A metro Atlanta dentist has pleaded guilty to defrauding the Georgia Medicaid program of nearly $1 million. Dr. Oluwatoyin Solarin, who had offices in Doraville and Duluth, had some employees of her Care Dental practice back-date claims for patients whose … Read More
The Audit division of the Health and Human Services Office of Inspector General released a report at the end of October (although TDMR just received the email notification about it today) about an audit they conducted on the practice of … Read More
Significant and persistent compliance, payment and fraud vulnerabilities exist within the Medicaid program that covers home care for elderly and disabled people, according to a recent report from HHS’ Office of Inspector General. In the report, the OIG highlighted some … Read More
MIAMI (AP) — A fall 2017 trial date is set for a South Florida businessman accused of orchestrating a $1 billion Medicare and Medicaid fraud scheme.Court records show a Miami federal judge on Wednesday scheduled 48-year-old Philip Esformes’ trial for … Read More
PULASKI COUNTY (KATV) — A 33-year-old Malvern woman was arrested for more than $700 in Medicaid fraud. Marquita Morgan faces a charge of Medicaid fraud. She is accused of billing more than $700 for services she didn’t receive in 2015, … Read More
There is a rumor circulating that the Texas Health and Human Services Commission is putting together a new request for proposals (RFP) for dental managed care organizations for Texas Medicaid. While this may or may not be the case as … Read More
Lawyers for Texas Attorney General Ken Paxton are no longer asking to have a state securities fraud case against him dismissed, moving him closer to a trial on the criminal charges. Paxton’s legal team confirmed Tuesday that it was getting … Read More
A Dallas doctor and businessman convicted of a health-care fraud conspiracy involving East Texas hospitals has been ordered to pay $1.22 million to the United States. Dr. Tariq Mahmood, a 65-year-old general practitioner from Cedar Hill, was found guilty in … Read More
Last November, former Texas Medicaid director Billy Millwee, now a private consultant, appeared before the Little Hoover Commission in Sacramento, California. The LHC is an independent state oversight agency that was created in 1962 with the mission to investigate California … Read More
Want to make some easy cash? Try defrauding Medicaid. It’s a booming business, according to the federal Centers for Medicare & Medicaid Services, which says the total amount of “improper payments” for Medicaid last year totaled more than $29 billion … Read More
Federal officials in recent years have increasingly worked to combat Medicare and Medicaid fraud.In fact, at the beginning of his second term, President Barack Obama made the issue a top priority, according to The Fiscal Times. Since then, there have … Read More
Mylan NV (NASDAQ:MYL) has agreed to pay $465 million to settle claims that the drug giant underpaid the federal government in rebates to Medicaid for its EpiPen allergy shot. However, the move is not enough. Senator Elizabeth Warren criticized the … Read More
In the latest chapter of the Obama administration’s crackdown on Medicare fraud, U.S. customs officials arrested a woman at the Dallas-Fort Worth International Airport last week who is accused of taking part in one of the biggest Medicare fraud schemes … Read More
ALBANY — The luxury rides that belonged to a crooked Bronx pill peddler can be yours for the right price.State officials are about to sell at auction a 2014 Maserati Gran Turismo and a 2014 BMW X6 seized by the … Read More
The Texas Tribune this morning published an article that indicates the fate of Texas Health and Human Services Inspector General Stuart Bowen is uncertain at this time. Planned Parenthood investigation tied to fund-raising effort The context of the story was … Read More
PULASKI COUNTY (KATV) — A 49-year-old Conway woman was arrested accused of $3,500 in Medicaid fraud.Georgia Broady faces one count of Medicaid fraud. The arrest was announced by Arkansas Attorney General Leslie Rutledge. Source: Conway woman arrested for $3,500 in … Read More
Two of Tenet Healthcare Corp.’s former subsidiaries admitted to conspiring to defraud Medicaid by using referral contracts for translation services to funnel pregnant patients through their doors.Atlanta Medical Center and North Fulton Hospital in Georgia each pled guilty to one … Read More
CBS – Baby boomers are expected to need more in-home care as they age, but federal investigators are now raising an alarm over what they call persistent fraud and abuse in Medicaid-funded personal care services.Investigators from the Department of Health … Read More
The Alaska Department of Health and Social Services has settled its complaints with Xerox over management of Medicaid claims, resetting its health-care contract with the business giant for an agreed-upon series of performance standards.The state’s claim against Xerox State Healthcare … Read More
In a quick action on Monday, the three counts of alleged Medicaid fraud against the former owner of Bluegrass Autism in Danville were dismissed amid allegations of misconduct by an attorney general’s office investigator. Judge Darren Peckler granted the request … Read More
AGENCIES: Office of Inspector General (OIG) and Centers for Medicare & Medicaid Services (CMS), HHS. ACTION: Proposed rule. SUMMARY: This proposed rule would amend the regulation governing State Medicaid Fraud Control Units (MFCUs or Units). The proposed rule would incorporate … Read More
The state of West Virginia accused Mylan NV of Medicaid fraud for inflating the price of the EpiPen by 500 percent and has asked the company to turn over documents related to Medicaid reimbursements. Heather Bresch, Mylan’s chief executive officer, … Read More
WHY WE DID THIS STUDY The Department of Health and Human Services (HHS) OIG is the designated Federal agency that oversees State Medicaid Fraud Control Units (MFCU or Unit). This MFCU Fiscal Year (FY) 2015 Annual Report highlights statistical achievements … Read More
TYLER, Texas – A 65-year-old Dallas County, Texas, physician, has been resentenced to federal prison for health care fraud and identity theft violations in the Eastern District of Texas, announced U.S. Attorney John M. Bales. In July 2014, Tariq Mahmood, of … Read More
Former Gov. Rick Perry brought some Texas flair to the Season 23 premiere of “Dancing With The Stars,” but his footwork brought few plaudits from the judges. The show partnered Perry, who performed in an floral embroidered Western jacket, with professional dancer Emma Slater … Read More
An Ohio man who is the son of a former Iranian prince and is said to be worth millions of dollars has been living off government assistance for the last two years.Ali Pascal Mahvi lives in an 8,000 square foot … Read More
McALLEN — Two Mission women pleaded guilty in connection with a 12-count indictment accusing them and several others of federal healthcare fraud totaling nearly $5 million, according to court records.Veronica Vela, 42, and Cynthia Lee Zapata, 50, appeared in federal … Read More
Nevada Attorney General Adam Paul Laxalt announced that Mamie Ree Hubbard-Washington, 73, of Las Vegas, was sentenced for Medicaid fraud. The fraud was committed between April and August 2012. Eighth Judicial District Court Judge Michelle Leavitt sentenced Hubbard-Washington to one … Read More
A former Seymour dentist faces felony charges related to an investigation into the false billing of the state’s Medicaid program for dental treatments he allegedly did not perform on patients, a Marion County official reports. Dr. James Judd, 69, has … Read More
A pediatric dental provider with practices in Milford and West Haven will pay more than $1.3 million to the state and federal government to resolve allegations that he submitted false claims to Connecticut’s Medicaid program for x-ray services that did … Read More
When FBI and Health and Human Services investigators announced earlier this summer they had snared more than 300 people trying to bilk Medicare out of $900 million, one might have concluded the corner had been turned in the fight against … Read More
Three hospitals in New York’s Mount Sinai Health System will pay $2.95 million to settle Medicaid fraud charges for taking two years to repay more than $844,000 of improper billings that had been flagged by a whistleblower, authorities said on … Read More
LITTLE ROCK – Arkansas Attorney General Leslie Rutledge today announced the conviction of eastern Arkansans for Medicaid fraud. Andrea Jefferson of Crittenden County pleaded guilty in Pulaski County District Court. She has been ordered to pay $470 in restitution to … Read More
The U.S. Department of Health and Human Services (HHS) released a report from its Office of the Inspector General (OIG) regarding the wireless networks of the Centers for Medicare & Medicaid Services’ (CMS) facilities. The report shows that CMS, which collects … Read More
In his recent quarterly report, Health and Human Services Commission Inspector General Stuart Bowen announced the kickoff off his initiative to increase awareness and cooperation on fraud, waste and abuse between Medicaid stakeholders. The IG Integrity Initiative (IGII) is described as … Read More
This week the Health and Human Services Commission Inspector General released his June 2016 quarterly report on the activities of his agency. Besides announcing the creation of a Pediatric Dentistry Action Team, the report also discloses that more Medicaid dentists … Read More
In 2015, the Government Accountability Office (GAO) estimated that taxpayers lost $136 billion to improper payments, a low-end estimate that mostly came from Medicare and Medicaid. The two popular and costly federal health care programs are growing rapidly, yet they … Read More
Today, Health and Human Services Commission Inspector General Stuart Bowen Jr. issued his fourth quarterly report since he took office back in early 2015 replacing former Inspector General Doug Wilson. Please find a copy of the report below. It can … Read More
A Baker woman accused of defrauding Louisiana to the tune of $1 million-plus in a Medicaid fraud scheme has been sentenced to five years in prison. Even though 38-year-old Chanda Hall pleaded guilty in April to a racketeering charge, The … Read More
TDMR has learned that a number of dental providers have reported being placed on payment hold by MCNA for “willful misrepresentation or abuse of claims.” Payment holds placed for mistakes and missing paperwork In these reports, dentists claim that MCNA’s … Read More
