Last year, the Texas legislature approved a $350 million cut in Medicaid reimbursement rates to early childhood intervention therapists and providers. The cuts, made to help balance a billion dollars in property tax relief, affect the most vulnerable Texas children … Read More
A recently published proposed rule expands the functions and responsibilities of state Medicaid Fraud Control Units (MFCUs). The rule was issued by the Centers for Medicare and Medicaid Services (CMS) and the Office of Inspector General (OIG) on Sept. 20 … Read More
Significant and persistent compliance, payment and fraud vulnerabilities exist within the Medicaid program that covers home care for elderly and disabled people, according to a recent report from HHS’ Office of Inspector General. In the report, the OIG highlighted some … Read More
MIAMI (AP) — A fall 2017 trial date is set for a South Florida businessman accused of orchestrating a $1 billion Medicare and Medicaid fraud scheme.Court records show a Miami federal judge on Wednesday scheduled 48-year-old Philip Esformes’ trial for … Read More
PULASKI COUNTY (KATV) — A 33-year-old Malvern woman was arrested for more than $700 in Medicaid fraud. Marquita Morgan faces a charge of Medicaid fraud. She is accused of billing more than $700 for services she didn’t receive in 2015, … Read More
Lawyers for Texas Attorney General Ken Paxton are no longer asking to have a state securities fraud case against him dismissed, moving him closer to a trial on the criminal charges. Paxton’s legal team confirmed Tuesday that it was getting … Read More
A group of physicians from around the state is suing federal health officials over a regulation that requires the doctors to repay some Medicaid reimbursements. Twenty-one primary care doctors are challenging how the U.S. Centers for Medicare and Medicaid Services … Read More
A Dallas doctor and businessman convicted of a health-care fraud conspiracy involving East Texas hospitals has been ordered to pay $1.22 million to the United States. Dr. Tariq Mahmood, a 65-year-old general practitioner from Cedar Hill, was found guilty in … Read More
Even as the share of children in Texas without health insurance continues to decline, the state still has nearly twice the national average, according to a new study. A Georgetown University Center for Children and Families report released Thursday found that Texas … Read More
SANTA FE, N.M. New Mexico is pursuing federal authority to charge medical co-payments and some other costs to patients enrolled in Medicaid health care for the poor and disabled, the state Human Services Department secretary told lawmakers on Wednesday.Secretary Brent … Read More
October 27, 2016 — A U.S. district court has ruled on October 26 that Propel Orthodontics has “disseminated false and misleading advertisements” for its tooth aligners, while granting a preliminary injunction against the company in favor of OrthoAccel Technologies.In the … Read More
Want to make some easy cash? Try defrauding Medicaid. It’s a booming business, according to the federal Centers for Medicare & Medicaid Services, which says the total amount of “improper payments” for Medicaid last year totaled more than $29 billion … Read More
HHSC ensures that policies are medically appropriate, patient-centered, transparent and based on the best available evidence. The agency’s medical and dental policies outline the types of procedures and treatments for which HHSC will pay for specific conditions. Medical practitioners, program … Read More
Overinflated promises being made for expansion of Texas’ Medicaid program remind us of two time-proven adages: “If it looks too good to be true, it probably is,” and “There ain’t no such thing as a free lunch.” Recent newspaper articles … Read More
Federal officials in recent years have increasingly worked to combat Medicare and Medicaid fraud.In fact, at the beginning of his second term, President Barack Obama made the issue a top priority, according to The Fiscal Times. Since then, there have … Read More
GRAND RAPIDS, MICH. (WZZM) – A former state lawmaker who pleaded guilty to health care fraud “considered himself beyond all reproach as a physician,’’ federal prosecutors said in asking that he be sentenced like any other person convicted of “serious … Read More
Mylan NV (NASDAQ:MYL) has agreed to pay $465 million to settle claims that the drug giant underpaid the federal government in rebates to Medicaid for its EpiPen allergy shot. However, the move is not enough. Senator Elizabeth Warren criticized the … Read More
In the latest chapter of the Obama administration’s crackdown on Medicare fraud, U.S. customs officials arrested a woman at the Dallas-Fort Worth International Airport last week who is accused of taking part in one of the biggest Medicare fraud schemes … Read More
States are beginning to turn to hospitals to cover the cost of Medicaid expansion once the federal match begins to drop next year.The Affordable Care Act provides 100% federal financing for those made newly eligible for Medicaid under the law. … Read More
Whoever wins this presidential election will have a lot of big decisions to make within their first year in office. One of those decisions is what to do about states, like Texas, that haven’t expanded Medicaid to more low income … Read More
ALBANY — The luxury rides that belonged to a crooked Bronx pill peddler can be yours for the right price.State officials are about to sell at auction a 2014 Maserati Gran Turismo and a 2014 BMW X6 seized by the … Read More
You can tell a lot about a person by a smile.A simple, straightforward, sincere smile can attract more than admiring looks. A smiling face tells people that you’re an outgoing and intelligent person worth getting to know.Beside showing off a … Read More
The U.S. Securities and Exchange Commission is not giving up on its case against Attorney General Ken Paxton. The commission filed amended civil charges against Paxton on Friday, two weeks after a federal judge dismissed the case. Paxton, who is also fighting similar criminal charges … Read More
Feeding on outrage sparked by the release of controversial undercover videos of Planned Parenthood officials, Gov. Greg Abbott vowed one year ago to cut off $3.1 million in Medicaid funding that the organization’s Texas affiliates receive to provide family planning … Read More
A Valdosta dentist pled guilty to one count of health care fraud Friday morning.According to the United States Attorney’s Office for the Middle District of Georgia, Dr. Stanley Marable billed Medicaid nearly $800,000 for teeth extraction that he did not … Read More
PULASKI COUNTY (KATV) — A 49-year-old Conway woman was arrested accused of $3,500 in Medicaid fraud.Georgia Broady faces one count of Medicaid fraud. The arrest was announced by Arkansas Attorney General Leslie Rutledge. Source: Conway woman arrested for $3,500 in … Read More
Former Texas Gov. Rick Perry has joined the board of a stem cell company where he underwent experimental back surgery before running for president in 2011 — a procedure that didn’t calm the chronic pain that he later blamed for … Read More
Access to dental care appears to be a struggle for Central Oregon’s Medicaid patients, according to a new report based on surveys from about 3,900 members.The region’s coordinated care organization, the group that takes in state funding and uses it … Read More
The highest criminal court in Texas said Wednesday it will not hear Ken Paxton’s appeal of securities fraud charges, putting the attorney general on a path to facing a trial in the coming months. “Today’s ruling marks an end to … Read More
Drugmaker Mylan will pay $465 million to settle allegations that it overbilled Medicaid for its life-saving EpiPen, ending one of the controversies over the soaring price of the emergency allergy injection.The settlement with the Department of Justice follows news that … Read More
A decadent, eight-bedroom mansion with its own water park in the backyard is hitting the market for $32million. You’d be forgiven for thinking the manor was owned by a European lord in the French countryside, but the Dallas, Texas, estate … Read More
A judge has thrown out the federal civil case accusing Attorney General Ken Paxton of securities fraud, giving him his biggest legal victory yet since the allegations surfaced more than a year ago. U.S. District Judge Amos L. Mazzant III on … Read More
ATLANTA–(BUSINESS WIRE)–Amerigroup Community Care, a Georgia statewide provider of Medicaid managed care services, has partnered with DentaQuest to launch Dental Home services to its members. The Patient-Centered Dental Home model connects each member to a personal dentist who leads a … Read More
It all started with a battle over information: In one corner was the Texas Health and Human Services Commission. In the other were Texas lawmakers. The commission holds the details of the state’s Medicaid contracts with large pharmaceutical companies, which show … Read More
Two of Tenet Healthcare Corp.’s former subsidiaries admitted to conspiring to defraud Medicaid by using referral contracts for translation services to funnel pregnant patients through their doors.Atlanta Medical Center and North Fulton Hospital in Georgia each pled guilty to one … Read More
When it comes to a patient’s health, the old phrase, “The doctor knows best,” still rings true, especially for medications. When the Texas Legislature meets in January, there will be plenty of budget and policy battles waged. The battles fought over one of … Read More
CBS – Baby boomers are expected to need more in-home care as they age, but federal investigators are now raising an alarm over what they call persistent fraud and abuse in Medicaid-funded personal care services.Investigators from the Department of Health … Read More
Nearly 300 East Texas children with disabilities who are part of the state’s Early Childhood Intervention program have no one to provide them with medically necessary therapies after the region’s lone provider closed its doors this week in response to hefty budget cuts … Read More
Although mandatory pediatric dental insurance was included in U.S. healthcare reform, coverage is a stark departure from the benefits envisioned by the Patient Protection and Affordable Care Act and those required under Medicaid, according to a new report. Coverage isn’t … Read More
September 29, 2016 — A class-action lawsuit against three of the dental industry’s biggest companies will be allowed to proceed after a U.S. District Court judge refused to dismiss the proposed litigation, according to multiple reports.U.S. District Judge Brian M. … Read More
