Texas could bring home $7 billion annually in federal dollars and cover more than a million uninsured U.S. adults today. Instead, Texans are stuck in the health care “coverage gap” — lacking the uninsured’s access to health insurance because they … Read More
November 6, 2015 — Adults enrolled in Medicaid may be living with unresolved dental problems, according to a new study. Almost half of the adults in the study who visited an emergency department (ED) for dental care did not visit … Read More
The federal government has warned Texas that it cannot block Medicaid participants from “qualified providers of their choice” or because of the provider’s “scope of practice.” In doing so, the U.S. Department of Health and Human Services has essentially put … Read More
SAN ANTONIO — The Texas health commission soon will begin a new project to fight waste, fraud and abuse in the state Medicaid program, a year after another anti-fraud effort fell apart in scandal. The “integrity initiative,” to be launched later … Read More
After more than a decade at the job, State Auditor John Keel plans to retire as of Jan. 4, his office confirmed Monday. “When I accepted my current job on Dec. 1, 2004, I expected to be here approximately 6 … Read More
The Health and Human Services Commission ruled Monday that it followed state contracting rules when it doled out a $68 million technology deal in September and that it doesn’t have to rebid the job. Deputy Executive Commissioner Ron Pigott dismissed … Read More
Gary Jessee, a 20-year veteran of state service, will be Texas’ new state Medicaid director, Health and Human Services Executive Commissioner Chris Traylor announced Oct. 30. Jessee, who has served three years as the Medicaid/CHIP Division’s chief deputy director for … Read More
When Lieutenant Governor Dan Patrick took to the mic on Texas Independence Day in March, he did so with the air of a man rallying his people before an alien invasion. “On March 2, 1836, a group of patriots gathered … Read More
HOUSTON—A Houston businessman has entered a guilty plea to engaging in a conspiracy to defraud Medicare of more than $6.6 million, announced U.S. Attorney Kenneth Magidson. At a hearing held today before U.S. District Kenneth Ellison, Robert Manning, 60, admitted … Read More
Texas officials are giving up on recovering most of the hundreds of millions of dollars spent on questionable Medicaid dental and orthodontic procedures. After years of an ongoing scandal over fraudulent billing and courtroom losses, the commission that oversees Medicaid … Read More
A House leader said Thursday that he plans to investigate the state’s oversight of a major technology contractor after Attorney General Ken Paxton alerted lawmakers to cost overruns in a contract. Earlier this week, Paxton aides informed GOP state leaders’ offices … Read More
Stuart Bowen, the inspector general of the Texas Health and Human Services Commission, told The Dallas Morning News that a whistleblower alleging Medicaid fraud at Texas Planned Parenthood clinics spurred the agency’s investigation. The Daily Signal previously reported that inspectors from the … Read More
The editorial board of the Austin American Statesman has called the decision by Texas “lawmakers and state officials” to investigate Planned Parenthood for Medicaid fraud part of a “witch hunt” that won’t stop until the health care provider “is completely dismantled … Read More
The Governor of the State of Texas said he hopes Planned Parenthood files legal action against their move to cut off Medicaid funding to the abortion biz so he can put their officials under oath. Newly-elected Governor Greg Abbot told … Read More
The Obama administration has warned state officials that pushing Planned Parenthood out of the state’s Medicaid program could put Texas at odds with federal law. Officials with the federal Centers for Medicare & Medicaid Services contacted the state Medicaid director on Tuesday … Read More
Texas health officials have asked an appeals court for permission to proceed with cutting payments to a therapy program for children with disabilities — the latest development in an ongoing lawsuit over the budget state lawmakers crafted this year. The … Read More
If Planned Parenthood has been billing Texas Medicaid for services it hasn’t been rendering, as Gov. Greg Abbott and state health officials suggested this week, it makes sense to cut off the money and go after the organization for whatever it stole. But … Read More
CARSON CITY — A dentist who overbilled Nevada’s Medicaid program by $285,000 has moved out of state and is under scrutiny by federal officials, the Legislative Commission was told Tuesday. Legislative auditors earlier this year found that the dentist, who … Read More
The top manager of the teacher’s pension fund received more than $2.2 million on top of his $504,000 a year salary. A lawyer making $153,000 a year at the General Land Office took home an extra $147,000. The Department of … Read More
Viju Mathew wanted to make sure that his wife could take care of their mentally disabled adult son and 4-year-old daughter, his lawyers say, so he agreed to plead guilty to federal health care fraud charges.But seven months later, his … Read More
A Santa Fe judge on Friday called a decision by Gov. Susana Martinez’s administration to withhold Medicaid funds from a behavioral health care agency “arbitrary, capricious or otherwise not in accordance with the law.” The decision by state First District … Read More
October 22, 2015 — The Indiana Attorney General’s Office has reached a settlement agreement on October 22 with Aspen Dental Management (ADMI), resolving allegations that the company used deceptive advertising and other unfair tactics to promote services at Aspen Dental-branded … Read More
The Obama administration just announced that fighting Medicaid fraud is going to be a “key priority” for the final year of the president’s term. That’s a tall order. Last year, the program lost more than $17 billion to fraud. That’s … Read More
As Congress stalls in its attempts to defund Planned Parenthood, a handful of states have succeeded in hitting the organization where it hurts. Texas announced Monday it will strip Planned Parenthood of its Medicaid funds after a 3-year video investigation captured … Read More
Advocates of Medicaid expansion in Texas often highlight our state’s record of the largest uninsured population in the nation, according to a recent U.S. Census Bureau report. Though the uninsured rate is falling, advocates say, it would fall even faster … Read More
In what may be the largest example of medicaid fraud in Nebraska’s history, investigators missed red flags that could’ve potentially saved millions. Now, the state wants to make sure it never happens again. Two weeks ago we told you about … Read More
EAST ST. LOUIS — A Brighton woman pleaded guilty Tuesday to engaging in a scheme to defraud a health care program. In a press release Wednesday, U.S. Attorney Stephen R. Wigginton said sentencing for Jessica A. Teets, 27, has been … Read More
PULASKI COUNTY (KATV) — A 32-year-old man from Desoto, Texas, was arrested for Medicaid fraud. Arkansas Attorney General Leslie Rutledge announced the arrest of DeAndre L. Taybore Tuesday by the Attorney General’s Medicaid Fraud Control Unit. He is accused of … Read More
BROOKLINE, Mass., Oct. 13, 2015 /PRNewswire/ — Bharani Padmanabhan MD PhD, a multiple sclerosis neurologist practicing in theBoston area who is called Dr. Bharani by patients and colleagues, filed a lawsuit in Federal court alleging massive violations of the Computer Fraud … Read More
Texas was within eight days of slashing the amount of money it pays therapists for poor and disabled children when a state district judge last month stepped in and blocked the move. It was the latest round in a high-profile … Read More
LITTLE ROCK, Ark. (Arkansas AG) – Arkansas Attorney General Leslie Rutledge announced the arrest of a Pulaski County man by the Attorney General’s Medicaid Fraud Control Unit. Myron Thrash, 35, of Little Rock was arrested on one count of Medicaid … Read More
Washington, DC – The nation’s second-largest nursing home pharmacy, PharMerica Corp., has agreed to pay $9.25 million to resolve allegations that it solicited and received kickbacks from pharmaceutical manufacturer Abbott Laboratories in exchange for promoting the prescription drug Depakote for … Read More
Congress and the President have two months to hammer out a budget before the country teeters on another fiscal cliff. One big issue is the $85 billion in spending cuts on defense and domestic programs imposed by the sequester. Some … Read More
HOUSTON—The owner and operator of Elite P Care Medical Services has been convicted of conspiracy to commit health care fraud and health care fraud in a $1 million fraud scheme, announced United States Attorney Kenneth Magidson. Verona Spicer, 46, pleaded … Read More
Jack Stick says he’s “the whipping boy,” the guy who became the face of the 21CT contract scandal as Texas officials pointed fingers and scrambled to save their own jobs. “I think in December of last year, people began to … Read More
Following an outcry from dozens of state lawmakers, Texas’ top health agency announced Thursday it will make less drastic cuts than originally planned to a therapy program for children with disabilities, even if that means spending more than lawmakers budgeted for the … Read More
The gap in dental care utilization in the U.S. narrowed between children enrolled in Medicaid and those with private dental benefits from 2005 to 2013, but a large gap remains between adults in those categories, according to a new research … Read More
EDINBURG — The new head of the state health agency’s investigative division visited with stakeholders in Hidalgo County Wednesday to learn about local healthcare issues and promote his vision. Stuart Bowen Jr., inspector general for the Texas Health and Human … Read More
Medicare spent more than $30 million during the first half of 2012 on ambulance transports for patients that appear to be ghosts on paper, according to a new report released by the Office of Inspector General (OIG) Tuesday. The report revealed … Read More
With more large-scale, multi-million dollar fraud schemes surfacing across the country, enforcement officials are utilizing Medicare Fraud Strike Force teams to dismantle entire fraud operations. Source: Anatomy of a fraud bust: Collaboration creates efficiency
