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
There are the days Lilia Valadez spends in pain — vomiting, pacing, aching, screaming — and the days she spends anticipating when the pain might come again, keeping her from work and potentially requiring an emergency room visit she can’t … Read More
Hospital leaders say restrictions on their property tax revenue growth could force them to scale back services. BY SHANNON NAJMABADI Squeezed by Medicare cuts and a growing number of uninsured patients, rural hospital districts in Texas are worried that the Legislature’s … Read More
A former pharmaceutical representative has pleaded guilty in Texas to a role in an $8 million health care fraud scheme that netted her over $1 million, according to U.S. Attorney John Bash and FBI Special Agent in Charge Christopher Combs, … Read More
CLEVELAND COUNTY, Okla. – A Moore woman is accused of using her former employer’s physician number to call-in and fill dozens of prescriptions for herself. Christine Galliher is charged with nine counts of obtaining a controlled substance by forgery, and … Read More
Two Rio Grande Valley residents have been taken into custody for submitting fraudulent claims for payment to Texas Medicaid for durable medical equipment (DME) supplies that were never delivered to Medicaid beneficiaries, announced U.S. Attorney Ryan K. Patrick. A federal … Read More
NEWARK, N.J. – An Essex County, New Jersey, man was sentenced today to 50 months in prison for his role in a conspiracy to defraud New Jersey state benefit programs, , U.S. Attorney Craig Carpenito announced. Brian Catanzarite, 43, a … Read More
BOISE, Idaho (KLIX) – A Boise woman has been sentenced after pleading guilty to Medicaid provider fraud. Kimberley A. Reed, 51, pleaded guilty in January and on Friday received a two-year unified sentence, according to Idaho Attorney General Lawrence Wasden. … Read More
FRANKFORT, Ky. (WTVQ) –A Prestonsburg woman was sentenced and ordered to repay the state Medicaid program more than $12,000 after pleading guilty to theft charges and engaging in a scheme to defraud the program, according to the state attorney general’s … Read More
March 5, 2019 — Medical device company Align Technology has announced that it will close its Invisalign stores after an arbitrator ruled that it violated its noncompete agreement with SmileDirectClub (SDC). The decision also prohibits Align Technology from providing certain … Read More
McALLEN — The owner and an employee of a now-closed durable medical equipment, or DME business each made their first appearance before a federal magistrate judge in connection with healthcare fraud charges. Standing before U.S. Magistrate J. Scott Hacker a … Read More
Republished from the Texas Tribune With more and more Texans seeking relief from shock medical bills, two prominent lawmakers — one Republican, one Democrat — are pushing far-reaching legislation that would bar emergency care providers from sending surprise bills to … Read More
LITTLE ROCK (KATV) — A North Little Rock dentist was arrested Monday on accusations of Medicaid fraud, authorities announced. The state attorney general’s office said in a news release that Dr. Brian Moore, 47, of Maumelle, is accused of billing … Read More
CALHOUN, La. – (2/28/19)–A family owned business that offers therapy services for children with behavioral issues, swarmed with police. It happened yesterday at ABA Therapy Solutions in Calhoun. A day later, we learn why. “ABA Therapy Solutions is under investigation … Read More
McALLEN, Texas – Two Rio Grande Valley residents have been taken into custody for submitting fraudulent claims for payment to Texas Medicaid for durable medical equipment (DME) supplies that were never delivered to Medicaid beneficiaries, announced U.S. Attorney Ryan K. … Read More
AUSTIN — Lawmakers from both parties are rolling out bills this month to overhaul the Texas Medicaid system, introducing protections for vulnerable patients who are denied treatments, increasing state oversight and signaling a crackdown on health care corporations that get richer by … Read More
When Attorney General Ken Paxton announced last week he had settled a giant Medicaid fraud case on behalf of Texas, he trumpeted how much money the state would collect from Xerox. “AG Paxton Recovers Record $236 Million for Texas in … Read More
A home health services company owner and a co-conspirator, both Miami, Florida residents, were sentenced to prison today for their roles in a $8.6 million health care fraud scheme. Assistant Attorney General Brian A. Benczkowski of the Justice Department’s Criminal … Read More
HOUSTON – A federal jury has convicted a 50-year-old internal medicine doctor and 47-year-old hospital owner of conspiracy to commit health care fraud, 17 counts of health care fraud and three counts of money laundering, announced U.S. Attorney Ryan K. … Read More
A former San Antonio pharmaceutical representative has pleaded guilty to her role in an $8.8 million healthcare fraud scheme, according to news website My San Antonio. Holly Blakely, 45, initially was charged in a 30-count indictment alleging she paid more … Read More
HAMPTON, Va. — A federal grand jury Thursday indicted a Hampton man and woman with conspiracy, health care fraud, false statements, and aggravated identity theft. According to allegations in the indictment, Maurice Moody, 40, and Dena Major, 48, conspired to … Read More
SPRINGFIELD, Mo. – U.S. Attorney Tim Garrison and Missouri Attorney General Eric Schmitt announced today that a Marshfield, Mo., couple has been convicted by a federal trial jury of multiple fraud schemes totaling more than $1 million that involved Medicaid … Read More
wo days after paying Texas $236 million to settle Medicaid fraud charges, New Jersey-based Conduent Inc. announced it has won a $232 million, four-year contract with the Indiana Family and Social Services Administration. The pact extends a contract that began … Read More
AUSTIN, Texas (CN) – Xerox and a former subsidiary agreed Tuesday to pay Texas over $235 million to settle claims they oversaw the payment of fraudulent Medicaid dental claims for over seven years. Texas Attorney General Ken Paxton said the … Read More
McALLEN — The owner of a durable medical equipment company accused of scamming more than $4 million in Medicaid funds will not be sentenced for another two months, court records show. Anna Ramirez-Ambriz was scheduled to be sentenced earlier this … Read More
