Medicaid — which has been a political football between Washington and state capitols during the past decade — scored big in Tuesday’s election. Following the vote, nearly 500,000 uninsured adults in five states are poised to gain Medicaid coverage under … Read More
Federal prosecutors obtained a jury conviction of two North Texas home health owners who stole over $3.7 million from Medicare and Medicaid. A joint investigation with the Medicaid Fraud Control Unit of the Texas attorney general’s office brought Celestine “Tony” … Read More
Although health coverage was a top voter priority, in the end Texans mostly opted for the status quo. In other words: Don’t go looking for governmental change in health care anytime soon in the Lone Star State. Republican incumbents Gov. … Read More
Catarina Martinez took 26 steps this week. After years of struggling with an undiagnosed medical condition, the 17-year-old girl who goes by “Catie” is starting to inch toward recovery. Her story was shared at a 20th anniversary celebration Oct. 25 … Read More
HOUSTON, Ts. – The owner of three Houston area clinics has been ordered to federal prison following her conviction of conspiracy to commit health care fraud, announced U.S. Attorney Ryan K. Patrick. Joy Aneke, 51, of Katy, entered her plea … Read More
Voters in three traditionally Republican states supported ballot measures to extend Medicaid benefits to more low-income adults. The results highlight the divide between voters, even in conservative states, who generally support providing health benefits to the poor, and conservative politicians … Read More
LOUISVILLE, Ky. – United States Attorney Russell M. Coleman announced today that ImmediaDent of Indiana, LLC (ImmediaDent), which operates nine dental care practices in Indiana, and Kansas based Samson Dental Partners, LLC (SDP), which provides administrative support services to ImmediaDent, … Read More
New Jersey-based Conduent Inc. (NYSE: CNDT), a Xerox spinoff, plans to cut 213 jobs in Houston by the end of the year. The affected employees are at Conduent Commercial Solutions LLC’s 3100 Hayes Road location, according to a Worker Adjustment … Read More
LONDON, Ky. (WKYT) – A cardiologist in southern Kentucky will spend years in federal prison after being convicted on fraud charges. U.S. District Court Judge Gregory F. Van Tatenhove sentenced Dr. Anis Chalhoub to 42 months in federal prison for … Read More
Zach Zezulka, a libertarian who lives in Williamson County, last week walked out of the early voting polling place at the Georgetown Parks & Recreation building proud to have cast ballots for candidates who will support President Donald Trump’s agenda. … Read More
A federal jury found two home health owners and two employees guilty today for their roles in a scheme to bill Medicare and Medicaid for over $3.7 million in charges when the owners had previously been excluded from participating in … Read More
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
