The Centers for Medicare and Medicaid Services has awarded positions on a potential 10-year, $2.5 billion contract vehicle to seven companies for program integrity support services intended to help CMS and its partners identify instances of healthcare fraud, waste and abuse … Read More
The Texas Supreme Court on Friday delivered a temporary, last-minute victory to families of children with disabilities who want to stop sweeping budget cuts to a state-funded children’s therapy program. State lawmakers last year approved $350 million in budget cuts … Read More
A recent disclosure shows that Texas Attorney General Ken Paxton accepted more than $329,000 from donors and “family friends” toward his legal bills as he defends himself against securities fraud charges. As the Tribune’s Jim Malewitz writes, filings to the … Read More
JEFFERSON CITY, Mo. (KMOV.com) – A personal care attendant will serve five years probation and be ordered to pay back $25,000 to Missouri’s Medicaid Program. Yvonne Conly was originally sentenced to serve three concurrent prison sentences of five years, following her … Read More
HOUSTON – A Houston federal jury has returned guilty verdicts against four defendants on all counts as charged in a $6 million fraudulent Medicare billing scheme, announced U.S. Attorney Kenneth Magidson. Giam Nguyen, D.O., 46, of Houston, Benjamin Martinez, M.D., … Read More
In a last-ditch effort to stave off $350 million in cuts to a state Medicaid program that provides therapy to disabled children, federal and state lawmakers are asking the federal government to intervene.Families that have sued the state to stop … Read More
Updated: 8:25 p.m. Thursday, June 30, 2016 | Posted: 7:34 p.m. Thursday, June 30, 2016A state appeals court Thursday rejected Attorney General Ken Paxton’s motion to reconsider its June 1 ruling that upheld criminal charges against him.The two-sentence order from the Dallas-based … Read More
HHSC’s Inspector General is enlisting the help of managed care organizations and health care providers to fight Medicaid fraud, waste and abuse in a cooperative effort. The office’s Integrity Initiative creates a framework for managed care organizations, health care providers … Read More
Heather Griffith Peterson and Kara Crawford have joined the HHS executive leadership team. They both began June 1. “We are putting together a strong leadership team that will continue to move the Texas Health and Human Services system forward,” Health … Read More
Child Protective Services officials have killed an idea to give some of its top employee big raises. “No salary increases for regional directors will even be considered until clear improvement is seen at CPS,” said Patrick Crimmins, spokesman for the … Read More
AUSTIN — Texas state health officials once again are delaying a massive data project that has struggled to get off of the ground for more than a decade. The state Health and Human Services Commission informed lawmakers Tuesday it was pausing … Read More
In Waco, a jury returned guilty verdicts against 55–year-old DTS Medical Supply Company owner Daniel Thomason Smith and 45-year-old DTS office manager Kathleen Marina Kelly-Tuorila in connection with an estimated $3.5 million Health Care Fraud scheme announced United States Attorney … Read More
Three North Texas cab company executives and their entities have agreed to pay the U.S. more than $1 million to resolve Medicaid fraud allegations. Jackie Bewley, Jeff Finkel and Elizabeth George — all executives at Irving Holdings, the parent company of … Read More
More than 300 people across the nation — including 22 in the Houston area and seven in McAllen — have been charged with stealing more than $900 million in what federal investigators say is the “largest Medicare fraud takedown in … Read More
Attorney General Loretta E. Lynch and Department of Health and Human Services (HHS) Secretary Sylvia Mathews Burwell announced today an unprecedented nationwide sweep led by the Medicare Fraud Strike Force in 36 federal districts, resulting in criminal and civil charges … Read More
A Chickasaw County nurse is headed to prison for one year after pleading guilty to Medicaid fraud, Mississippi Attorney General Jim Hood announced Tuesday. Cheryl Renee Hamblet, 42, of Houston, appeared before Choctaw County Circuit Court Judge Joseph H. Loper … Read More
Although they are more likely to graduate from high school and less likely to abuse drugs compared with prior years, children are worse off in Texas than their peers in all but seven states, a study says. According to its … Read More
Like many parents of children with autism, Braulio De La Cruz sought an expensive therapy called applied behavioral analysis — or ABA – when his son Noah Leonardo was diagnosed last year. Noah, now 3 years old, qualifies for Medicaid … Read More
Today, Health and Human Services (HHS) Secretary Sylvia M. Burwell announced nearly $156 million in funding to support 420 health centers in 47 states, the District of Columbia and Puerto Rico to increase access to integrated oral health care services … Read More
The federal government will soon unveil a new contractor program aimed at fraud in both the Medicare and Medicaid programs, according to an official with the Centers for Medicare & Medicaid Services. The new Unified Program Integrity Contractor program will … Read More
AUSTIN – Gary Jessee will lead the newly created Medical and Social Services division of the Health and Human Services system, HHS Executive Commissioner Charles Smith announced today. Jessee, who is currently the state Medicaid director, will become deputy executive … Read More
The New Jersey Office of the State Comptroller, Medicaid Fraud Division, did not always suspend Medicaid payments to providers with credible allegations of fraud in accordance with the Affordable Care Act. Of the 49 providers with credible allegations of fraud … Read More
Donald Trump told Bloomberg Politics Wednesday that he won’t be choosing former Gov. Rick Perry as his running mate, but would like to find some role for him in his administration. “I like him,” Trump said of Perry in the … Read More
WHY WE DID THIS STUDY OIG administers the Medicaid Fraud Control Unit (MFCU or Unit) grant awards, annually recertifies the Units, and oversees the Units’ performance in accordance with the requirements of the grant. As part of this oversight, OIG … Read More
From October 1, 2009, through September 30, 2012, the Washington State Health Care Authority (State agency) claimed $117,000 in unallowable Federal Medicaid reimbursement for dental services. The unallowable payments consisted of (1) duplicate payments, (2) payments for services that were … Read More
“Last Week Tonight” host John Oliver made television history when he paid off nearly $15 million of debt from Texas on last night’s show. For 20 minutes, Oliver focused on the systems behind debt collecting and the corruption surrounding them. The episode explained … Read More
AUSTIN — The Texas Medicaid program, under pressure from lawmakers, is again proposing significant cuts in pay for therapists who treat more than a quarter-million disabled children and elderly Texans. On Friday, the Texas Association for Home Care & Hospice … Read More
Texas Gov. Greg Abbott and Comptroller Glenn Hegar stepped into the conversation around “emergency leave” on Wednesday, ordering state agencies to stop using the system as a form of severance pay. State employees in Texas are not awarded severance pay when … Read More
The Texas Ethics Commission on Tuesday unanimously approved a new rule aimed at restricting when lobbyists can pay for state lawmakers and officials to go on so-called fact-finding trips that critics say sometimes amount to little more than lavish junkets … Read More
AUSTIN — A Democratic advocacy group has asked the Texas Rangers, Travis County district attorney and State Auditor’s Office to investigate whether several state agencies misused taxpayer money to pay employees long after they left their jobs. The Lone Star Project on Tuesday sent letters … Read More
Should taxpayers pay severance to state employees to take the sting out of unexpected job losses or to protect the uncovered tails of the elected officeholders who fire them? The state’s legislative budget writers have promised to dig into stories … Read More
Americans who live in the two biggest states that haven’t expanded Medicaid have more complaints about health care costs and quality, according to a new survey released by the Texas Medical Center Health Policy Institute in Houston. They’d also like … Read More
After reports of state agencies keeping former employees on the payroll after they stopped working, Texas Attorney General Ken Paxton and other agency heads have taken heat for stretching the rules on paid “emergency leave” to keep the ex-workers on … Read More
HOUSTON – A 20-count federal indictment has been unsealed following the arrest of the owner of KMD Healthcare Services Inc., and his brother on charges they engaged in a conspiracy involving fraudulent Medicare and Medicaid billing for ambulance services, announced … Read More
Subpar provider enrollment screening processes continue to plague Medicare and Medicaid, leaving both programs vulnerable to fraud and contributing to nearly $90 billion in improper payments in 2015, according to testimony during a House subcommittee hearing. In her testimony Tuesday, Ann … Read More
The prosecution and defense in the case of Dr. Howard S. Schneider, 78, each hired medical experts to diagnose Schneider, who has pleaded not guilty to those charges and one count of scheme to defraud. Schneider’s trial was set to … Read More
AUSTIN — Leaders in the Senate and House vowed Tuesday to crack down on widespread misuse of so-called emergency leave following reports by The Dallas Morning News that detailed dozens of cases in which employees continued to be paid months … Read More
A 36-year-old woman from Lubbock, Texas, Paula McNeal, who pleaded guilty in January 2016 to one count of health care fraud, was sentenced today by Senior U.S. District Judge Sam R. Cummings to 18 months in federal prison and ordered … Read More
AUSTIN – Texas Land Commissioner George P. Bush has spent nearly $1 million in taxpayer money to entice dozens of people fired by his administration to agree not to sue him or the agency, a practice that may run afoul … Read More
Bolstered by the federal health care law, the number of lower-income kids getting health coverage continues to rise. During 2014, the first full year of the law’s implementation, 91 percent of children who were eligible for Medicaid or the Children’s … Read More
