A reasonable person would not question the righteousness of the mission, which is rooting out fraud and fighting crime. Yet it’s not unreasonable to ask whether so many Texas Attorney General’s Office investigators need assault-style rifles, handguns and tactical gear … Read More
We want to close out 2015 with a round-up of the year’s most important stories relating to TDMR issues. It has been an exceptional year for changes at the Health and Human Services Commission. The implosion that occurred at HHSC … Read More
PLANO, TX—A Denton County, Texas, nurse has been convicted of 9 counts of health care fraud in the Eastern District of Texas, announced U.S. Attorney John M. Bales today. Florence Kroma a/k/a Florence Kamara a/k/a Florence Koroma a/k/a Florence Bangura, … Read More
SOUTHINGTON – State officials have reached a settlement with a local dentist accused of defrauding Medicaid. The Attorney General’s office announced Monday that Dr. Thomas DeRienzo, owner of Plantsville Family Dental, will pay $55,000 to resolve the False Claims Act … Read More
In the latest government blow against rampant Medicare fraud, two doctors and a registered nurse in New Orleans were given stiff prison sentences and millions of dollars in fines this week in federal court for their roles in a long-term $50 … Read More
HHS says few states have taken it up on an offer to receive federal funding for data-mining, which would allow their Medicaid fraud units to search claims. States say they don’t need it, even though the improper payment rate has … Read More
AUSTIN — A court hearing set for Monday about the effort by Texas to halt Medicaid reimbursements to Planned Parenthood has been canceled because state officials have not yet actually kicked the organization out of the program.Health inspector general Stuart … Read More
With the Government Accounting Office estimating that in 2014 some $124 billion was siphoned off the Medicaid and Medicare system nationally, we are again witnessing the truly schizophrenic nature of Medicaid enforcement actions in this country. In New York, this past week the … Read More
Almost two months after Gov. Greg Abbott praised state health officials for moving decisively to drop Planned Parenthood as a Medicaid health-care provider, the organization is still seeing patients and being reimbursed under the program.State health officials have not yet … Read More
ROCHESTER – Attorney General Eric T. Schneiderman today announced the arrest and guilty plea of Erica Viverette, a Rochester licensed practical nurse employed to provide private nursing services to a special needs young adult, for stealing nearly $5,000 from the … Read More
The U.S. government has recovered $1.9 billion from companies and individuals in the healthcare industry through False Claims Act cases in the fiscal year ending Sep. 30, the Department of Justice announced Thursday.The healthcare industry accounted for the bulk of … Read More
A suit to compel the Texas Health and Human Services Commission to release the full list of names of Medicaid providers that have been placed under a “credible allegation of fraud” payment hold since 2010 has been filed in Travis … Read More
HOUSTON – Regent Management Services L.P. has agreed to pay approximately $3.199 million to settle allegations that it received kickbacks from various ambulance companies in exchange for rights to its more lucrative Medicare and Medicaid transport referrals. Several government officials, … Read More
November 30, 2015 — If you pay your hygienist a guaranteed salary, it could be hurting your practice. Surprised? Think about it. While you know exactly how much you need to pay your hygienist each month and your hygienist knows … Read More
ALBANY – The State of New York is getting into the luxury car business courtesy of a pair of Medicaid scammers who were busted in Brooklyn. Officials are preparing to auction off two high-priced cars – including a 2013 Mercedes-Benz … Read More
Washington, DC–(ENEWSPF)–November 20, 2015. A Texas man was sentenced today to 63 months for his role in a $3.4 million scheme to defraud Medicare, announced Assistant Attorney General Leslie R. Caldwell of the Justice Department’s Criminal Division, U.S. Attorney Kenneth … Read More
A McAllen doctor was convicted Friday after he pleaded guilty to healthcare fraud and an illegal kickback scheme with his assistant. Eduardo Carrillo, 42, admitted he attempted to bill Medicare for providing services to deceased patients, according to a news … Read More
Planned Parenthood’s Texas affiliates on Monday filed a federal lawsuit to keep state health officials from booting them from the state’s Medicaid program. Following Texas’ announcement in October that it would stop funding any care for poor women at Planned Parenthood clinics — a response … Read More
A state worker who came under scrutiny during a high-profile contracting scandal last year has been paid more than $100,000 over the past 11 months without having to work a single day. Frianita Wilson — who earns $115,000 a year … Read More
November 17, 2015 — The Supreme Court of Texas has dismissed a petition that would have prevented practitioners from receiving Medicare funds when that provider is being investigated for fraud. In the November 13 dismissal, the state Supreme Court upheld … Read More
Amanda Barry, holding her son Dominic who she claims was among the dozens of children brutally treated by dentist Howard Schneider, smiled on Monday hoping the arrest of the former Jacksonville dentist meant he could not harm any more children. … Read More
This past Friday, the Texas Supreme Court dismissed a petition from the Texas Office of Attorney General to review a 3rd Court of Appeal decision preventing the Health and Human Services Commission Office of Inspector General from placing payment holds … Read More
A federal jury on Thursday convicted a Bowie, Md., couple of orchestrating a multi-year campaign to defraud D.C. Medicaid of more than $80 million between 2009 and 2014, the largest local health-care fraud scheme ever prosecuted in the city. After a … Read More
State officials canceled their multimillion-dollar Medicaid contract with financially troubled TAPS Public Transit on Thursday and launched an investigation into the possibility of fraud. Sherman-based Texoma Area Paratransit System won the three-year contract in July 2014 to provide non-emergency medical … Read More
As TDMR reported back at the end of September, the new Health and Human Services Commission Inspector General Stuart Bowen had started settling outstanding investigations and cases against Medicaid dentists and providers. Senator Charles Perry was quoted in the media … Read More
A Pharr woman has been sentenced for her role in a scheme to defraud the Medicare program, according to a news release from the Department of Justice. Martha Lidia Flores, 51, pled guilty to conspiring to commit health care fraud … 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
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
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 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
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
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
Earlier this month, the Attorney Generals of Illinois and Arkansas announced the arrest and/or conviction of three individuals in different cases for Medicaid fraud. Going to jail for $1,000 The amounts of the fraud involved were around $1,000 per party … Read More
