The state's $235 million settlement this week with Xerox/Conduent, its former Medicaid claims administrator, unfortunately, leaves unresolved some disturbing questions about how the company could operate its insanely irresponsible orthodontic prior authorization process for so long with state officials either looking the other way or incapable of doing anything about it. While … [Read more...]
Audit reveals states owe federal government billions for fraudulent Medicaid overpayments
Watchdog estimates recent audit of fraudulent Medicaid payments totaling nearly $2 billion ‘is really closer to $60 billion’ A recent audit of the Department of Health and Human Services (HHS) reveals that it directed $2.6 billion worth of taxpayer money toward fraudulent and/or mismanaged Medicaid claims over a period of five years. More than half – $1.6 billion – remains … [Read more...]
Did Texas OAG Forget to Sue Xerox For $133 Million Owed the Feds for Medicaid Orthodontic Prior Authorization Debacle?
It appears that Texas Office of the Attorney General (OAG) forgot to sue Xerox to recover over $133 million that the federal government determined it was owed because of the state’s lack of oversight over Xerox, its then-Medicaid claims administrator, which mishandled the state’s orthodontic prior authorization process from 2008-2011. Revealed in recent court filing by … [Read more...]
UPDATE: Indiana Dental Practice & DSO Shell Out $5.1 Million Over Medicaid False Claims Allegations
UPDATE: TDMR has received a copy of the ImmediaDent and Samson Partners press statement from Samson Partners vice-president of marketing Stephen Valenti. It is at the bottom of our story in full. Indiana-based ImmediaDent and DSO Samson Dental Partners of Kansas have agreed to pay the federal government and Indiana some $5.139 million to resolve false claims allegations of … [Read more...]
$5.1 Million Dollar Settlement Reached With Indiana Dental Firm To Resolve False Claims Allegations
LOUISVILLE, Ky. – United States Attorney Russell M. Coleman announced today that ImmediaDent of Indiana, LLC (ImmediaDent), which operates nine dental care practices in Indiana, and Kansas based Samson Dental Partners, LLC (SDP), which provides administrative support services to ImmediaDent, have agreed to pay the United States and the State of Indiana $5.139 million to resolve … [Read more...]
Under investigation and on the ballot, Sen. Charles Schwertner avoids spotlight
Zach Zezulka, a libertarian who lives in Williamson County, last week walked out of the early voting polling place at the Georgetown Parks & Recreation building proud to have cast ballots for candidates who will support President Donald Trump’s agenda. But Zezulka said he wasn’t sure whether he would grow to regret his vote for state Sen. Charles Schwertner, the … [Read more...]
Medicaid Managed Care Companies in Ohio Received $90 Million in Payments for Dead People
Reported in a shocking report released this week, the Office of Inspector General for the U.S. Department of Health found that the Ohio Department of Medicaid made $90.5 million in capitation payments to managed care organizations in the state on behalf of deceased beneficiaries. Over 81,000 payment made over two years The audit covered a two-year period from July 1, … [Read more...]
New HHS-OIG Report Criticizes MCO Identification of Medicaid Fraud and Abuse
The U.S. Department of Health and Human Services Office of the Inspector General issued a report yesterday that found that managed care organizations are not doing enough to identify Medicaid waste, fraud and abuse. HHS-OIG undertook the review because it and "others have ongoing concerns about program integrity in Medicaid managed care." Reviewed survey data and … [Read more...]
“Truth Decay” One Year Later
In January of last year, Dr. Juan Villarreal's long-awaited book "Truth Decay: How Government Corruption Caused a Political Scandal Victimizing Texas Dentists and How It Could Happen to You!" was released on Amazon.com. "Truth Decay" details Dr. Villarreal's personal struggles and victories overcoming allegations of Medicaid fraud by the Texas Office of Inspector General … [Read more...]
Legislation Aimed at the Root Causes of Medicare and Medicaid Fraud
Recently the Health and Human Services Office of Inspector General issued a report A-17-17-52000- U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES MET MANY REQUIREMENTS OF THE IMPROPER PAYMENTS INFORMATION ACT OF 2002 BUT DID NOT FULLY COMPLY FOR FISCAL YEAR 2016. In the report, OIG recommends that HHS focus on the root causes of the improper payment rate percentage and … [Read more...]