WASHINGTON — If the 23 states that have rejected expanding Medicaid under the 2010 health care law continue to do so for the next eight years, they’ll pay $152 billion to extend the program in other states _ while receiving … Read More
Data mining is the process of identifying fraud through the screening and analysis of data. On May 17, 2013, the Department of Health and Human Services (HHS) issued the final rule "State Medicaid Fraud Control Units; Data Mining" (78 Fed. … Read More
State regulators in Texas last week agreed to settle allegations of Medicaid fraud against Trueblood Dental Associates, P.A. Brace yourself for the numbers: The state agreed to recover just $39,211 out of a $16,209,289 projected overpayment for dental claims in a … Read More
AUSTIN (KXAN) — You take the toll road to save time and you get a TxTag to save time paying your bill, but for many of you, dealing with TxTag has been anything but saving time. For two months, you’ve … Read More
August 29, 2014 — In the latest development in the ongoing Texas Medicaid scandal, the state Health and Human Services Commission (HHSC) has filed a second lawsuit against Xerox, claiming the company is refusing to turn over patient records. Without … Read More
Xerox, a company that worked on the Texas Medicaid program, may still have files that contain information about many current and former Medicaid clients. The company is being sued by the state and has refused to return the files. One … Read More
September 1 marks latest expansion of Medicaid managed careAn additional 134,000 people who are elderly or have disabilities are now getting their Medicaid services through STAR+PLUS managed care. The switch came September 1 as HHSC continued its expansion of managed … Read More
NEW YORK – Attorney General Eric T. Schneiderman today announced the arrests of four individuals for allegedly practicing dentistry without a license at two Brooklyn dental clinics, which are separately owned by a father and his son who are licensed … Read More
Law360, New York (August 11, 2014, 2:39 PM ET) — The state of Texas has reached a $19.5 million settlement with Taro Pharmaceuticals USA Inc. to resolve allegations that the drug company fraudulently reported inflated drug prices to the Medicaid … Read More
Fraud in Medicaid constitutes a scam amounting to more than a billion dollars and a newly installed computer system is assisting to ferret out the criminals. As per Kaiser, about $28 billion is paid by Texas to provide care for … Read More
ABINGDON, VIRGINIA – A Wise, Va. dentist has admitted to obtaining hydrocodone by fraud and to illegally distributing over 2,500 hydrocodone pills. Newton Carroll Mullins, 65, of Wise, Va., who operates a dental practice in Wise, Virginia, waived his right … Read More
The allegations state health regulators leveled against Rachel Trueblood two years ago were dramatic: The Austin dentist had billed the government for millions of dollars in unnecessary procedures and office time, they said. Regulators froze $100,000 of outstanding Medicaid payments … Read More
HOUSTON—Andrea Michelle Tellison, 47, has been ordered to federal prison for eight years following her convictions of 14 counts of health care fraud and seven counts of aggravated identity theft, announced United States Attorney Kenneth Magidson. A jury convicted Tellison … Read More
To understand waste, fraud and abuse of taxpayer dollars in the Medicaid system, let’s begin with a couple of basics on what the role of Medicaid is in health care and how it works. Medicaid Basics Medicaid is a program … Read More
August 27, 2014 — Newly formed dental service organization (DSO) Modern Dental Services (MDS) of Dallas has raised $2.5 million in private equity to purchase dental practices from older practitioners and use them as job opportunities for new dentists. Backed … Read More
The state is suing Xerox for a second time, afraid the company’s recent actions in withholding a large number of documents relating to its tenure as the state’s primary Medicaid claims administrator will lead to millions of dollars of federal … Read More
August 26, 2014 — Texas health officials have accepted a $39,211 settlement from an Austin dental practice that had been charged with improperly billing more than $16 million in orthodontic Medicaid claims. Glenn Wood, MD, who owns Carousel Pediatrics, disputed … Read More
Texas Medicaid officials, already in a legal battle with Xerox Corp. over the company’s alleged failure to prevent widespread dental fraud, filed another lawsuit Tuesday accusing Xerox of improperly taking large quantities of medical records and not protecting patients’ confidentiality. … Read More
Summary WHY WE DID THIS STUDY OIG oversees the activities of all State Medicaid Fraud Control Units (MFCUs or Units). As part of this oversight, OIG conducts periodic reviews of all Units and prepares public reports based on these reviews. … Read More
Rick Perry is defending his attempt to coerce Travis County District Attorney Rosemary Lehmberg out of office—an attempt which resulted in not one, but two indictment charges—by claiming that he was taking a stance against her drunk driving conviction. However, … Read More
Department of Justice Office of Public Affairs FOR IMMEDIATE RELEASEWednesday, August 20, 2014 Michigan Home Health Agency Owner Pleads Guilty to Participating in $22 Million Medicare Fraud Scheme A greater Detroit-area owner of three home health agencies pleaded guilty today … Read More
Summary WHY WE DID THIS STUDY Medicaid is the primary source of dental coverage for children in low-income families and provides access to dental care for approximately 37 million children. In recent years, a number of dental providers and chains … Read More
AUSTIN — Rick Perry was outraged at the spectacle of Travis County District Attorney Rosemary Lehmberg’s drunken-driving arrest last year. But he didn’t feel that strongly when two other district attorneys faced the same charges under similar circumstances. In those … Read More
Gov. Rick Perry of Texas is one of the least thoughtful and most damaging state leaders in America, having done great harm to immigrants, abortion clinics and people without health insurance during his 14 years in office. But bad political … Read More
AUSTIN — Gov. Rick Perry has used longevity and sharp elbows to control state government. His aggressive push last year to oust a damaged district attorney and insert his appointee over an anti-corruption unit was just another step in his … Read More
Today, Gov. Rick Perry was a guest on FOX News Sunday, the interview can be viewed below. Politico Magazine also published and op-ed today by Gov. Perry, “America’s New Mission in Iraq,” which you can read here. Louisiana Governor Bobby … Read More
Gov. Rick Perry today made the following statement regarding the decision by the Travis County Grand Jury: “As governor, I took an oath to faithfully uphold the constitution of Texas, a pledge that I have kept every day as I’ve … Read More
The former owner of a Los Angeles medical clinic management company pleaded guilty today in connection with his role in a scheme to defraud Medicare. Assistant Attorney General Leslie R. Caldwell of the Justice Department’s Criminal Division, Acting U.S. Attorney … Read More
A grand jury indicted Gov. Rick Perry on Friday on charges of abuse of power and coercion as part of an ethics inquiry into his veto of funding for the state’s public integrity unit. The inquiry began last summer after … Read More
Texas lawmakers are exploring ways the state could provide more access to health care for 1.9 million uninsured poor people without acquiescing to guidelines set under the Affordable Care Act, sometimes referred to as Obamacare. They’re calling it the “Texas … Read More
AUSTIN — Texas state government ultimately is to blame for hundreds of millions of dollars of Medicaid spending wasted on braces and orthodontic work that were not medically necessary, according to federal auditors. The audit report, released last week, concludes … Read More
A federal audit has found a Texas state agency to blame in an ongoing fight with Xerox Corp. over who is responsible for hundreds of millions of Medicaid dollars potentially misspent on unnecessary dental and orthodontic procedures. The Austin American … Read More
The HHS OIG’s contractor self-disclosure program provides a means for contractors to self-disclose potential violations of the False Claims Act and various Federal criminal laws involving fraud, conflict of interest, bribery or gratuity. The Federal Acquisition Regulation (FAR) requires certain … Read More
Texas is “ultimately responsible” for millions of misspent Medicaid dollars, according to a new federal audit, because a state agency failed to properly oversee the contractor that reviewed the medical necessity of Medicaid claims. For nearly five years, the Texas … Read More
Not all of the Medicaid direct medical service costs that the Kansas Department of Health and Environment, Division of Health Care Finance (State agency), claimed for school-based health services (SBHS) were reasonable, adequately supported, or otherwise allowable in accordance with … Read More
The Nebraska Department of Health and Human Services, Division of Finance and Support (State agency), did not always comply with Federal Medicaid requirements for billing drug manufacturers for rebates for physician-administered drugs. To collect these rebates, States submit to the … Read More
August 11, 2014 — In the latest development in the ongoing Texas Medicaid scandal, a federal report has laid the responsibility for hundreds of millions of dollars spent on dental and orthodontic procedures that may have been medically unnecessary squarely … Read More
A federal auditor has laid responsibility for hundreds of millions of dollars spent on dental and orthodontic procedures that may have been medically unnecessary squarely on the state agency that oversaw the program. The Texas Health and Human Services Commission … Read More
Gov. Rick Perry has come a long way since 2012, when he went from presidential front-runner to punch line in the blink of an eye and his campaign staff disintegrated into warring factions that eventually met in separate buildings. He … Read More
The Idaho Department of Health and Welfare (State agency) did not ensure that Molina Medicaid Solutions (Molina) implemented adequate information system general controls over the State agency’s Medicaid Management Information System (MMIS). We identified 21 reportable weaknesses, which we consolidated … Read More
