After more than a year of delays, Texas is officially kicking Planned Parenthood out of the state’s Medicaid program. In a move that could affect thousands of low-income women, state health officials on Tuesday delivered a final legal notice to … Read More
HOUSTON – Two brothers have been convicted on charges of conspiracy to commit health care fraud, health care fraud and money laundering, announced U.S. Attorney Kenneth Magidson. Kevin Olufemi Davies, 29, and his brother Melvin Olusola Davies, 28, owned and … Read More
A Charlotte woman was sentenced in federal court this week to 16 years in prison for orchestrating an $11 million Medicaid fraud scheme, authorities said Thursday.Cynthia Teresa Harlan, 49, was sentenced Wednesday following a July conviction on one count each … Read More
There have been rumors flying by the last few weeks that Inspector General Stuart Bowen wants to make it easier to place “credible allegation of fraud” (CAF) payment holds against Medicaid providers. We had no idea that this was difficult … Read More
Operators of two Fort Defiance medical transportation companies have been sentenced to prison for health-care fraud after collecting more than $3 million from a government health program for thousands of trips that never occurred, federal prosecutors said.Sylvia Begay, 50, who operated Hozho Nahasdlii … Read More
Zwanger-Pesiri Radiology will pay more than $10 million in a settlement over Medicare and Medicaid fraud the firm committed.Attorney General Eric T. Schneiderman and United States Attorney Robert L. Capers announced Wednesday that Zwanger & Pesiri Radiology Group, LLP, Zwanger … Read More
Our story on MCNA secretly recouping payments from a dentist who had an MCNA pre-approved treatment plan for a young Medicaid-eligible cancer patient touched a raw nerve with a number of dentists from around the state. The story received a … Read More
Massachusetts auditor Suzanne Bump’s office identified $15.45 million in public benefits fraud in fiscal 2016, a 12 percent increase over last year, according to an annual report released Tuesday.”This is not an indication of more fraud, but that we are … Read More
FBI and Drug Enforcement Administration agents were seen going in and out of Family Medicine in the 1600 block of Callaghan Road taking pictures.More News HeadlinesArrest made in robbery of NW Side pizza delivery manSuspect linked to theft of tires, … Read More
A former Medicare provider who owned an ambulance company has been found guilty of engaging in organized crime after deceiving dozens of mentally disabled patients and attempting to steal more than $1.3 million through fraudulent Medicare and Medicaid programs, the … Read More
A metro Atlanta dentist has pleaded guilty to defrauding the Georgia Medicaid program of nearly $1 million. Dr. Oluwatoyin Solarin, who had offices in Doraville and Duluth, had some employees of her Care Dental practice back-date claims for patients whose … Read More
The Audit division of the Health and Human Services Office of Inspector General released a report at the end of October (although TDMR just received the email notification about it today) about an audit they conducted on the practice of … Read More
Significant and persistent compliance, payment and fraud vulnerabilities exist within the Medicaid program that covers home care for elderly and disabled people, according to a recent report from HHS’ Office of Inspector General. In the report, the OIG highlighted some … Read More
MIAMI (AP) — A fall 2017 trial date is set for a South Florida businessman accused of orchestrating a $1 billion Medicare and Medicaid fraud scheme.Court records show a Miami federal judge on Wednesday scheduled 48-year-old Philip Esformes’ trial for … Read More
PULASKI COUNTY (KATV) — A 33-year-old Malvern woman was arrested for more than $700 in Medicaid fraud. Marquita Morgan faces a charge of Medicaid fraud. She is accused of billing more than $700 for services she didn’t receive in 2015, … Read More
There is a rumor circulating that the Texas Health and Human Services Commission is putting together a new request for proposals (RFP) for dental managed care organizations for Texas Medicaid. While this may or may not be the case as … Read More
Lawyers for Texas Attorney General Ken Paxton are no longer asking to have a state securities fraud case against him dismissed, moving him closer to a trial on the criminal charges. Paxton’s legal team confirmed Tuesday that it was getting … Read More
A Dallas doctor and businessman convicted of a health-care fraud conspiracy involving East Texas hospitals has been ordered to pay $1.22 million to the United States. Dr. Tariq Mahmood, a 65-year-old general practitioner from Cedar Hill, was found guilty in … Read More
Last November, former Texas Medicaid director Billy Millwee, now a private consultant, appeared before the Little Hoover Commission in Sacramento, California. The LHC is an independent state oversight agency that was created in 1962 with the mission to investigate California … Read More
Want to make some easy cash? Try defrauding Medicaid. It’s a booming business, according to the federal Centers for Medicare & Medicaid Services, which says the total amount of “improper payments” for Medicaid last year totaled more than $29 billion … Read More
Federal officials in recent years have increasingly worked to combat Medicare and Medicaid fraud.In fact, at the beginning of his second term, President Barack Obama made the issue a top priority, according to The Fiscal Times. Since then, there have … Read More
Mylan NV (NASDAQ:MYL) has agreed to pay $465 million to settle claims that the drug giant underpaid the federal government in rebates to Medicaid for its EpiPen allergy shot. However, the move is not enough. Senator Elizabeth Warren criticized the … Read More
In the latest chapter of the Obama administration’s crackdown on Medicare fraud, U.S. customs officials arrested a woman at the Dallas-Fort Worth International Airport last week who is accused of taking part in one of the biggest Medicare fraud schemes … Read More
ALBANY — The luxury rides that belonged to a crooked Bronx pill peddler can be yours for the right price.State officials are about to sell at auction a 2014 Maserati Gran Turismo and a 2014 BMW X6 seized by the … Read More
The Texas Tribune this morning published an article that indicates the fate of Texas Health and Human Services Inspector General Stuart Bowen is uncertain at this time. Planned Parenthood investigation tied to fund-raising effort The context of the story was … Read More
PULASKI COUNTY (KATV) — A 49-year-old Conway woman was arrested accused of $3,500 in Medicaid fraud.Georgia Broady faces one count of Medicaid fraud. The arrest was announced by Arkansas Attorney General Leslie Rutledge. Source: Conway woman arrested for $3,500 in … Read More
Two of Tenet Healthcare Corp.’s former subsidiaries admitted to conspiring to defraud Medicaid by using referral contracts for translation services to funnel pregnant patients through their doors.Atlanta Medical Center and North Fulton Hospital in Georgia each pled guilty to one … Read More
CBS – Baby boomers are expected to need more in-home care as they age, but federal investigators are now raising an alarm over what they call persistent fraud and abuse in Medicaid-funded personal care services.Investigators from the Department of Health … Read More
The Alaska Department of Health and Social Services has settled its complaints with Xerox over management of Medicaid claims, resetting its health-care contract with the business giant for an agreed-upon series of performance standards.The state’s claim against Xerox State Healthcare … Read More
In a quick action on Monday, the three counts of alleged Medicaid fraud against the former owner of Bluegrass Autism in Danville were dismissed amid allegations of misconduct by an attorney general’s office investigator. Judge Darren Peckler granted the request … Read More
AGENCIES: Office of Inspector General (OIG) and Centers for Medicare & Medicaid Services (CMS), HHS. ACTION: Proposed rule. SUMMARY: This proposed rule would amend the regulation governing State Medicaid Fraud Control Units (MFCUs or Units). The proposed rule would incorporate … Read More
The state of West Virginia accused Mylan NV of Medicaid fraud for inflating the price of the EpiPen by 500 percent and has asked the company to turn over documents related to Medicaid reimbursements. Heather Bresch, Mylan’s chief executive officer, … Read More
WHY WE DID THIS STUDY The Department of Health and Human Services (HHS) OIG is the designated Federal agency that oversees State Medicaid Fraud Control Units (MFCU or Unit). This MFCU Fiscal Year (FY) 2015 Annual Report highlights statistical achievements … Read More
TYLER, Texas – A 65-year-old Dallas County, Texas, physician, has been resentenced to federal prison for health care fraud and identity theft violations in the Eastern District of Texas, announced U.S. Attorney John M. Bales. In July 2014, Tariq Mahmood, of … Read More
Former Gov. Rick Perry brought some Texas flair to the Season 23 premiere of “Dancing With The Stars,” but his footwork brought few plaudits from the judges. The show partnered Perry, who performed in an floral embroidered Western jacket, with professional dancer Emma Slater … Read More
An Ohio man who is the son of a former Iranian prince and is said to be worth millions of dollars has been living off government assistance for the last two years.Ali Pascal Mahvi lives in an 8,000 square foot … Read More
McALLEN — Two Mission women pleaded guilty in connection with a 12-count indictment accusing them and several others of federal healthcare fraud totaling nearly $5 million, according to court records.Veronica Vela, 42, and Cynthia Lee Zapata, 50, appeared in federal … 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
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
