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
Democrats and their enablers in the media are hyperventilating about the GOP’s drive to cap federal Medicaid funding with a series of “block grants” to the states as part of their replacement plan for Obamacare.”25 million people could lose health … Read More
Progressives have already homed in on Republican efforts to privatize Medicare as one of the major domestic political battles of 2017. If Donald J. Trump decides to gut the basic guarantee of Medicare and revamp its structure so that it … Read More
After more than a year of delays, Texas is officially kicking Planned Parenthood out of the state’s Medicaid program. In a move that could affect thousands of low-income women, state health officials on Tuesday delivered a final legal notice to … Read More
AUSTIN, Texas (AP) — Some $350 million in cuts to a Texas Medicaid program providing therapy for disabled children have taken effect.The reductions sparked outcry after being approved by the GOP-controlled Legislature last year.They reduce revenue for some Texas therapy … Read More
On Dec. 7, 2016, just in time for the holiday season, the Office of Inspector General (OIG) released a policy statement regarding the nominal value of gifts that healthcare providers may give to Medicare and Medicaid beneficiaries. In short, the … Read More
The Illinois General Assembly opted to expand Medicaid through Obamacare in May 2013. This expansion created a new Medicaid category for able-bodied adults ages 19-64 with incomes below 138 percent of the federal poverty level. But the Medicaid program was … Read More
At 59 years old, Bill Miller is starting to have neck and back problems. Thirty-two years of bending over to check patients’ teeth and gums will do that, he said.Miller is the only dentist in Hill City, a community of … Read More
HOUSTON – Two brothers have been convicted on charges of conspiracy to commit health care fraud, health care fraud and money laundering, announced U.S. Attorney Kenneth Magidson. Kevin Olufemi Davies, 29, and his brother Melvin Olusola Davies, 28, owned and … Read More
Former Gov. Rick Perry is President-elect Donald Trump’s choice for secretary of energy, CBS and MSNBC reported Monday night.The apparent choice followed Perry’s meeting with the president elect in New York Monday, his second post-election meeting with Trump at Trump … Read More
Rick Perry, who proposed eliminating the U.S. Energy Department during his unsuccessful bid for the 2012 Republican presidential nomination, has emerged as a leading candidate to head the agency under President-elect Donald Trump, a transition official said on Sunday.Democratic U.S. … Read More
A Charlotte woman was sentenced in federal court this week to 16 years in prison for orchestrating an $11 million Medicaid fraud scheme, authorities said Thursday.Cynthia Teresa Harlan, 49, was sentenced Wednesday following a July conviction on one count each … Read More
Two former employees of an Iowa dental-office chain told authorities the company was billing Medicaid for procedures that were unnecessary or weren’t being performed – leading to a $300,000 settlement of fraud allegations. Lifepoint Dental Partners, which has five clinics, … Read More
DALLAS — Founders and investors of the physician-owned Forest Park Medical Center (FPMC) in Dallas, other executives at the hospital, and physicians, surgeons, and others affiliated with the hospital, have been charged in a federal indictment, returned by a grand … Read More
There may be help on the way for tens of thousands of disabled Texas children on the verge of losing much needed therapy to budget cuts.State House Speaker Joe Straus told the Texas Tribune lawmakers will work to make sure … Read More
The three for-profit companies managing Iowa’s Medicaid program continue to lose tens of millions of dollars on the project, a report released Wednesday shows.The companies, Amerigroup, AmeriHealth Caritas and UnitedHealthcare, reported losses ranging from 18 percent to 25 percent for … Read More
December 1, 2016 — The number of U.S. children receiving dental care significantly increased from 2000 to 2014, according to a new study in Pediatrics. Even more positively, the researchers found a steep narrowing of coverage disparities in race/ethnicity and … Read More
DALLAS (AP) – Prosecutors say a Texas woman who operated a home health care company has pleaded guilty in a case linked to more than $40 million in fraudulent services. Myrna S. Parcon pleaded guilty Tuesday in Dallas to conspiracy … Read More
President-elect Donald Trump unveiled two big health care decisions Tuesday.He picked Rep. Tom Price to head the Department of Health and Human Services and tapped Seema Verma, a health care consultant, to head the Centers for Medicare & Medicaid Services. … Read More
The idea by president-elect Donald Trump to change how Medicaid coverage for poor Americans is financed by giving block grants of money to states will face a tough time becoming a reality.Medicaid, which is jointly funded by federal and state … Read More
Operators of two Fort Defiance medical transportation companies have been sentenced to prison for health-care fraud after collecting more than $3 million from a government health program for thousands of trips that never occurred, federal prosecutors said.Sylvia Begay, 50, who operated Hozho Nahasdlii … Read More
Attorney General Ken Paxton announced today that a former Medicare provider, Chimaroke Echenwune, has been convicted of conducting fraudulent Medicare and Medicaid programs, attempting to steal more than $1.3 million through illegal practices. Echenwune worked with his wife and 13 … Read More
When President-elect Donald Trump tweeted Sunday — without evidence — that “millions” of people voted illegally in the race for the White House, he invited a wrath of condemnation for again stoking doubts about the U.S. election system. But in … Read More
A nursing home chain’s lawsuit against the state of Kansas hinges largely on the state’s failure to implement an electronic system to verify the assets of people applying for Medicaid. But Kansas is far from the only state to fall … Read More
Think less federal funding, more state control, fewer participants and higher costs for those in the program. Here’s how Medicaid works now: Nearly 73 million Americans are on Medicaid or the related Children’s Health Insurance Program (CHIP). The programs cost … Read More
