The state's $235 million settlement this week with Xerox/Conduent, its former Medicaid claims administrator, unfortunately, leaves unresolved some disturbing questions about how the company could operate its insanely irresponsible orthodontic prior authorization process for so long with state officials either looking the other way or incapable of doing anything about it. While … [Read more...]
Virginia couple accused of defrauding Medicaid
HAMPTON, Va. — A federal grand jury Thursday indicted a Hampton man and woman with conspiracy, health care fraud, false statements, and aggravated identity theft. According to allegations in the indictment, Maurice Moody, 40, and Dena Major, 48, conspired to defraud the Virginia Medicaid program out of about $109,000. The couple planned to submit fake claims to Medicaid for … [Read more...]
Whistleblowers File Motion for Their Share of $235 Million Xerox/Conduent Settlement
Dr. Christine Ellis testifying in Washington TDMR was informed yesterday that indeed there are qui tam relators associated with the Xerox/Conduent Medicaid fraud settlement and that their lawyers have now filed a motion to obtain their share of the $235 million in proceeds. The relators are Christine Ellis, DDS, Madelayne Castillo, Mary Espinoza, Mireya Miranda, Yarubi … [Read more...]
Texas Settles with Xerox for $235 Million Out of “Desire to Buy Peace and Avoid Further Litigation”
This morning Attorney General Ken Paxton announced that the State of Texas had settled its $2 billion Medicaid fraud lawsuit against Xerox/Conduent, its former Medicaid administrator from 2004 to 2012, for $235 million. The settlement over Xerox/Conduent's inadequate orthodontic prior authorization process was touted as a record recovery for Medicaid fraud in Texas. The … [Read more...]
Xerox Reaches $235M Deal to Settle Medicaid Fraud Claims
AUSTIN, Texas (CN) – Xerox and a former subsidiary agreed Tuesday to pay Texas over $235 million to settle claims they oversaw the payment of fraudulent Medicaid dental claims for over seven years. Texas Attorney General Ken Paxton said the settlement “represents the largest single resolution in a case filed” by his office regarding Medicaid fraud. Filed in Travis County … [Read more...]
Xerox Quality Assurance Checks on Ortho PAs Apparently Consisted of Re-checking the Addition of HLD Score Sheets
For those following the $2 billion Medicaid fraud case against Xerox/Conduent here in Texas, another plank in the state's case against the company is that it alleges that no meaningful Quality Assurance check was ever done to ensure medical necessity on some 500,000 orthodontic prior authorizations the company approved from 2004 to 2012. "Can't recall" Under deposition, … [Read more...]
Sentencing delayed in Texas medical equipment fraud case
McALLEN — The owner of a durable medical equipment company accused of scamming more than $4 million in Medicaid funds will not be sentenced for another two months, court records show. Anna Ramirez-Ambriz was scheduled to be sentenced earlier this week, but notes show the court has agreed to reschedule the hearing for late April. The 57-year-old woman, who owned … [Read more...]
Walgreens to Pay $269.2 To Settle Civil Fraud Lawsuits
The Walgreens Boots Alliance has agreed to pay $269.2 million to settle two separate whistleblower lawsuits accusing it of civil fraud for overbilling federal healthcare programs for over ten years. Insulin Settlement In the first suit, the chain will pay $209.2 million to resolve claims it improperly billed Medicare, Medicaid, and other federal programs from 2006 through … [Read more...]
“I approved all of them regardless” – Xerox/Conduent Dental Director on Ortho PAs
Dr. Jerry Felkner Some of the evidence that the state is using to pursue Medicaid fraud allegations against its former Medicaid claims administrator on its orthodontic prior authorization program from 2004 to 2012 comes directly from depositions of the Xerox/Conduent dental director, Dr. Jerry Felkner. Xerox/Conduent kept telling the state in their policy manuals that he was … [Read more...]
Ohio joins alleged overbilling and fraud settlement with Walgreens
COLUMBUS, Ohio (WKBN) - Ohio Attorney General Dave Yost announced on Thursday that Ohio will be joining other states in settling two whistleblower lawsuits against Walgreens Boots Alliance. According to a press release, the agreements settle allegations that Walgreens knowingly engaged in overdispensing of insulin pens to Medicare and Medicaid beneficiaries and billed … [Read more...]