FLORHAM PARK, N.J., Jan. 31, 2019 /PRNewswire/ — Conduent Incorporated (NYSE: CNDT), a digital interactions company, was awarded a $100 million, seven-year contract extension to provide third-party administration services for Gold Coast Health Plan (GCHP), a Ventura County, Calif.-based Medi-Cal … Read More
January 30, 2019, Washington, DC—Two Houston, TX, physicians were sentenced to 25-year and 3-year prison terms for their roles in separate schemes to defraud Medicare out of payments for medical services. Assistant Attorney General Brian A. Benczkowski of the Justice … Read More
Tampa, Florida – U.S. District Judge James S. Moody Jr. today sentenced Jayam Krishna Iyer (66, Clearwater) to six months in federal prison for committing health care fraud, ordered Iyer to forfeit over $52,000 in health care fraud proceeds, and … Read More
A Dickinson County woman was ordered yesterday to repay more than $2,500 to the Kansas Medicaid Program after being found guilty of Medicaid fraud-related charges, Attorney General Derek Schmidt said. Ashley Loomis, 29, of Abilene, pleaded no contest in November … Read More
In Elwood, Indiana, a school superintendent has been charged with three felonies and a misdemeanor after she used her son’s name to get medical treatment for a sick student who didn’t have health insurance. Casey Smitherman says she picked up … Read More
They grow the food we eat. They farm the materials for the clothes we wear. They provide the energy that drives our cities. These are the rural Texans we love and idealize. But we overlook a serious reality: Rural healthcare … Read More
A co-founder of Sumter-based Early Autism Project Inc. is facing the possibility of having to pay $9 million if she is convicted of embezzling money from Medicaid and TRICARE, an accusation the organization itself settled in 2018. An indictment from … Read More
Walgreens Boots Alliance Inc. agreed to pay $269.2 million to settle U.S. claims that the drugstore chain defrauded a federally funded health care program over insulin drugs and a consumer-discount initiative. The two settlements, announced Tuesday, cover allegations over improper … Read More
The former executive director of Cleveland Clinic Innovations, the development and commercialization arm of Cleveland Clinic, was sentenced Dec. 19 to 30 months in prison for his role in a fraud scheme, according to the Department of Justice. Federal prosecutors … Read More
Texas Health and Human Services is accepting comments from stakeholders on the following proposed rules. The comment period ends February 10, 2019. Department of State Health Services 25 TAC, Part 1, Chapter 289, Radiation Control Interested parties can participate by: … Read More
A Riley County nurse has been sentenced to 21 months in prison after being found guilty of Medicaid fraud and related charges in three Kansas counties. According to Kansas Attorney General Derek Schmidt, 57-year-old Kathleen M. Kleuskens of Ogden entered … Read More
“Federal appeals court lifts order blocking Texas from kicking Planned Parenthood out of Medicaid” was first published by The Texas Tribune, a nonprofit, nonpartisan media organization that informs Texans — and engages with them — about public policy, politics, government … Read More
COLUMBIA — Federal authorities are seeking to recover $9 million that they say a S.C. woman stole in a wide-ranging scheme involving false medical bills for treating autistic children. Susan A. Butler, the “founder” of the S.C. Early Autism Project, … Read More
A group of home health agencies is suing the Texas Health and Human Service Commission (HHSC) for allegedly halting reimbursements for telemonitoring services. The agencies claim they will go out of business and deprive Texans of necessary care if the … Read More
WACO, TX (KXXV) – Millions of Texans could be out thousands of dollars with a single trip to the doctor. The Episcopal Health Foundation released a report that shows Texas has the most people without health insurance in the entire … Read More
A Lansing woman has been sentenced to nearly two years in prison for Medicaid fraud and related charges, according to a news release from the Kansas Attorney General’s Office. Erin Grae Whitlow, 29, pleaded guilty in November to one count … Read More
Jefferson City, MO – Missouri Attorney General Eric Schmitt announced that a St. Louis County woman was ordered to repay more than $5,000 to the MO HealthNet program after pleading guilty to Medicaid fraud-related charges. “Missourians have a rightful expectation … Read More
Texas is leading the charge in a federal lawsuit seeking to end the Affordable Care Act, known as “Obamacare,” arguing the law is no longer constitutional after Congress ended the individual mandate. The state also has the highest uninsured rate … Read More
A former Texas Health and Human Services executive commissioner has been tapped to be the acting director of the federal Center for Medicaid and CHIP Services. Chris Traylor will oversee how states are running Medicaid, the joint federal-state health insurance … Read More
LITTLE ROCK — Arkansas Attorney General Leslie Rutledge today announced the arrest of a mental health therapist at Preferred Family Healthcare (PFH). Kandice Robinson, 33, of Bartlett, Tenn., is accused of billing the Arkansas Medicaid Program for services not rendered … Read More
OMAHA, Neb. (AP) — A former state Medicaid audit administrator accused of bilking his father and Medicaid out of nearly $379,000 has pleaded guilty. Court records say Lincoln resident Craig Barnett entered the pleas last week in U.S. District Court … Read More
ABINGDON, Va. — A former Russell County psychiatrist who admitted in October to bilking an insurance company and Medicaid of thousands of dollars received a 7-month prison from a federal judge. Besides surrendering his medical license, Alfredo Cervantes, 61, must … Read More
A mental health therapist who worked for Preferred Family Healthcare has been accused of defrauding the state’s Medicaid program. Kandice Robinson, 33, of Bartlett, Tenn., is the fourth former employee of the Missouri-based health provider charged by Arkansas authorities in … Read More
A judge in a federal fraud case has ordered an Edmond couple to pay $268,796 in restitution to the state’s Medicaid program. Lawrence Vasquez, 62, and his wife, Eunja L. Vasquez, 56, operated Mercy Diabetic Supply Inc. in Oklahoma City. … Read More
The Department of Justice has announced that it obtained $2.5 billion in settlements and judgments from cases involving healthcare fraud in 2018. The healthcare fraud settlements are part of more than $2.8 billion the government obtained through False Claims Act … Read More
(St. Paul, MN) — The Minnesota Attorney General’s Office brought charges Wednesday against a man alleged to have defrauded the state medical assistance program out of more than 260-thousand dollars. State Attorney General Lori Swanson said Abdi Ali Gure of … Read More
BAKERSFIELD, Calif. — Two former employees of Landmark Dental are being investigated by the California Department of Insurance (CDI) Fraud Division for allegedly filing 27 false insurance claims, according to court documents. According to a search warrant, on July 5, … Read More
FAIRBANKS, Alaska (AP) – A former personal care attendant in Alaska has been sentenced to three years of probation for fraudulently billing more than $50,000 to Medicaid. The Fairbanks Daily News-Miner reports 57-year-old Sirje Kulakevich was sentenced last week in … Read More
A Dearborn pharmacist accused of prescribing medication to dead people and billing Medicare and Medicaid is now facing serious consequences. Haytham “Tom” Fakih is no stranger to the spotlight. Local 4 interviewed him in April after he began using halal … Read More
A federal judge’s ruling that the Affordable Care Act is unconstitutional is likely to be overturned on appeal and may boomerang politically on Republicans. Judge Reed O’Connor ruled for some 20 state plaintiffs that the ACA’s individual mandate is no … Read More
An Idaho think tank has filed a lawsuit asking the state’s Supreme Court to block a scheduled expansion of Medicaid. The suit, brought by the Idaho Freedom Foundation, says the expansion— which was passed through a ballot initiative during the … Read More
An operator of a durable medical equipment (DME) company was ordered to federal prison following his admission of defrauding Medicaid, announced U.S. Attorney Ryan K. Patrick. George Louis Moreno, 59, of McAllen, pleaded guilty Jan. 24, 2018. Today, U.S. District … Read More
The owner of an Upper Valley durable medical equipment company has been indicted for medicaid fraud. A 14-count federal indictment was unsealed Thursday against Omar Cuate Canales, who operates Bluebonnet DME in Roma. Canales is charged with submitting false health … Read More
PHOENIX — A dentist who was arrested for falsifying his anesthesia credentials is being sued by a former patient for medical malpractice and consumer fraud. Kris Peterson filed a lawsuit against Dr. Pankaj Goyal on December 7. “It’s pretty shocking,” … Read More
Watchdog estimates recent audit of fraudulent Medicaid payments totaling nearly $2 billion ‘is really closer to $60 billion’ A recent audit of the Department of Health and Human Services (HHS) reveals that it directed $2.6 billion worth of taxpayer money … Read More
McALLEN — The operator of a local durable medical equipment company was sentenced to three years in prison Wednesday, court documents show. George Louis Moreno, operator of Mars DME Inc., stood before U.S. District Judge Micaela Alvarez Wednesday morning during … Read More
Eight Dallas, Texas-area pharmacy owners and marketers were charged in an indictment unsealed today for their roles in a scheme involving approximately $92 million in compound drug claims to TRICARE and the U.S. Department of Labor (DOL), which were allegedly … Read More
HHS has published the 12th edition of a reference guide for Texas Medicaid and CHIP, commonly known as the Pink Book. The new version that has under gone a complete redesign is posted here.
A Fairfield County woman has admitted to her role in an elaborate scheme to defraud Medicaid for services they never provided. Toshirea Jackson of Bridgeport has pleaded guilty in Bridgeport district court to one count of healthcare fraud for participating in … Read More
A Texas federal judge’s ruling Friday invalidating the Affordable Care Act could create political headaches for Medicaid expansion supporters in states that are moving to implement or maintain expansion. https://www.modernhealthcare.com/article/20181218/NEWS/181219901
