in a plea agreement requiring him to repay the program $200,000 and surrender his license to practice dentistry for five years. Thomas H. Alms Jr., 63, … Read More
CHARLOTTE, N.C. – A woman is accused of running a Medicaid fraud scheme that took millions of dollars in medical care away from North Carolina families who deserve it. It involved many false claims to Medicaid and, experts said, ultimately … Read More
United States Attorney John H. Durham, Special Agent in Charge Phillip Coyne of the U.S. Department of Health and Human Services, Office of Inspector General, and Connecticut Attorney General William Tong today announced that DR. BASSAM AWWA and his medical … Read More
NEW HAVEN, Conn. (AP) – A former Connecticut doctor who prosecutors say bilked Medicaid out of nearly $5 million and spent hundreds of thousands of dollars on women and luxury goods is facing sentencing. Ramil Mansourov is set to be … Read More
The owner of a Washington, D.C.-based durable medical equipment company was sentenced to 42 months in prison today for her role in a scheme to submit $9.8 million in fraudulent claims to Medicaid. Assistant Attorney General Brian A. Benczkowski of … Read More
ST. LOUIS • An Illinois prison inmate pleaded guilty Wednesday to federal charges and admitted using fake nursing and educational credentials to work at three area health-care facilities. Benjamin Danneman, 37, who is serving a prison sentence in Illinois, pleaded … Read More
Lack of routine dental care can result in complications and high-cost emergency department visits. Yet almost two-thirds of Medicare recipients, 37 million people, don’t have dental coverage, according to a recent report from the Kaiser Family Foundation (KFF). As a … Read More
AUSTIN — Texas would soon start relying on Uber, Lyft and other ridesharing services to shuttle Medicaid patients to and from the doctor, if a new House bill becomes law. The state is one of several eyeing rideshare as a … Read More
A federal program known as the 1115 waiver helps pay for the costs of providing health care to the uninsured. Advocates want the Texas Legislature to order a renegotiation of the waiver, which partially expires in 2021. BY EDGAR WALTERS To … Read More
Former Palo Pinto General Hospital CEO Harris Brooks pleaded guilty to defrauding BlueCross BlueShield of Texas, CIGNA Texas, and United Healthcare for millions of dollars, according to U.S. Attorney for the Northern District of Texas Erin Nealy Cox. An FBI … Read More
