Can you imagine a Texas Medicaid budget half of what it was last year? Is it possible for Medicaid patients to get a next-day appointment with their doctor? What if Austin, rather than Washington, controlled “Texas Medicaid”? Texas, can you … Read More
Full disclosure: I initially pegged this Stoneleigh residence (the very same Brant McFarlin-designed residence featured on the cover of our last issue) for this week’s “Hot Property,” but then I came across this magnificently bonkers Strait Lane estate and everything … Read More
The parents of a 14-month-old who died after a dental procedure in North Austin have filed a wrongful death lawsuit. The suit names the dentist, the dentist’s office, an anesthesiologist and the Texan Anesthesiology Association.14-month-old Daisy Lynn Torres visited Austin … Read More
COOKE COUNTY, Texas (KXII) — Sixteen people at a North Texas hospice are charged with ripping off federal taxpayers for $60 million in a Medicare fraud scheme. That includes two people from Cooke County.One is a doctor who still has … Read More
HOUSTON, TX — The owner of a medical clinic with locations in Houston and Port Arthur was sentenced this week to 33 months in federal prison after being convicted of Medicare and Medicaid fraud.Verona Spicer, 47, the owner of Elite … Read More
Medicaid Fraud Control Units delivered nearly $1.9 billion in recoveries in fiscal year 2016, according to a new data set and interactive map released Monday by federal officials. The data and the map, put out by the Office of Inspector … Read More
The Government Accountability Office recently issued a pair of reports within days of one another critical of how the Medicaid program gathers data and screens its provider participants. Medicaid, by far, is the leading source of payment for long-term care … Read More
AUSTIN (KXAN) — As GOP leaders unveil and move their replacement plan for the Affordable Care Act through Congress, millions of Texans will be watching. Hundreds showed up Monday to protest changes to Medicaid by making it a “block grant,” … Read More
WASHINGTON (AP) — House Republicans on Monday released their long-awaited plan for unraveling former President Barack Obama’s health care law, a package that would scale back the government’s role in helping people afford coverage and likely leave more Americans uninsured. … Read More
The chief budget writer in the Texas House on Friday proposed using $1.4 billion from the state’s savings account to pay bills coming due for a wide array of the state’s health and human services programs. The proposal from state … Read More
WASHINGTON — The U.S. Senate approved the confirmation of Rick Perry as the next secretary of the Department of Energy on Thursday. The vote was 62-37, and included the support of both Texans in the chamber, U.S. Sens. John Cornyn and Ted Cruz. … Read More
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
