Media

Data released by the Centers for Medicare and Medicaid Services on Tuesday reveals the scale of Medicaid and Children’s Health Insurance Program enrollment in the United States. In 2017, 46.3 million children in the United States were enrolled at one … Read More

Following the president’s rescissions proposal, it’s not surprising there has been some confusion surrounding what it would and would not do. The term “rescission” itself is budgetary jargon rarely heard outside the Beltway, and it is apparently rarely understood even … Read More

WORCESTER – Three former managers of a now-defunct Westminster transportation company were placed on probation and ordered to pay restitution Monday for their roles in what prosecutors allege was a scheme to fraudulently bill the state’s Medicaid program for nearly … Read More

Christina Deras, who worked for years for the Veterans Affairs Administration, winced with pain as she took a seat outside the Bexar County Courthouse on Tuesday. Read more at expressnews.com

Day after day, Heather Powell lay in bed, in pain, in her small San Antonio apartment. For two years she languished there, staring at the ceiling, watching cop dramas on Netflix, surfing the Internet with a computer mouse tucked under … Read More

A federal jury found Mercy O. Ainabe, a patient recruiter for Texas Tender Care, guilty today for her role in a $3.6 million Medicare fraud scheme involving fraudulent claims for home health services. Acting Assistant Attorney General John P. Cronan … Read More

By Marissa Evans, The Texas Tribune May 3, 2018 “Amid contracting scandal, Charles Smith to retire as head of Texas health commission” was first published by The Texas Tribune, a nonprofit, nonpartisan media organization that informs Texans — and engages … Read More

A Detroit woman was sentenced to a year in jail and ordered to pay $915,000 in restitution to a nonprofit after being convicted of embezzlement and health care and Medicaid fraud. Lajuana Scott, 59, also received five years of probation … Read More

Law360 (May 30, 2018, 8:08 PM EDT) — Texas has reached settlements totaling $15.2 million with six individuals and four companies involved in physical therapy that were accused of making false statements and conspiring to obtain unauthorized Medicaid benefits, the … Read More

Federal officials accused David Williams of Fort Worth of fraudulently billing health insurance companies more than $25 million and billing those companies for medical services while impersonating a certified health care provider. Read more at star-telegram.com

A dentist from Macomb County has been sentenced to serve 218 days in jail and ordered to pay $1.7 million in restitution for committing a Medicaid fraud scheme. David Johnson, 51, of Chesterfield Township, also was sentenced to five years … Read More

The former owner of Livernois Dental has been sentenced to about seven months in jail for Medicaid fraud and ordered to pay $1.7 million in restitution, Attorney General Bill Schuette announced Wednesday.   Read more at Crain’s Detroit Business

A dentist was sentenced to 20 months in jail after pleading no contest in December to charges of performing unnecessary work on several patients in Daly City and then stealing someone’s identity to seek other dental jobs, San Mateo County … Read More

RICHMOND, VA – A Mechanicsville dentist was sentenced Friday to 30 months in prison for defrauding Medicaid and four dental insurers of approximately $783,000. According to court documents, Maryam E. Zarei, 47, of Glen Allen, was the owner and operator … Read More

A Mechanicsville dentist who defrauded Medicaid and several insurance companies out of $783,000 from 2013 to 2016 was sentenced Friday to 30 months in prison. In pleading guilty to health care fraud last December, Maryam E. Zarei, 47, of Glen … Read More

A Hanover County dentist faces a possible prison term when sentenced Friday for defrauding Medicaid and four insurance companies out of more than $783,000. Maryam E. Zarei, 47, of Glen Allen, the owner and operator of Atlee Station Family Dentistry … Read More

PHOENIX — The Arizona Attorney General’s Office announced that two women were arrested for allegedly performing unlicensed dental work in a Glendale office. Melissa M. Pavey, 45, and Jolene E. Houchens, 38, were accused of performing unlicensed tooth extractions and … Read More

A Bucks County dentist has pleaded guilty to Medicaid fraud, and agreed to pay $1.5 million in restitution after he and his company submitted fraudulent claims to the Medicaid Program for dental work that was never performed. Dr. Ilya Babiner, … Read More

The shake-up over contract mismanagement at the Texas Health and Human Services Commission continued Friday with the resignation of another state official who oversees contracting. Ron Pigott, the agency’s deputy executive commissioner for procurement and contracting services, is leaving as … Read More

Since the start of the Obama administration in 2009, Texas has sued the federal government more than 48 times, costing taxpayers millions of dollars. The state’s latest lawsuit is a renewed effort to dismantle the Affordable Care Act (ACA), a … Read More

AUSTIN — Gov. Greg Abbott says he is alarmed by contracting mistakes at the Texas Health and Human Services Commission and is sending a top aide, former state Sen. Tommy Williams, to correct the problems. Abbott said through a spokesman … Read More

Medical records, driver’s license and Social Security numbers, and other personal information of Texas Health Resources patients may have been accessed unlawfully, the Arlington-based health system is warning. Texas Health is one of North Texas’ largest provider groups with more … Read More

Texas overcharged the federal government for a portion of primary care reimbursement following a state Medicaid rate cut, according to the HHS Office of Inspector General, so Texas should refund the federal government $20.7 million for those overcharges and other … Read More

Certain occupations are inherently more dangerous than others. But whether you are a dentist, lawyer, or business executive, your business can become a target of employee fraud. When fraud does occur, what happens next? How will you feel? And as … Read More

AUSTIN — The state has canceled five new managed-care contracts for low-income youngsters enrolled in the Children’s Health Insurance Program after finding errors in a spreadsheet used to evaluate bids. In addition, the Health and Human Services Commission on Monday … Read More

Dentists are being told not to treat extremely heavy patients for fear of getting sued. Patients weighing more than 20st should be sent to specialist clinics, dentists are being warned unless their clinics have dental chairs specially designed to bear … Read More

April 03, 2018 – Medicaid fraud control units (MFCUs) recovered $1.8 billion in 2017 through effective collaboration with state governments, according a new report released by the Office of the Inspector General (OIG). MFCUs recovered $6.52 for every dollar spent … Read More

Every year, hundreds of thousands of Americans spend around $2,000 on veneers to make their teeth look whiter and to hide imperfections. The custom-made shells are extremely thin and are bonded to the front of the teeth in order to … Read More

GALVESTON COUNTY, Texas – On Tuesday, the Galveston County Health District said that out of the 9,500 patients who may have been exposed to deadly diseases at Texas City’s Coastal Health and Wellness facility, roughly 600 are children. So far, … Read More

Dental practices are reporting to Henry Schein Practice Solutions that they have received calls from an individual posing as a company employee who then asks for remote access to the office servers. The company in late January stated that, according … Read More

Patients who learned they may have been exposed to serious diseases at a Texas City clinic are angry and scared. Galveston County Sheriff’s Office deputies would not allow reporters to enter the Coastal Health and Wellness Clinic on Saturday afternoon … Read More

While getting patients to the dentist can be like pulling teeth, Dr. Lan Chi Le has built a business designed to make dental care easy, affordable and accessible for all. Le is the founder of ZYGO Dental Management Group, a … Read More

Texas is frequently criticized in the media for having the highest uninsured rate in the nation. The presumption is that uninsured Texans and uninsured residents in other states aren’t getting health care because they lack health insurance, particularly government supported … Read More

AUSTIN, Texas, March 15, 2018 /PRNewswire/ — In its first such rating measuring member satisfaction, Superior HealthPlan finished in the top five nationally for its STAR+PLUS Medicare-Medicaid Plan (MMP). The company earned a score of 89 out of 100 in … Read More

LONG BEACH, Calif.–(BUSINESS WIRE)–Molina Healthcare, Inc. (NYSE: MOH) today announced that its Texas subsidiaries, Molina Healthcare of Texas, Inc. and Molina Healthcare of Texas Insurance Company, have been awarded contracts by the Texas Health and Human Services Commission (HHSC) for … Read More

With only nine days left before the expiration of the existing 1115 Waiver, in late December 2017, the Centers for Medicare & Medicaid Services (CMS) approved another extension of the 1115(a) demonstration project, “Texas Healthcare Transformation and Quality Improvement Program” … Read More

Medical equipment suppliers in Texas recently banded together to hold off reimbursement reductions proposed by a managed care company. Texas’ 85th Legislature requires that the state’s Health and Human Services Commission (HHSC) reduce Medicaid spending by $830 million and suggests … Read More

During last year’s fight against efforts in Washington to repeal the Affordable Care Act, poll after poll showed most Americans opposed Medicaid cuts that would turn back the clock on decades of civil rights progress for people with disabilities. Disability … Read More

For now, congressional Republicans appear to have set aside efforts to repeal the Affordable Care Act (ACA). Yet, it’s increasingly clear that the Trump administration is doubling down on its attempts to seriously weaken the ACA’s Medicaid expansion by making … Read More

LITTLE ROCK, Ark. (KTHV) — A family practitioner based in Helena has turned himself in for Medicaid fraud. The arrest is related to the October arrests of Pearlie Bailey, 63, of Hollandale, Mississippi; Charline Brandon, 61, of Cleveland, Mississippi; Clotee … Read More