HOUSTON (CN) — Texas’s Medicaid reimbursement policy violates federal rules and should be put on hold because it leaves some health care providers “holding the bag,” a federal judge ruled. The Texas Children’s Health Plan denied about 2,000 claims that … Read More
A key domestic policy directive presidential aspirant Donald Trump made to Congress as a way to reform the healthcare system is to “block-grant Medicaid to the states.”The health insurance program for poor Americans, which is funded by a matching formula of state … Read More
Nevada Attorney General Adam Paul Laxalt announced that Mamie Ree Hubbard-Washington, 73, of Las Vegas, was sentenced for Medicaid fraud. The fraud was committed between April and August 2012. Eighth Judicial District Court Judge Michelle Leavitt sentenced Hubbard-Washington to one … Read More
Hospitals in the Dallas-Fort Worth region were overpaid by $27 million in federal funds to provide health care for the uninsured, according to a new order from the Obama administration, which is threatening to take the money back. Federal health … Read More
KIMT News 3 – Gary Holland recently needed some work done on his teeth, but he’s on Medicaid and ran into some problems. “Once you get registered with Medicaid you almost can’t switch doctors and your dentist and I called … Read More
A former Seymour dentist faces felony charges related to an investigation into the false billing of the state’s Medicaid program for dental treatments he allegedly did not perform on patients, a Marion County official reports. Dr. James Judd, 69, has … Read More
A pediatric dental provider with practices in Milford and West Haven will pay more than $1.3 million to the state and federal government to resolve allegations that he submitted false claims to Connecticut’s Medicaid program for x-ray services that did … Read More
May 17, 2016 – A company that manages dental benefits for the state children’s health insurance program is fighting the release of records it says contain “trade secrets.” Managed Care of North America (MCNA) sued the Florida Healthy Kids Corp. after it … Read More
Former Gov. Rick Perry may be taking a break from campaigning to bust a move on the dance floor, following reports from an entertainment website that the politician may be joining the next season of “Dancing With the Stars.” As … Read More
An Idaho 4th District judge has ordered a Florida dental services contractor to disclose nearly 100 pages of material from its successful bid for an Idaho Medicaid contract that the company had claimed was exempt from public disclosure as trade … Read More
When FBI and Health and Human Services investigators announced earlier this summer they had snared more than 300 people trying to bilk Medicare out of $900 million, one might have concluded the corner had been turned in the fight against … Read More
A controversial whistle-blowing investigator for the state Office of Medicaid Inspector General has been reinstated by a labor arbitrator who says higher-ups at the agency placed him on paid suspension in 2012, and then forgot about him. A few months … Read More
Health care realities for Georgia’s at-risk children often resemble something out of Dickens. And it’s not always just the abjectly poor who suffer, but also those who fall into the gaps between those eligible for public assistance and those whose … Read More
At a Managed Medicaid Town Hall meeting in May, state Sen. Juan “Chuy” Hinojosa, D-McAllen, heard numerous concerns about Medicaid reimbursement (payment) schedules and the large losses that McAllen area hospitals are experiencing when these institutions care for Medicaid patients. … Read More
The irony of Barb Lewis’ situation is that if she wasn’t so poor, she wouldn’t risk losing what little she has. The Iowa City woman, who is among the 13 percent of Iowans who live in poverty, discovered this year that … Read More
Three hospitals in New York’s Mount Sinai Health System will pay $2.95 million to settle Medicaid fraud charges for taking two years to repay more than $844,000 of improper billings that had been flagged by a whistleblower, authorities said on … Read More
GOP presidential nominee Donald Trump strongly praised Rick Perry when asked at an Austin fundraiser on Tuesday about the possibility of the former governor challenging U.S. Sen. Ted Cruz in a Republican primary. “I’ve been hearing a lot about that … Read More
SALT LAKE CITY (AP) A recent Utah state audit has revealed that Medicaid money was used to pay for a small number of ineligible controlled-substance prescriptions. The Salt Lake Tribune reports (http://bit.ly/2b6sFjH ) that the Auditor’s Office found several problems … Read More
A Swanton woman has been convicted of Medicaid fraud and ordered to serve prison time after she submitted false time sheets claiming three employees had provided personal care services to her children. Karen Tucker pleaded guilty and was convicted of four counts of Medicaid … Read More
This week, Pennsylvania’s Department of Human Services expects to award Medicaid contracts worth more than $7 billion annually that cover almost 421,000 low-income, disabled adults. But the contracts were scheduled to be awarded in June, raising questions about why state … Read More
LITTLE ROCK – Arkansas Attorney General Leslie Rutledge today announced the conviction of eastern Arkansans for Medicaid fraud. Andrea Jefferson of Crittenden County pleaded guilty in Pulaski County District Court. She has been ordered to pay $470 in restitution to … Read More
The weekend can’t come fast enough for the Texas Health and Human Services Commission. On Wednesday, federal officials asked the state’s largest agency to return $57,884,268, the federal share of $95,359,841 in supplemental payments to doctors made improperly from 2004 to … Read More
The U.S. Department of Health and Human Services (HHS) released a report from its Office of the Inspector General (OIG) regarding the wireless networks of the Centers for Medicare & Medicaid Services’ (CMS) facilities. The report shows that CMS, which collects … Read More
Edith Stowe, 83, waited patiently on a recent afternoon at the bus stop outside MedStar Washington Hospital Center in the District of Columbia. It’s become routine for her, but that doesn’t make it any easier. Stowe, who lives about five … Read More
Computer giant Hewlett Packard Enterprises has entered into a $215 million contract with the state of Kansas to upgrade a Medicaid computer system that tracks patient claims payments to providers. According to a recent news release from the California-based company, … Read More
The state of Colorado could have to pay back more than $38 million it received in bonuses from the federal government for enrolling more children in Medicaid, after an audit concluded the state received money for kids who didn’t qualify.The audit was conducted by … Read More
In 2015, the Government Accountability Office (GAO) estimated that taxpayers lost $136 billion to improper payments, a low-end estimate that mostly came from Medicare and Medicaid. The two popular and costly federal health care programs are growing rapidly, yet they … Read More
A Baker woman accused of defrauding Louisiana to the tune of $1 million-plus in a Medicaid fraud scheme has been sentenced to five years in prison. Even though 38-year-old Chanda Hall pleaded guilty in April to a racketeering charge, The … Read More
HARTFORD — A state court has ordered a Winsted dentist to pay $717,046 in restitution and fines for bilking the state’s Medicaid program, including using unlicensed assistants to provide pediatric dental cleanings and fluoride treatments. http://rep-am.com/news/local/974243.txt Republican American
DALLAS C The Estate of Dr. Kenneth Michael Rice and UMC Physicians (UMCP) have agreed to pay a total of $3,280,000.00 to the United States and the State of Texas to settle allegations that Dr. Rice and UMCP violated the … Read More
AUSTIN — The lawyer for a whistleblower who sued a top Ken Paxton donor said he was unaware the donor gave $100,000 to the attorney general during an investigation into his client’s claims, and he wants proof that it did … Read More
August 2, 2016 — A project designed to improve the oral health of children up to 5 years old succeeded in getting more kids to the dentist. The 21st Century Dental Homes Project achieved the goal by tackling common barriers … Read More
A woman has been sentenced to three years in prison for Medicaid fraud. Delphine Lucas, 50, pleaded guilty to one felony count of vendor fraud on July 7, according to a statement from Illinois State Police. She has since been … Read More
If the irony of Ken Paxton being Texas’ attorney general were a wall, it would be a huge, magnificent wall growing taller by the day. As the state’s top legal authority, an attorney general is expected to be above ethical … Read More
AUSTIN — A top lawyer at the attorney general’s office was fired last year when she raised concerns that her bosses were breaking federal rules as they scrambled to salvage a foundering technology deal that has cost taxpayers hundreds of millions of dollars. After Martha … Read More
There may be, strictly speaking, a question on the legality, but there is no question on the ethics. Attorney General Ken Paxton was wrong to accept a gift from a party under investigation by his office.Last year, Preferred Imaging founder … Read More
LITTLE ROCK (KATV) — Arkansas Attorney General Leslie Rutledge announced the sentence of a Johnson County woman who pleaded guilty to Medicaid fraud. Sherry Wommack, 46, was sentenced to three years of probation and ordered to pay a $600 fine, … Read More
July 29, 2016 — Is it possible to recreate the dental service organization (DSO) model and put the dentist and the patient first, not the organization? An industry veteran has launched a new DSO called Avitus Dental Management Solutions in … Read More
Dang. That Ken Paxton sure seems snakebit. The Texas attorney general’s latest pratfall was the sort of mistake that your average statewide politician is — or ought to be — too paranoid to make. Paxton was indicted last year for allegedly steering people to … Read More
AUSTIN — Attorney General Ken Paxton took a $100,000 gift from a Texas CEO who was being investigated for Medicare and Medicaid fraud, but he had no knowledge of the probe and his agency had little to do with it, multiple agencies … Read More
