AUSTIN — A federal jury on Monday convicted two Austin-area psychologists on numerous charges after a fraud investigation at their establishment, Psychological A.R.T.S., P.C. After a three-week-long trial, the jury convicted Dr. William Joseph Dubin, 73, and his son, Dr. … Read More
Two residents of Brownstown, Michigan were sentenced to 10 and six years in prison for conducting a multi-million-dollar scheme to defraud Medicare for health services that were never rendered. According to officials, between 2009 and 2017, Tasneem Tahir and Hafiz … Read More
A founding physician of now-defunct Forest Park Medical Center in Dallas admitted his role in a $200 million bribery and kickback scheme Oct. 4, according to the Department of Justice. Wade Neal Barker, MD, pleaded guilty to conspiracy to pay … Read More
An anti-abortion group that continuously failed to provide reproductive health services to the number of patients it told the state it could is getting its contracts terminated — and is facing an investigation by Texas’ health agency over questionable billing. … Read More
October 24, 2018 – Two recent advisory opinions from the Office of the Inspector General (OIG) at HHS are demonstrating why current healthcare fraud and abuse laws are not aligned with value-based payment and care delivery. The federal watchdog recently … Read More
An indictment was unsealed today charging the owner and sole practitioner of a medical clinic with conspiracy to illegally distribute prescription drugs, U.S. Attorney Matthew Schneider announced today. Schneider was joined in the announcement by Special Agent in Charge Timothy … Read More
A coding error in a portal of the Employee Retirement System of Texas inadvertently allowed some users to view the information of others, potentially exposing information on nearly 1.25 million of its members. In a statement posted on its website, … Read More
Berger Montague is pleased to announce that the government has intervened in a False Claims Act lawsuit filed by shareholder Shauna Itri, along with co-counsel, against a cardiovascular center in Texas. The lawsuit alleges that the cardiologist group defrauded the … Read More
October 17, 2018 – New high-profile Medicare fraud cases have led to convictions and lengthy prison sentences for providers that attempted to defraud Medicare of $36.9 million. Federal agencies including HHS, the FBI, the Department of Justice (DoJ), and the … Read More
An anti-abortion group that continuously failed to provide reproductive health services to the number of patients it told the state it could is getting its contracts terminated — and is facing an investigation by Texas’ health agency over questionable billing. … Read More
Fujifilm Holdings came away with a victory in court this week after rulings in litigation brought against the company by Xerox Corp. shareholders were reversed or dismissed in appellate court. Darwin Deason, a top Xerox shareholder, was involved in several … Read More
CLEARWATER (FOX 13) – Four Bay Area businessmen have been indicted in an alleged scheme that defrauded patients, doctors, and insurance companies out of almost a billion dollars. A district court in Tennessee unsealed a 32-count indictment charging Andrew Assad … Read More
Law360 (October 17, 2018, 8:29 PM EDT) — Arizona’s attorney general filed a lawsuit Wednesday in state court accusing dental supply company Benco of participating in a boycott of the state’s dental association and pressuring suppliers not to work… Source: Ariz. … Read More
Washington, DC, October 16, 2018—Two Dallas doctors and three nurses were sentenced yesterday in an $11.3 million Medicare fraud scheme involving false and fraudulent claims for home health services. Assistant Attorney General Brian A. Benczkowski of the Justice Department’s Criminal … Read More
Healthcare Fraud Detection Market are difficult to detect and are generally go unnoticed, therefore detection of such fraudulent claims is necessary, as they increase burden on the society. The use of fraud detection solution enable healthcare firms in accounting, and … Read More
HARRISBURG, Pa., Oct. 12, 2018 /PRNewswire/ — The Delta Dental Community Care Foundation recently awarded the HACC Foundation a $50,000 grant to upgrade dental equipment in its dental clinic at the Harrisburg Campus of HACC, Central Pennsylvania’s Community College. HACC … Read More
The Texas prison system is changing its denture policy — creating a dedicated denture clinic and hiring a prosthodontic specialist — in an effort to ensure that more inmates get teeth. The move to amp up dental care comes after … Read More
The Texas Health and Human Services Commission (HHCS) recently published its “Rider Report 61,” a review of Medicaid and Children’s Health Insurance Program (CHIP) managed care contracts commissioned by the legislature. The report aims to be a comprehensive assessment of … Read More
Attorney General Leslie Rutledge during the taping of a debate on AETN this morning said former lawmakers remain under investigation in the Medicaid fraud probe of Preferred Family Healthcare. She provided no further details. Source: Rutledge says ‘former’ legislators under investigation … Read More
OIG recognizes Protecting HHS Data, Systems, and Beneficiaries from Cybersecurity Threats as a top management and performance challenge facing HHS. In partnering with various HHS agencies to address this challenge, OIG has formed a multidisciplinary Cybersecurity Team comprised of auditors, … Read More
Antitrust officials gave CVS the green light on Wednesday to purchase Aetna, the nation’s third-largest health insurance company, in a $69 billion deal that could potentially transform the health care industry and change how millions of Americans receive basic medical … Read More
A federal jury convicted a Houston-area hospital administrator on Friday for his role in a $16 million Medicare fraud scheme. Assistant Attorney General Brian A. Benczkowski of the Justice Department’s Criminal Division, U.S. Attorney Ryan K. Patrick of the Southern … Read More
CHICAGO (CBS)–The former manager of a dental office with locations in Chesterton and Crown Point, Indd., has been charged with felony Medicaid fraud after allegedly swindling Medicaid out of more than $365,000. Justyn Arch, 32, of Valparaiso, is accused of … Read More
A Houston, Texas-area patient recruiter was sentenced to 108 months in prison today for her role in a $3.6 million Medicare fraud scheme involving fraudulent claims for home health services. Assistant Attorney General Brian A. Benczkowski of the Justice Department’s … Read More
LAREDO, TX (KGNS) – The clinic known as Laredo Laser and Surgery has reopened for business a day after the FBI shut down operations for a few hours. The FBI, federal agencies and the attorney general’s Medicaid Fraud Control Unit … Read More
Local, state and federal authorities raided a local clinic on Tuesday morning. Federal Bureau of Investigation special agents along with the U.S. Department of Health and Human Services-Office of Inspector General and the Texas Attorney General’s Office Medicaid Fraud Control … Read More
AUSTIN — The state’s mega-agency for social services has found “serious issues” with managed care insurers’ bids and will re-open bidding on three large contracts in Medicaid and the Children’s Health Insurance Program, an agency spokeswoman said Monday. Many bidders … Read More
Texas Health and Human Services Commission officials announced Monday that they have canceled three solicitations for contracts after finding problems with almost two dozen bids. Monday’s revelation is the latest in a series of contract woes that have beset the agency, … Read More
The Affordable Care Act of 2010 (ACA) and subsequent executive actions by the Obama administration accelerated efforts to bring value-based payment to health care. Under the banner of value-based purchasing, federal officials have touted the “triple aim”—improving the quality of … Read More
An updated collection of state Medicaid fact sheets from the Kaiser Family Foundation summarizes Medicaid coverage and spending nationally and in each state. The fact sheets for each state are accessible via an interactive map of the U.S. and display a wide range … Read More
Conduent Inc (NYSE:CNDT) has grabbed attention in the last trading session to close at $22.28. Average trading volume remained 1.87 Million shares, while its relative volume stands at 0.65. Conduent Inc (NYSE:CNDT) has a market cap of $4.69 Billion and … Read More
An X-ray technician married to a dentist has been accused of illegally performing dental work on patients at her New Jersey practice, authorities said. Both South Hackensack residents are now charged with a series of healthcare fraud claims offenses, the Passaic … Read More
Dr. Shahrzad Haghayegh-Askarian was banned from participating in MassHealth in 2013, but continued to bill the state’s health insurance program for low-income residents between 2014 and 2017 using another dentist’s name and identification number. Read more at the Patriot Ledger
A psychologist and his wife pleaded guilty in federal court on Tuesday to billing Wyoming Medicaid $6.2 million for purported mental health services such as karaoke and shopping, according to court records and a news release from Wyoming U.S. Attorney … Read More
An Anchorage woman has been sentenced to serve eight months in federal prison for defrauding Alaska’s Medicaid program of $90,000. Mi Ran Yu, 41, had been a personal care assistant for Medicaid patients between 2012 and 2016 according to U.S. Attorney … Read More
Program integrity includes activities to prevent, detect and respond to fraud, waste, abuse and noncompliance with certain contractual or other regulatory requirements that result in improper payments. Medicaid’s Payment Error Rate Measurement (PERM) program estimates the improper payment rate in … Read More
It was without surprise that I read Gov. Kim Reynolds’ administration had agreed to give Iowa Medicaid managed care insurers a 7.5 percent increase. With Medicaid managed care, once you’re in for a dime, you’re in for a dollar. In … Read More
A federal jury found a physician and two clinic owners and operators guilty yesterday for their roles in a $17 million Medicare fraud scheme. Assistant Attorney General Brian A. Benczowski of the Justice Department’s Criminal Division, U.S. Attorney Ryan Patrick … Read More
If you’re interested in health and human services in Texas, you might be interested in being a member of the STAR Kids Managed Care Advisory Committee. The Texas Health and Human Services Commission executive commissioner will appoint a member to … Read More
Rep. Beto O’Rourke (D-Texas) on Monday called for the state of Texas to expand Medicaid. “Texas should expand Medicaid today,” O’Rourke, who is challenging Sen. Ted Cruz (R-Texas), for a U.S. Senate seat this November, tweeted, linking to an editorial from The Houston Chronicle about the … Read More
