Federal authorities say a former Parkland Memorial Hospital employee illegally used information from thousands of patients to defraud Medicare and Medicaid. Viju Mathew, 49, of Garland has agreed to plead guilty to a federal fraud charge and is scheduled to … Read More
The Texas Rangers are now investigating the Health and Human Services Commission Office of Inspector General and the firing of actuary Brad Nelson per a story in the Houston Chronicle. The Commission requested the investigation after Nelson was fired for … Read More
A Stillwater-based dental company has agreed to pay more than $5 million in civil claims stemming from allegations that it submitted false Medicaid claims. Ocean Dental PC, which operates 28 clinics in seven states, did not admit any liability in … Read More
On October 22, 2014, the Department of Justice (DOJ) announced that DaVita Healthcare Partners, Inc. (DaVita), a provider of dialysis services, has agreed to pay the U.S. Government $350 million for allegedly violating several provisions of the False Claims Act … Read More
David Feinwachs was general counsel for the Minnesota Hospital Association. Until 2010 when he was fired. His firing ended a 30 year career with the hospital association. He was fired because he began asking questions about why the four HMOs … Read More
Oct 27 (Reuters) – The United States on Monday joined a lawsuit accusing New York City and Computer Sciences Corp of defrauding Medicaid into making millions of dollars of improper reimbursements by exploiting a computerized billing system that the company … Read More
A key legislator with oversight of the state’s Health and Human Services Commission has asked that agency’s Office of Inspector General to review all Medicaid fraud cases handled by an actuary who admitted recently to falsifying numbers on at least … Read More
It appears other states besides Texas are having problems with their Medicaid fraud investigations. Jury found innocent Per a news report in the Concord Register, a New Hampshire orthodontist, after a two day trial, was found innocent of 45 counts of … Read More
A Texas Health and Human Services Commission employee in the Office of the Inspector General was fired because he apparently “cooked the books” in OIG’s case against Dr. Rachel Trueblood, according to a story published in the Austin American Statesman … Read More
Last year’s shake-up of behavioral health providers in New Mexico drew comparisons to the Salem witch trials and injustices perpetrated by rulers of the Roman Empire on Wednesday at a hearing where a state lawmaker unveiled proposed legislation that would … Read More
ANCHORAGE – An Anchorage personal-care provider was raided by federal agents Tuesday night, as part of a joint investigation with state prosecutors into alleged Medicaid fraud at the facility. Kevin Donovan, assistant special agent in charge of the FBI’s Anchorage … Read More
Another HHS-OIG audit about to be released of the Texas Medicaid program will cost Texas another $30 million, according to a story in this morning’s Austin American Statesman. The federal audit covers 2011 for non-emergency medical transportation services. The article reports … Read More
Last Updated: Tuesday, 21 October 2014 06:10 Read Complete Document (pdf, 522.97 KB) October 20, 2014 – Observers often cite fraud as an important contributor to high health care spending, particularly in federal programs. This report describes how CBO estimates the … Read More
Two weeks ago, the Texas Office of the Attorney General quietly filed a lawsuit against yet another company associated with Texas Medicaid – the drug company AstroZeneca. Millions of dollars in excess reimbursements It accuses the company of defrauding the Texas … Read More
This summer, state regulators settled a Medicaid fraud case against an Austin dentist for literally pennies on the dollar. Although the Texas Health and Human Services Commission’s Office of Inspector General had initially accused Rachel Trueblood of bilking the government … Read More
AUSTIN—Texas Attorney General Greg Abbott has resolved an enforcement action against Ranbaxy, a generic drug manufacturer. The agreement resolves the State’s lawsuit under the Texas Medicaid Fraud Prevention Act (“TMFPA”) against Ranbaxy Pharmaceuticals, Inc., Ranbaxy Laboratories, Inc., Ranbaxy USA, Inc. … Read More
National medical billing company Medical Business Service (MBS) reached a settlement this week with the United States Attorney’s Office over allegations of defrauding the Medicare and Medicaid systems. The company has agreed to pay $1.95 million to rectify violations of … Read More
OKLAHOMA CITY — Oklahoma Attorney General Scott Pruitt has filed charges against a Yukon man for allegedly charging Medicaid recipients for counseling services he never provided. John Edward Karis has been arrested and faces four counts of Medicaid fraud and … Read More
The St. Mary’s University Mu Psi Chapter of the Pi Sigma Alpha National Political Science Honor Society is holding The Texas Medicaid Fraud Issue Forum on Wednesday, November 5th, 2014 in San Antonio. The purpose of the forum is to … Read More
A former certified home health aide in Passaic County was indicted on 175 counts of Medicaid fraud for submitting $87,616 in phony billing records, acting Attorney General John J. Hoffman announced today. Vladimir Faerman, 66, of Hawthorne, is the sixth … Read More
TALLAHASSEE – Attorney General Pam Bondi’s Medicaid Fraud Control Unit and the St. Lucie County Sheriff’s Office have arrested Claudia Laurenceau, 43, for defrauding the Medicaid program. According to the investigation, Laurenceau was responsible for assisting developmentally disabled Medicaid recipients … Read More
(AP) — The state reports saving more than $2 billion and recovering $879 million last year from spending on the Medicaid program that pays for health care for low-income New Yorkers. The Office of the Medicaid Inspector reports three-year recoveries … Read More
SANTA FE, N.M. — A Santa Fe-based behavioral health company says it felt forced by Gov. Susana Martinez’s administration to agree to pay a $4 million settlement to the state to resolve Medicaid fraud allegations in order to stay in … Read More
TDMR received a notice from the Texas Sunset Commission on Tuesday requesting feedback on the staff report just issued on HHSC which was particularly scathing of the Office of Inspector General. Make your voice heard Any Texan can comment on … Read More
ORANGE COUNTY — An Orange County man is facing serious charges alleging that he practiced as a Medicaid provider without having a medical license in the state of Florida. In an affidavit released by the Orange County Clerk’s Office, Liranzo … Read More
The Houston Chronicle has reported that as a result of the Sunset Commission’s scathing report on the Health and Human Services Commission Office of Inspector General, HHSC Executive Commissioner Kyle Janek is appointing a special assistant to review OIG procedures … Read More
AUSTIN – The top health official in Texas has decided to appoint a special assistant to review the state’s Medicaid anti-fraud program after an audit found it is so poorly run that it may be better for taxpayers if it … Read More
DANVILLE — An elderly father was placed in a special program to expunge a charge of Medicaid fraud while his son will spend at least two months in jail. Montour County Judge Gary Norton allowed David L. Albertson, 75, of … Read More
The Tucson woman who earned nearly $6 million as the whistleblower who uncovered overbilling at the Carondelet Health Network is launching her own effort to prevent health-care fraud.“Providers are turning their heads, not wanting to hear about fraud, waste and … Read More
A Detroit federal jury convicted the operator of an adult day care center and two home health care company owners in a $29 million Medicare fraud scheme, The Detroit Free Press reported on Thursday. Felicar Williams, 51, Abdul Malik Al-Jumail, … Read More
The Massachusetts Executive Office of Health and Human Services, Office of Medicaid (State agency), did not always use the correct Federal medical assistance percentages (FMAPs) when processing claim adjustments reported on the Quarterly Medicaid Statement of Expenditures for the Medical … Read More
The federal government and 48 state attorney generals, including Texas Attorney General Greg Abbot, resolved a Medicaid fraud investigation with a $56.5 million agreement. The investigation was being conducted into Shire Pharmaceuticals LLC for unlawfully promoting Adderrall XR, Vyvanse, Daytrona, … Read More
WASHINGTON—The owner of a Miami home health care agency has been arrested in connection with an $8 million health care fraud scheme involving Acclaim Home Healthcare Inc. Assistant Attorney General Leslie R. Caldwell of the Justice Department’s Criminal Division, U.S. … Read More
OLYMPIA — In a case brought by the Attorney General, the owner of a wheelchair company that fraudulently delivered 119 used or refurbished wheelchairs to the poor and disabled across the state was convicted on felony charges Sept. 25 in … Read More
The following article was published today in the Texas Tribune, authored by Christine Ayala and Jay Root. UPDATE: The same article was republished in the New York Times with the title “A Texas Official’s D.W.I. Case Is Being Seen in … Read More
AUSTIN – Call it the billion-dollar blame game. Six years after auditors discovered signs that some Texas orthodontists were putting unneeded braces on teeth of the state’s poorest children, an army of lawyers are battling over who is liable for … Read More
The owner of a home health services company was sentenced to serve five years in prison for his leading role in a conspiracy to structure over $1.8 million in bank withdrawals to conceal a $4.5 million healthcare fraud scheme. Assistant … Read More
A New Orleans grand jury today indicted seven defendants for their roles in a $56 million Medicare fraud scheme that operated in New Orleans and surrounding communities. Thirteen defendants have now been charged in this case, three of whom pleaded … Read More
NORFOLK, Va. – W. Wayne Perry, Jr., 55, and his wife, Angela Perry, 52, formerly of Suffolk, Va., were convicted after a three-week trial late yesterday afternoon by a federal jury of one count of conspiracy to commit health care … Read More
On September 3rd, Rachel Hammond of the Texas Association for Homecare and Hospice testified before the House Human Services Committee on SB 1803 and due process rights for Medicaid providers. Hammond gave examples of difficulties that their members were having … Read More
