PHILLIPS COUNTY, Ark. – A Phillips County woman was arrested on Wednesday on suspicion of Medicaid fraud, according to Attorney General Leslie Rutledge. Jacqueline Young, 36, surrendered to the Phillips County Sheriff’s Office and was later released on her own recognizance, … Read More
PULASKI COUNTY (KATV) — A 36-year-old Heber Springs woman was given three years of probation and order to pay a fine and restitution for Medicaid fraud. Arkansas Attorney General Leslie Rutledge announced Thursday that Jessica Eddy pleaded guilty to Medicaid … Read More
Medicaid managers have done little to stem rampant fraud in the massive government health care program for the poor, which totaled more than $29 billion last year, according to a new Government Accountability Office (GAO) report to Congress. As Medicaid … Read More
The Houston Chronicle reported this morning that Frianita Wilson, the wife of former Health and Human Services Commission Inspector General Doug Wilson and an HHSC executive in her own right, is now back at work at HHSC after being on administrative … Read More
AUSTIN — A Texas state official put on paid leave amid last year’s contracting scandal has been reinstated after 15 months in which she received nearly $150,000 in salary without having to work. The official, Frianita Wilson, a longtime procurement … Read More
Jacksonville, FL — He has “severe mental deficits” and a “lack of memory” which makes him unable to stand trial.That’s why the lawyers for a former Southside pediatric dentist accused of hurting patients want him ruled incompetent by a judge.WOKV … Read More
For three months, Courissa Hall essentially lived in a Houston rehabilitation hospital providing care for her 4-year-old daughter, who suffered brain damage during a routine appointment at a local dental clinic that specialized in treating Medicaid patients. She’s still processing … Read More
Earlier this week, TDMR received an email from a mother who had her sons under Medicaid orthodontic treatment back in 2011 and 2012 and is still very upset at the both the state handling of the matter and the lack … Read More
An Avoca man faces 10 years in prison for allegedly sending fraudulent billing claims to Medicaid. Darren Washington, 52, worked as a service provider for Healthy Homes Family Services. From January 2015 to May 2015 while working for Healthy Homes, … Read More
CRITTENDEN COUNTY (KATV) — Two Crittenden County women have been arrested on charges of Medicaid fraud.Arkansas Attorney General Leslie Rutledge announced the arrests Wednesday by the Attorney General’s Medicaid Fraud Control Unit.36-year-old Pamela Pollard, of Marion, and 38-year-old Lacasha Perry, … Read More
ROCKFORD (WIFR) – A Rockford woman pleads guilty to felony fraud after Illinois State Police say she was being paid by Medicaid for services she wasn’t actually providing. 59-year-old Lucinda Germann was arrested after an investigation revealed she was submitting … Read More
Dr. Michael Goodwin of Amarillo pleaded guilty to one charge of health care fraud back in 2012 relating to the investigation into allegations of statewide Medicaid orthodontic billing fraud. Goodwin is the only dentist out of that morass to so … Read More
Health and Human Services Commission Inspector General Stuart Bowen Jr. announced in his quarterly report a new initiative to help combat Medicaid fraud and also help Medicaid providers. This is the IG Integrity Initiative. It was formally rolled out on … Read More
New details emerge in the Medicaid fraud case against an Amarillo Dentist. Michael Goodwin pleaded guilty in 2012 to one count of health care fraud, now he wants his plea vacated as well as the charges. Goodwin’s family says his attorney at … Read More
The office of Attorney General Ken Paxton is formally defending his decision to continue paying two high-level staffers after they resigned, saying Paxton “acted in a compassionate, legal, and ethical manner.” In an op-ed submitted Tuesday to a number of media … Read More
CLEVELAND, Ohio – A Cleveland dentist allegedly billed Medicaid for fillings on patients with dentures and other work not performed; now he’s charged with health care fraud, Ohio’s U.S. Attorney announced Monday.Robert Rouzaud, 59, allegedly billed for an excessive number … Read More
BATON ROUGE – Attorney General Jeff Landry announced five people were arrested on defrauding the Medicaid program following investigations by his Medicaid Fraud Control Unit (MFCU).“Fraudulent claims to the Medicaid program will be investigated, and the scammers will be arrested,” said … Read More
The Health and Human Service Commission Inspector General’s office has replaced a controversial Medicaid fraud data analytics program with a statistical software package that cost the agency nothing. The 21CT contracting scandal cost the state $20 million and took out … Read More
This morning Health and Human Services Commission Inspector General Stuart Bowen Jr. issued his latest quarterly report on OIG activities and results. Bowen has ushered in a new era of transparency and accountability for the agency and these reports provide … Read More
Picture yourself as a physician, health care administrator, or nurse. The government initiates a False Claims Act (FCA) investigation and you (or your company), as a provider, commence an immediate internal investigation. The findings are brought to the government, you … Read More
ALBANY – Amongst the surplus vehicle, highway equipment, and miscellaneous property to be auctioned Wednesday morning by the New York State Office of General Services is a 2012 Porsche Cayenne SUV. The Porsche, with approximately 14,850 miles on its odometer, … Read More
The investigative digging of the Texas media into the operations of state government has once again revealed to the public, otherwise blissfully ignorant, the tremendous apparent hypocrisy of several state officials who view their positions as the divine right of … Read More
TALLAHASSEE, Fla.—Attorney General Pam Bondi’s Medicaid Fraud Control Unit today announced the arrest of a Broward County dentist for allegedly billing the Medicaid program more than $14,000 for services not rendered. Dr. Marino F. Vigna, 49, allegedly billed Medicaid for … Read More
An Angelina County grand jury has indicted a Lufkin hearing center owner accused of charging Medicaid for services that were not performed by properly licensed personnel. Richard Charles Geraci, 50, of Lufkin, has been booked in and out of the … Read More
Since 2012, there have been a large number of outstanding but here-to-date sealed False Claims Act lawsuits against Texas dentists who billed Medicaid for orthodontic treatment from 2007 to 2011. Some are known and high profile but there are 46 pages … Read More
Federal charges of money laundering were filed against a former Tulsa dentist previously accused of infecting patients with HIV and hepatitis.The attorney representing one of Harrington’s former patients said the latest federal charge comes as no surprise.Scott Harrington is accused … Read More
A recent court ruling in favor of a Texas orthodontics provider adds to the state’s longstanding inability to prove claims that dental providers overbilled Medicaid tens of millions of dollars, according to the Austin American-Statesman. In the latest case, an … Read More
In an important win for hospice and other health care providers facing claims under the False Claims Act (FCA), a federal court in Alabama gave a summary judgment victory last week to hospice provider Aseracare Inc. Key Takeaway A difference … Read More
When Brianna Dupuie was a year old, a babysitter shook her so hard she had a stroke that paralyzed her right side. Everything Brianna had learned to do — how to walk, crawl and speak — was erased.In the seven … Read More
State Medicaid regulators pursuing orthodontists who they claim bilked Texas out of tens of millions of dollars suffered another decisive setback Thursday, when an appeals court ruled investigators hadn’t proven any fraud had occurred in one of the state’s largest … Read More
Today the Sixth Court of Appeals issued their decision in the Medicaid payment hold case of Antoine Dental Center of Houston. The court again exonerated the practice from allegations of Medicaid fraud, again terminated the payment hold and, for the … Read More
A Zachary home health care business owner accused of violating Louisiana’s sparingly used racketeering statute in an alleged Medicaid fraud scheme pleaded guilty this week to a racketeering charge and faces up to 50 years in prison when she is … Read More
What was a woman accused of 11 counts of dependent adult abuse and ongoing criminal conduct doing working for AmeriHealth Caritas Iowa, one of the three private, out-of-state Medicaid management companies hired by the state to serve low-income and disabled Iowans?That … Read More
Two people are facing federal charges in connection with defrauding and scheming to defraud through false billing via their local medical equipment companies. But the two cases, however similar, are not linked to each other, according to a news release … Read More
ALBUQUERQUE (AP) – The last two of 15 mental health nonprofit providers under investigation for possible Medicaid fraud have been cleared by New Mexico’s top prosecutor. Attorney General Hector Balderas is sending a letter to state lawmakers Tuesday, informing them … Read More
WHY WE DID THIS STUDY The Office of Inspector General (OIG) oversees the activities of all Medicaid Fraud Control Units (MFCUs or Units). As part of this oversight, OIG conducts periodic reviews of all Units and prepares public reports based … Read More
SANTA FE – A health care company that tried to root out fraud in New Mexico’s Medicaid program has now been accused of committing Medicaid fraud itself. Three lawsuits filed against OptumHealth Inc. this year accuse the company of malfeasance stemming … Read More
Four federal lawmakers from New Mexico – Sen. Martin Heinrich, Sen. Tom Udall, Rep. Ben Ray Luján and Rep. Michelle Lujan Grisham – filed a bill last week to guarantee due process rights to Medicaid providers across the country who are … Read More
When agencies that receive Medicaid reimbursements are accused of fraud, it can impact that provider as well as its patients for months at a time—regardless of whether any parties are ever found guilty.Four U.S. lawmakers recently introduced a bill meant … Read More
WILMINGTON, N.C. (WNCT) – Terry Lamont Speller, 38, was sentenced to 240 months in federal prison and three years of supervised release following his guilty plea to Medicaid fraud. The Winterville-native was also ordered to pay back the money he … Read More
