In a harsh rebuke of the 2013 behavioral health shake-up that thrust mental health care for indigent New Mexicans into disarray, a Santa Fe judge on Friday ruled that the state Human Services Department had denied due process to one … Read More
A Rockwall man who the feds say is at the center of one of the largest schemes to bilk Medicaid in history has once again had his trial delayed. Jacques A. Roy’s long-delayed criminal trial was set to begin on … Read More
Jan. 21–The trial for a Pullman dentist accused of four counts of Medicaid fraud began late Tuesday afternoon in Latah County. After a lengthy morning spent selecting jurors, attorneys gave their opening statements a little past 2 p.m. in the … Read More
HELENA – A Republican state senator from Billings Wednesday presented a key piece of GOP plans to reform Medicaid and public-assistance programs in Montana: A bill to hire an outside contractor to verify the eligibility of welfare applicants. “If we … Read More
David Gibson, CEO from Reflective Medical, one of the companies that demonstrated their Medicaid fraud detection software to HHSC back in 2010 and 2011, sent TDMR links to a couple of YouTube videos that show the kind of fraud that … Read More
FORT WORTH, Texas (U.S. Attorney’s Office, Northern District of Texas) — The owner/operator of a chiropractic clinic in Fort Worth, Texas, was sentenced this morning on a federal felony conviction stemming from her submission of false reimbursement claims to Medicare … Read More
SEATTLE (AP) — A health center that provides services to the poor and minority residents in 10 counties has agreed to pay $3.65 million to settle an investigation by the Washington Attorney General’s Office. The Seattle Times reports (http://is.gd/sS880v ) … Read More
Six Leon County case managemers are facing charges of Medicaid fraud after an investigation by Florida Attorney General Pam Bondi’s office. The six were arrested in connection with more than $170,000 in Medicaid fraud. All of those arrested worked for … Read More
Today, Sen. John Whitmire sent a letter to HHSC Executive Commissioner Kyle Janek suggesting he resign immediately for “the best interest of the State of Texas.” “Enough is enough” The Austin American Statesman quoted Whitmire as telling them, “Enough is enough. I … Read More
The mastermind of a more than $700,000 stolen identity tax refund fraud scheme was found guilty by a jury of conspiracy to commit theft of public money, theft of public money and aggravated identity theft, the Department of Justice, the … Read More
AUSTIN – The company that won a massive no-bid state contract now embroiled in scandal has decided to launch an aggressive campaign to defend its reputation and other business deals. Austin technology firm 21CT has hired an all-star cast of … Read More
Everybody knows going to the dentist is important, yet half of American adults skip out on regular dental care. Some avoid dentistry out of fear of pain or sheer busyness, but a large portion of Americans can’t afford it without … Read More
A New York City dentist from Rockland is facing felony counts of defrauding Medicaid by submitting phony bills for care he didn’t provide, officials said Thursday. Howard Rothenberg, 64, of West Nyack, was charged with billing the taxpayer-funded health insurance … Read More
COLUMBUS — Ohio Attorney General Mike DeWine announced Tuesday that Ohio has joined four states and the federal government to settle allegations that one of the leading providers of dialysis services in the United States paid illegal kickbacks to induce … Read More
A leading state senator says she will propose tougher safeguards against unethical behavior by those involved in awarding contracts to the private vendors who increasingly deliver medical care and social services to vulnerable Texans. Sen. Jane Nelson, R-Flower Mound, is … Read More
New Mexico’s Medicaid director, who was involved in the state’s controversial behavioral health shake-up in 2013, is leaving her $103,000-a-year position later this month to go to work for the private contractor that had set the provider overhaul in motion. … Read More
Today, HHSC-OIG issued a report detailing amounts recovered by state managed care organizations for certain fraud and abuse in state fiscal year 2014. 22 MCOs recover $3.8 million The report entitled “HHSC OIG Annual Report on Certain Fraud and Abuse … Read More
At the the start of a new year, it’s traditional to hope for changes that would improve on last year. And yet, some very dysfunctional aspects of our lives are bound to stay the same, even deteriorate — and the same happens to be true … Read More
An incendiary lawsuit over the business practices of one of the companies running KanCare, the Brownback administration’s privatization of Kansas’ $3 billion Medicaid program, just got more explosive. The company, Sunflower State Health Plan, responded this week to a lawsuit … Read More
Forget about losing weight and quitting smoking, Texans need to resolve to pay more attention in 2015. The recent controversies, suspected fraud, and backroom deals taking place within Texas state agencies are happening so fast that it’s hard to keep … Read More
Centene Corp., one of the managed care companies participating in Kansas’ Medicaid program, says a former executive filed a lawsuit against the company as part of a $3 million extortion scheme. Jaqueline Leary, who was the vice president of network … Read More
One of the companies running Kansas’ privatized Medicaid program charges a former executive tried to extort $3 million from the business before she filed a wrongful-termination lawsuit. Overland Park resident Jacqueline Leary, who had been vice president of contracting and … Read More
John and David Mkhitarian found a soft spot in Medicare’s defenses against fraud: Inspectors aren’t required to visit medical providers deemed to present a lower risk of fraud and abuse. So the cousins used exchange students to create some 70 … Read More
Unscrupulous caregivers submit millions of dollars in fraudulent home care bills to the state every year, yet only a fraction are ever prosecuted, and even fewer wind up in jail or paying substantial restitution. Of the 425 home caregivers and … Read More
AUSTIN – One of Rick Perry’s most prominent gubernatorial appointees knew as early as 2012 about the project now at the center of a growing contracting scandal, the appointee disclosed Tuesday, offering the clearest indication yet of how high in … Read More
According to a story in the Austin American Statesman today, the leadership of HHSC Executive Commissioner Kyle Janek is being questioned by state Sen. John Whitmire in the upheaval that is shaking HHSC over the now-canceled multi-million dollar contract for … Read More
State health officials circumvented two separate contract oversight boards when they brokered a $110 million no-bid deal with an Austin tech company — a transaction which is now the subject of a criminal investigation and much public scrutiny after two … Read More
BEAUMONT, Texas (U.S. Attorney’s Office, Eastern District of Texas) – A 75-year-old Beaumont doctor has been sentenced to federal prison for health care fraud violations in the Eastern District of Texas, announced U.S. Attorney John M. Bales. John Q. A. … Read More
While he was brokering a multimillion-dollar state contract for Austin technology company 21CT, then-state health official Jack Stick was promoting 21CT’s software to other states, assisting the company’s growth plans and seemed poised to take an executive position with the … Read More
here’s a delicious irony in the news that a state contract intended to root out fraud and increase transparency in Texas’ Medicaid program might itself show the need for more transparency and oversight of the contracting process. But it mostly … Read More
AUSTIN – When then-Texas health official Jack Stick suggested earlier this year that a company he had helped land $20 million in no-bid state contracts might get another one through a sister department, he was referring the firm to a … Read More
Gov. Rick Perry on Friday fired Doug Wilson, inspector general of the Texas Health and Human Services Commission, following the removal of Wilson’s former deputy after questions arose over the selection of a relatively unknown company for a $110 million … Read More
AUSTIN, TEXAS The widening fallout over $110 million in no-bid state contracts awarded to an Austin tech company forced the resignation of a second top state official Friday, this time at the request of Republican Gov. Rick Perry, as criminal … Read More
Health and Human Services Commission Inspector General Doug Wilson resigned Friday, scarcely more than an hour after the state auditor announced it would launch an investigation into no-bid contracts brokered under his watch in conjunction with an anti-public corruption at … Read More
*Editor’s note: This story has been updated. As questions continue to surround agreements made between the Texas Health and Human Services Commission and a contractor, a legislator is calling for investigators to get involved. State Sen. John Whitmire, D-Houston, on … Read More
A spokesman for House Speaker Joe Straus on Thursday said the House will propose “a budget in January that requires much more stringent reporting on contracts by state agencies and institutions.” Jason Embry sent the statement in response to inquiries … Read More
Within the last 24 hours, major media in Texas have published stories on their continuing investigations into former OIG deputy inspector general for enforcement Jack Stick and his allegedly favored treatment of an Austin software company for Medicaid fraud detection … Read More
AUSTIN – The powerful Texas Health and Human Services Commission official who resigned last week stretched the boundaries of a little-known state purchasing program to ensure a local company would not face competition for a $110 million contract, according to … Read More
We can no longer have an OIG that accuses providers of fraud, presumes them guilty, and denies them due process.” via Reform sought for agency investigating health, human services fraud – Reporter News.
New York State is going paperless, at least when it comes to drugs. A deadline imposed by the New York State Department of Health is rapidly approaching, to make New York State one of the first to axe state-issued prescription … Read More
