A federal judge has again thrown out securities fraud charges against Texas Attorney General Ken Paxton, effectively ending one of two legal battles that have dogged Paxton for close to a year. U.S. District Judge Amos Mazzant on Thursday dismissed … Read More
All 50 states, the District of Columbia, and Congress are all having the same nightmare. It is called Medicaid. Now there is a chance to turn bad dreams into great, big happy ones. Texas is in a unique position to … Read More
MCALLEN – A McAllen woman is waiting to learn her sentence after she was convicted in connection with a Medicaid fraud scheme. Federal prosecutors said 41-year-old Maria Garza was found guilty on 18 counts to defraud Texas Medicaid. Authorities said … Read More
U.S. President Donald Trump’s first budget proposal will spare big social welfare programs such as Social Security and Medicare from any cuts, Treasury Secretary Steven Mnuchin said in an interview broadcast on Sunday. Mnuchin said Trump would use his first … Read More
Over 65,000 ineligible providers have been culled from the Medicaid program due to a component of the Affordable Care Act that requires periodic recertification of eligibility, according to Modern Healthcare. The measure, which was meant to prevent fraud and inefficiency, … Read More
Law360, Dallas (February 21, 2017, 6:33 PM EST) — Xerox Corp. accused Texas of using a “web of lawsuits” to divide and conquer in a $1 billion civil Medicaid fraud suit over allegedly unneeded orthodontics, telling the Texas Supreme Court … Read More
U.S. District Judge Sam Sparks ruled Tuesday afternoon that Texas clinics affiliated with Planned Parenthood can continue to care for patients under the state’s Medicaid program, a phew-worthy victory for reproductive rights advocates and a loss for the state’s GOP leaders. In … Read More
How to deal with Medicaid expansion has become the latest sticking point in Republicans’ effort to dismantle the Affordable Care Act. While most lawmakers acknowledge it’s a major source of tension, there appears to have not been any decisions made … Read More
ATLANTA (AP) — An Atlanta-area dentist has been sentenced to a year and six months in federal prison for filing nearly $1 million in false claims with Georgia’s Medicaid program. U.S. Attorney John Horn, in a news release Wednesday, said … Read More
Facing 19 years in prison after losing his pediatric dentistry practice on charges of Medicaid fraud and accusations of child abuse, Howard Schneider was deemed incompetent for trial Wednesday, according to Times-Union news partner First Coast News. The decision, passed down … Read More
In the first nine months of 2016, just 28.2 million Americans, or 8.8 percent, were uninsured, according to survey data from the CDC. That’s 20.4 million fewer Americans than in 2010, when the ACA was signed into law, and 0.4 … Read More
McALLEN — Prosecutor Michael Edward Day stood before a federal jury Tuesday to deliver his opening statement in a case connected to the largest healthcare fraud takedown in U.S. history, and repeated an ominous saying three times in Spanish. Paz, … Read More
After initially scoring last among four bidders, a Florida company won a contract to manage dental benefits provided to Arkansas Medicaid recipients after the state’s procurement director on Friday disqualified two of the other bidders. The ruling cleared the way … Read More
McALLEN — A Mission doctor accused of submitting false Medicaid claims for patients who were deceased pleaded guilty to the charges Tuesday. Dr. Pedro Garcia, 68, went before federal District Judge Ricardo Hinojosa and pleaded guilty to conspiracy to commit … Read More
BOSTON (Legal Newsline) — Massachusetts Attorney General Maura Healey announced Jan. 25 that Newton dentist Dr. Julia Faigel and her 21 corporations will pay a total of $475,000 following allegations of improperly billing the state’s Medicaid system. “This pattern of … Read More
Lee College’s Center for Workforce and Community Development will host two free health care fraud prevention seminars on Feb. 28. “We’re excited to offer both a morning and evening presentation to the public. It’s an important topic, and we want … Read More
AUSTIN—Pointing to significant taxpayer savings and more efficient care, the Texas Association of Business (TAB) today urged the Texas Legislature to allow for the transition of the Medicaid prescription drug benefit to private health plan management to occur as scheduled. … Read More
Medicaid is a joint federal-state health care program for low income and medically needy people, with an estimated $36 billion in improper payments in fiscal year 2016. We’ve identified some ways to reduce these errors, such as by confirming that … Read More
It’s light on details, but so far the Trump administration has proposed one big change to how we pay for health care in the U.S. President Trump wants to turn the federal Medicaid program into a block grant system. This … Read More
A former Tenet Healthcare Corp. VP is the first executive of the Dallas-based hospital chain to be charged for an alleged role in defrauding Medicaid through a $400 million kickback scheme. John Holland, 60, pleaded not guilty Wednesday in a … Read More
January 31, 2017 — Policy experts discussed what dental care might look like under U.S. President Donald Trump and the new Congress during a January 24 webinar. The panelists were particularly concerned about children’s dental benefits if the Patient Protection … Read More
As Texas House and Senate leaders gird for a high-stakes fight over the state budget, a preliminary round of that showdown is taking shape over whether to partially undo cuts to a Medicaid program that reimburses therapists who serve low-income … Read More
A mother and son were convicted of crimes related to a $7 million home healthcare fraud conspiracy in which they provided forged documents and fraudulent forms to bill for services that were not provided. Delores L. Knight, 70, of Cleveland … Read More
Poor Americans insured by Medicaid will pay more out-of-pocket toward their healthcare services under proposals favored by Dr. Tom Price, Donald Trump’s pick to be U.S. Secretary of Health and Human Services. During the first of two committee hearings he … Read More
States may receive their Medicaid funding in block grants under President Donald Trump’s plan to replace the Affordable Care Act, one of his advisers reported this weekend. White House adviser Kellyanne Conway, appearing on Sunday Today, said that moving the … Read More
The administrator of five Houston-area home health agencies pleaded guilty today to conspiring to defraud the State of Texas’ Medicaid-funded Home and Community-Based Service and the Primary Home Care Programs of more than $7.8 million. These programs provide qualified individuals … Read More
MCALLEN – The owner of a Rio Grande Valley medical equipment company accused of trying to defraud state Medicaid was arrested on Thursday. Anna Ramirez-Ambriz faces six counts of healthcare fraud and three counts of aggravated identity theft. A federal … Read More
The Health Insurance Portability and Accountability Act of 1996 (HIPAA) established a national Health Care Fraud and Abuse Control Program (HCFAC or the Program) under the joint direction of the Attorney General and the Secretary of the Department of Health … Read More
Update 3:30 p.m.: U.S. District Judge Sam Sparks issued a temporary order Thursday blocking Texas officials from ousting Planned Parenthood as a Medicaid provider — a termination set to take place Saturday.Sparks did not rule on the merits of the … Read More
The Texas Attorney General’s office has accused some of the state’s largest pharmacies of cheating the Medicaid program by reporting exaggerated prices on medications and raking in larger reimbursements than they deserve. And while several pharmacies have settled with the … Read More
AUSTIN – The leaders of the Texas Legislature appear to be unwilling or unable to hire a state auditor, an unprecedented situation that has deprived residents of their most powerful government watchdog for more than a year. Lt. Gov. Dan … Read More
*UPDATE – According to the Statesman, Rick Perry resigned from MCNA and other firms December 31. Former Gov. Rick Perry, who saw a financial windfall in the private sector thanks in part to wealthy donors he cultivated while in state … Read More
Texas Attorney General Ken Paxton’s trial on criminal securities fraud charges is set to begin May 1. Jury selection will be held April 20-21 and April 27-28, according to a recent order by George Gallagher, the judge presiding over Paxton’s … Read More
DALLAS – Texas-based MB2 Dental Solutions (MB2) and 21 pediatric dental practices affiliated with MB2, along with their owners and marketing chief, have agreed to pay the United States and the State of Texas Medicaid program $8.45 million to resolve … Read More
Tony Soprano would be outraged; Governor Chris Christie and New Jersey’s congressional delegation should be. Every year, the state of New Jersey loses enormous wealth through the Medicaid program. As it happens, its neighbor to the north is gaining almost … Read More
New Jersey improperly claimed at least $94.8 million in Medicaid reimbursement claims, according to a recent estimate from HHS’ Office of Inspector General. Out of 100 claims from a random sample OIG investigated, 92 did not comply with federal or … Read More
Enrollment in Medicaid and CHIP has grown by nearly 17 million people since the Affordable Care Act was enacted, according to the Centers for Medicare and Medicaid Services. CMS compared enrollment data from October 2016 to July through September 2013, … Read More
AUSTIN — Despite three criminal indictments and a looming fraud trial, Texas Attorney General Ken Paxton raised $1.8 million in the second half of 2016, his largest six-month haul in a non-election year since he entered politics.After a brief downturn just after he was indicted … Read More
CVS Pharmacy, accused by the state of Texas of defrauding Medicaid of $30.5 million, is suing the state Health and Human Services Commission, claiming state officials approved the billing practices at the heart of the fraud case, court records show. … Read More
The statistics are encouraging: In the half a year since the state expanded access to Medicaid, doctors in Louisiana have diagnosed 1,770 cases of high blood pressure, 728 cases of diabetes and more than 90 cases of cancer.That’s good news. … Read More
