Media

Extendicare Health Services Inc. (Extendicare) and its subsidiary Progressive Step Corporation (ProStep) have agreed to pay $38 million to the United States and eight states to resolve allegations that Extendicare billed Medicare and Medicaid for materially substandard nursing services that … 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

Summary Some of the New York State Department of Health’s (Health Department) claims for Federal Medicaid reimbursement for supported employment services did not comply with certain Federal and State requirements. On the basis of our sample results, we estimated that … Read More

In August, House Ways and Means Subcommittee on Health Chairman Kevin Brady (R-TX) introduced a bill, Protecting Integrity in Medicare Act of 2014, designed to help Medicare drug plans reduce fraud. More than 16,000 people die annually from abusing pain relievers, … 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

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

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

The government agency charged with rooting out medical fraud and waste is poorly managed, occasionally is unfair to those it investigates and has failed to do an effective job identifying and recovering money lost to medical fraud, according to a … Read More

by Becca Aaronson, The Texas Tribune In a blistering 225-page report on the Texas Health and Human Services Commission, the Texas Sunset Advisory Commission recommended that the state’s health and human services system undergo a massive overhaul.  The Sunset Commission, which reviews the … Read More

The government agency charged with rooting out medical fraud and waste is poorly managed, occasionally is unfair to those it investigates and has failed to do an effective job identifying and recovering money lost to medical fraud, according to a … Read More

The Colorado Department of Health Care Policy & Financing (State agency) claimed $4.1 million ($2.5 million Federal share) in unallowable Medicaid nursing facility supplemental payments for State fiscal years (FY) 2010 and 2011. For these two FYs, the State agency … Read More

A Florida managing member of a shell company pleaded guilty today in federal court in Tampa for his role in a multi-million dollar health care fraud and money laundering scheme. Assistant Attorney General Leslie R. Caldwell of the Justice Department’s … Read More

Jack Stick could find out this month whether he will stand trial on a two-year-old drunk driving arrest. After a Thursday pretrial hearing, County Court-at-Law Judge Nancy Hohengarten said she will rule before an Oct. 21 hearing whether to admit … 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 Texas Health and Human Services Commission claimed $746,000 in unallowable supplemental payments made to the University of North Texas for the period May 1, 2004, through September 30, 2007. via Review of Physician Supplemental Payments Made to the University … 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

Also during the debate, Abbott proposed Texas seek and receive a block grant to reform the state’s Medicaid system. It is a proposal similar to the ones Patrick and Perry have laid out for how to deal with the state’s … 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

WASHINGTON—A Miami man was arrested today on health care fraud and money laundering charges in connection with an alleged $24 million scheme to defraud Medicare. Assistant Attorney General Leslie R. Caldwell of the Justice Department’s Criminal Division; U.S. Attorney Wifredo … Read More

Republican lawmakers in Florida and Texas snubbed the Affordable Care Act’s Medicaid expansion for adults, but their states did broaden the program this year — for school-age children. Those states were among 21 – including some big Democratic-led states, such … Read More

AUSTIN — A top state official is stopped for drunken driving and refuses breath and blood tests. Police cite erratic driving and uncooperative behavior, and critics say the official is unfit to serve in public office. This is not the … 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

September 29, 2014 — Late last week, California Gov. Jerry Brown signed a bill that establishes standardized requirements for dental plans to disclose how they spend patient premiums. The bill, AB 1962 introduced by Assemblymember Nancy Skinner (D-Berkeley), puts the … Read More

While critics were hounding Gov. Rick Perry a decade ago about his job-luring Texas Enterprise Fund, his lawyers went to Attorney General Greg Abbott to block the release of applications that supposedly had been filled out by the entities requesting … 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

The facts of the auditor’s report released Thursday on the administration of Gov. Rick Perry’s Texas Enterprise Fund are, as the Tribune’s Aman Batheja termed it, “damning.” How bad? Eleven companies receiving a total of $223.3 million “either did not … Read More

he Alaska Department of Health and Social Services has filed a claim against the private company responsible for rolling out a Medicaid payment system that the state says is riddled with defects. In the claim filed Monday, the health department said … Read More

Erin Fair Taylor’s job isn’t easy. That’s because every day, she must figure out how to pay doctors. Taylor works for CareOregon, which is playing an active part in Oregon’s effort to overhaul its Medicaid system. As such, it’s her … Read More

AUSTIN — The Texas Health and Human Services Commission (HHSC) plans to re-issue a request for proposals (RFP) for a major data project this fall. The original procurement was canceled so the state could make revisions to help lower the … Read More

September 22, 2014 — Even after months of debate, Missouri lawmakers still can’t settle the debate over how to fund the costs of a government-funded health plan that would provide dental care for almost 300,000 low-income adults in the state. … Read More

AUSTIN – Texas health officials abruptly have pulled the plug on a major data project amid concerns about its cost and suggestions the tentative contract winner was receiving inside information from state negotiators. The decision to end negotiations with Truven … Read More

ATLANTA, GA – The United States Attorney’s Office announced it has reached settlements with Banks-Jackson-Commerce Hospital and Nursing Home Authority d/b/a Banks Jackson Commerce Medical Center (BJC) and Dr. Narasimhulu Neelagaru that total over $500,000. “Kickbacks pervert our health care … Read More