The Centers for Medicare & Medicaid Services (CMS) released renewed guidance on Medicaid eligibility determinations and spending integrity the organization announced. According to CMS, Medicaid eligibility for adults in expansion states are not being assessed within federal and state requirements … Read More
Washington, D.C.—Yesterday, the U.S. House of Representatives passed the Medicaid Patient Abuse Prevention Act (H.R. 233), bipartisan legislation introduced by Reps. Tim Walberg (R-MI) and Peter Welch (D-VT). The Walberg-authored legislation was incorporated into H.R. 3253, which includes a series … Read More
Akron native Frank Lazzerini, once a respected doctor with a thriving practice in Jackson Township, left the Stark County Courthouse on Tuesday afternoon as a felon. After hearing testimony for nearly five weeks, a Common Pleas Court jury backed the … Read More
Texas Tech took another step in producing future dentists in El Paso who will serve West Texas and the borderland. Of the 2,400 dentists who have graduated from a Texas dental school in the past decade, only 22 opened a … Read More
Charged with Medicaid fraud in a separate case, a former healthcare executive pleaded guilty in federal court Wednesday to committing a conspiracy to bribe an Arkansas state senator. In exchange for the bribes, then-Arkansas State Senator Jeremy Hutchinson allegedly influenced … Read More
A Mira Mesa dentist was charged Tuesday with insurance fraud for falsifying hundreds of root canal claims to scam insurance companies out of nearly $600,000, the San Diego County District Attorney’s Office said. April Rose Ambrosio, 58, was charged with … Read More
TULSA — Multiple Tulsa-area doctors were charged in the U.S. District Court with violations of the federal anti-kickback statute and other offenses, said U.S. Attorney Trent Shores. Shores said the men caused federal health care insurance programs to pay reimbursement … Read More
A Vanderburgh County judge on Wednesday handed down an 820-day sentence to an Evansville certified nurse aide (CNA) who pleaded guilty to three counts of neglect of a dependent following an investigation by the Attorney General’s Medicaid Fraud Control Unit … Read More
Former pharmacist Ravi Morisetty has been sentenced to two years in federal prison for his involvement in a health-care kickback scheme that defrauded the military’s insurance program out of more than $100 million, The Dallas Morning News reported. The 44-year-old … Read More
A Los Angeles dentist was sentenced Thursday to 40 months in federal prison for a health-care insurance fraud scheme in which he submitted phony billings for crowns and fillings that were never actually provided to patients. Benjamin Rosenberg, 59, pleaded … Read More
Richard “Nate” Schott, the ex-Murfreesboro dentist who grifted nearly $1 million from insurance companies, is headed to prison for 33 months. U.S. District Court Judge Waverly Crenshaw handed down the sentence Friday morning before a courtroom crowd of about 30 … Read More
A new study found that almost 81% of antibiotics prescribed for infection prophylaxis before dental visits were unnecessary. In the first such study to examine the appropriateness of U.S. dentists’ prescriptions of prophylactic antibiotics, the researchers reported that just under … Read More
The attorney general’s office has added a misdemeanor Medicaid fraud charge to its actions against Chirie Bazzelle, owner and CEO of New Beginnings Health Services, a Medicaid-financed services provider to children. Bazzelle, 46, is accused in this case of giving … Read More
The last person arrested in what federal authorities allege was a scam that bilked Medicare out of $150 million was the first to plead guilty. Jesus Virlar-Cadena, of San Antonio, pleaded guilty Tuesday afternoon to charges of conspiracy to commit … Read More
A Lake Township man is facing federal allegations he defrauded Medicare and Medicaid out of roughly $2 million. Thomas G. O’Lear, 55, has been indicted in U.S. District Court in Cleveland on 25 counts of health care fraud and a … Read More
OKLAHOMA CITY – OKLAHOMA HEART HOSPITAL, LLC, AND OKLAHOMA HEART HOSPITAL SOUTH, LLC, have agreed to pay $2,800,000 to settle civil claims stemming from allegations that they submitted false claims to Medicaid, announced First Assistant U.S. Attorney Robert J. Troester. … Read More
RALEIGH — A Mebane dentist has agreed to pay nearly $730,000 to the state in a Medicaid fraud case, N.C. Attorney General Josh Stein said in a news release. The settlement against Zhanying Guo and her dental practice, Complete Dental … Read More
McALLEN — A Mission man indicted in connection with a healthcare fraud scheme pleaded guilty Wednesday, avoiding a jury trial that was expected to begin next week, court records show. U.S. District Judge Micaela Alvarez accepted a guilty plea from … Read More
About 146,000 fewer children in Texas were enrolled in Medicaid and the Children’s Health Insurance Program between the end of 2017 and the end of 2018, according to a study released Thursday by the Georgetown University Center for Children and … Read More
A former teacher who owned a home health agency has been sentenced to serve 18 months in jail for stealing about $2.5 million from the Massachusetts Medicaid program. The state attorney general’s office says 48-year-old Hellen Kiago was sentenced last … Read More
In 2016, a foster baby born with severe defects needed constant monitoring from a nurse, to ensure he didn’t pull out his breathing tube and choke to death. The insurance company Texas pays to provide that care refused, saving Superior … Read More
A Houston, Texas patient recruiter was sentenced to 188 months in prison today for her role in a $20 million scheme to pay illegal health care kickbacks to physicians and Medicare beneficiaries in order to fraudulently bill for medically unnecessary … Read More
May 24, 2019 — The percentages of oral health and dentist visits are about the same in the U.S. and England, but what about the rates of opioid prescriptions? Researchers conducted an international study to find out. Researchers conducted a cross-sectional … Read More
A Port St. Lucie man is accused of performing at least two dental surgeries without a dentistry license. His patients ended up in the emergency room with infections and in severe pain, police said. Jose Espinoza-Aleman, 57, of the 100 … Read More
AUSTIN - Texas once boasted one of the strongest laws protecting public access to government records, including those that detail how taxpayer money is spent – and often misspent. But the law has been slowly defanged in recent decades by … Read More
Jeff Patton lost $3,300. Rochelle Therrien lost $400. Vessie Moore lost a whopping $14,000. These are a few people whose finances were destroyed when they visited Richard “Nate” Schott, the former dentist who pleaded guilty to swindling nearly $1 million … Read More
With seven days left until the sine die, the last day for the regular session of the Texas Legislature, lawmakers are poised to do nothing to help the state’s 5 million adults without health insurance – the largest in the … Read More
HARRISBURG — The former owner of a Harrisburg-based dental and vision claims processing business pleaded guilty to one count of health care fraud in federal court this week, according to U.S. Attorney David J. Freed. Michael Timothy Buchanan, 68, of … Read More
TEXARKANA, Texas – A Texarkana, Texas, physician has agreed to pay $118,000 to settle allegations of improper billing practices for his Medicare patients at his three clinics, announced U.S. Attorney Joseph D. Brown today. Dr. Donald S. Douglas, 50, operates … Read More
It looks like the state really is going to cut off health care to poor Oklahomans — most of them children — if they can’t be reached by mail. This time, we can blame the federal government. Using returned mail … Read More
A former Massachusetts teacher has been convicted of stealing $2.5 million from the state’s Medicaid program. Attorney General Maura Healey announced Wednesday that Hellen Kiago, of Sturbridge, fraudulently billed MassHealth through a home health agency she owned, Lifestream Healthcare Alliance. … Read More
State officials in Texas and Louisiana have launched multiple probes into the Cenikor Foundation following an investigation by Reveal that found the prominent drug rehab has turned patients into an unpaid labor force for private companies. Reveal from The Center … Read More
HOUSTON — A Brazoria County woman is suing a Houston dentist, alleging she paid for dental implants that broke and were defective. Gail Windham of Pearland filed a complaint May 6 in Harris County District Court against Houston Implant Dentistry … Read More
In a Lowndes County federal courtroom a jury handed down guilty verdicts for conspiracy to commit healthcare fraud and six counts of healthcare fraud, according to court records. Moss faces a maximum penalty of 10 years in prison, a $250,000 … Read More
The healthcare professionals were sentenced to federal prison last week for illegally distributing opioids and other controlled substances in the Eastern District of Texas. After pleading guilty last October, Dr. Howard Gregg Diamond, a Sherman physician, received a 20-year sentence … Read More
California made capitation payments after beneficiaries’ deaths. Of the 184 capitation payments in our random sample, 6 payments were correct. For the remaining 178 payments, California made unallowable payments totaling $433,948 ($302,755 Federal share). Despite California’s efforts to identify and … Read More
Detroit — A federal grand jury has indicted a Wayne County man who was once a member of the state board that regulates pharmacies and drugs for allegedly bilking health insurance plans out of millions, officials said. Nabil Fakih, owner … Read More
A doctor from Morristown was found guilty on charges related to a $30 million Medicare and Medicaid scheme, authorities said on Thursday. Paul Mathieu, 53, posed as the owner of three medical clinics in Brooklyn for six years while billing … Read More
A company known as “Acadia Healthcare” has agreed to pay penalties and fines totaling $17 million. Acadia and it’s subcontractors admitted overcharging for drug testing of clients at drug treatment centers across West Virginia. Source: Largest healthcare fraud settlement in … Read More
In Mississippi and Arkansas, Kool Smiles Dental has changed its brand name to Sunnybrook Dentistry. The report by the Daily Journal of Tupelo, Mississippi, implied that the rebranding may have been a consequence of the death of a child at … Read More
