December 31, 2013 — A 57-year-old New Hampshire dentist indicted on 189 counts of Medicaid fraud faces up to 1,300 years in prison, according to a story in the Concord Monitor. Nicholas Marshall, DDS, who practices in Manchester, is accused … Read More
Debra Jean Velasquez, of Robstown, and Sylvia Salinas Ramirez, of Driscoll, have been ordered to prison in a scheme to defraud the Texas Medicaid program through fraudulent home health billings, announced United States Attorney Kenneth Magidson along with Texas Attorney … Read More
Washington, DC – A Houston doctor has been arrested on charges related to her alleged participation in a $158 million Medicare fraud scheme involving false claims for mental health treatment.Acting Assistant Attorney General Mythili Raman of the Justice Department’s Criminal … Read More
December 12, 2013 — The U.S. Consumer Financial Protection Bureau (CFPB) has ordered GE Capital Retail Bank and its subsidiary, CareCredit, to refund up to $34.1 million to potentially more than 1 million consumers who were victims of deceptive credit … Read More
Back on October 15th, 2012, now more than a year ago, Texas Deputy Attorney General for Civil Litigation John Scott testified before the House Committee on Public Health in the Capitol. TDMR has just reviewed the archived video from the … Read More
Before the Thanksgiving long weekend, TDMR received a copy of the August 2012 audit conducted by the HHSC Office of the Inspector General on the Texas Medicaid and Healthcare Partnership. As far as we know this is the first time … Read More
The Texas Sunset Commission is evaluating the state Health and Human Services Commission this coming year under its mandate to periodically review Texas state agencies for their operation and need to exist. About the Commission The Texas Legislature created the … Read More
November 19, 2013 — A New York judge on November 18 ordered a new trial in the Small Smiles case after ruling that a lawyer for the insurance company stalked the jury during the trial. The judge found that the … Read More
BROWNSVILLE, Texas –– Texas spent $400 million on speech therapy for children under Medicaid last year, up 30 percent from three years ago. Speech therapists along a 76-mile stretch of Texas Highway 83, from Brownsville to Mission, collect more money … Read More
After a 40-year career, Dr. Paul Dunn is now on the verge of bankruptcy because he helped Medicaid children. In 2012, HHSC-OIG placed Dunn’s practice in Levelland under a 100% “credible allegation of fraud” payment hold for his orthodontic Medicaid … Read More
BEAUMONT, Texas — A Southeast Texas dentist who pleaded guilty to health care fraud has been sentenced to nearly two years in prison and must pay $835,000. A federal judge in Beaumont on Thursday sentenced Dr. Terrence Ewing Syler to … Read More
DOUGLAS WILSON | Texas Health and Human Services Inspector General Adult diapers are delivered to a resident who doesn’t need and didn’t order them. A man says he needs your benefit card and PIN number for your free phone. A … Read More
Austin: (PR Web): Two administrative law judges with the Texas State Office of Administrative Hearings (SOAH) have issued their proposal for decision in the case of Antoine Dental Center of Houston (ADC) SOAH Docket No. 529-13-0997. ADC had been placed … Read More
by Becca Aaronson, The Texas Tribune November 5, 2013 The Texas Health and Human Services Commission’s Office of Inspector General, which says that hundreds of millions of dollars have been misspent on fraudulent Medicaid orthodontic and dental claims, has lost … Read More
The Office of the Inspector General website now has a report detailing the 2012 fraud detection and recovery activity of all managed care organizations (MCOs) that participate in Texas Medicaid. Under Texas Government Code, Section 531.113, the MCOs are required … Read More
AUSTIN — Freed from a nearly yearlong moratorium, Texas’ revamped $3 billion cancer agency will take another look at research grants frozen by state lawmakers before finally releasing millions in taxpayer dollars, the agency’s top executive said Thursday. Revamped Texas … Read More
Texas – Peter Pedro Egede was arrested in Houston. He is awaiting sentencing. Peter Pedro Egede was indicted on charges of conspiracy to commit health care fraud and health care fraud. Egede admitted that he received approximately $1.7 million in … Read More
Washington, DC—(ENEWSPF)—October 31, 2013. A federal jury in Houston has convicted Gwendolyn Climmons-Johnson, 53, of multiple counts of health care fraud for submitting false and fraudulent claims to Medicare for ambulance services. Owner of Texas-based Ambulance Service Convicted … Read More
October 23, 2013 — A U.K. dentist who bilked the National Health Service (NHS) for more than 1.5 million pounds ($2.5 million) has been officially barred from practicing. Joyce Trail has been suspended from practicing by the General Dental Council … Read More
by Becca Aaronson October 15, 2013 Texans discovered nearly two years ago that the state was spending more on orthodontic claims in its Medicaid program than the other 49 states combined, but recovery of millions in purportedly misspent Medicaid money … Read More
Dr. Roque Joel Ramirez, 48, of Robstown, has been charged in a 14-count indictment for a scheme to defraud Medicare and Medicaid through fraudulent billings, amounting in $1.4 million. For the fulll story, follow the link: Local doctor arrested in … Read More
By Donna Domino, Features Editor October 9, 2013 — A jury has found that Small Smiles dentists did not perform unnecessary dental procedures on a young boy at one of the chain’s clinics in New York. The judge found that … Read More
Nearly two years after news broke that Texas spent more on orthodontic claims in its Medicaid program than the other 49 states combined, the Health and Human Services Commission’s Office of Inspector General is barely knee deep in its effort … Read More
September 23, 2013 — A Texas judge has ordered the state to return $1.3 million that was withheld from Harlingen Family Dentistry (HFD) based on unfounded allegations of fraud on orthodontic Medicaid billings. Travis County Judge Amy Clark Meachum has … Read More
This morning the San Antonio Express published a feature article headlining the case of Harlingen Family Dentistry and Dr. Juan Villarreal and his fight against the Office of Inspector General and their “credible allegation of fraud” payment holds. Reporter Jeremy … Read More
SPECIAL TO THE EXPRESS NEWS- HARLINGEN,Tx July 30,2013- Dr. Juan Villarreal, a dentist at Harlingen Family in Harlingen Texas gets ready to check a patient at his office Tuesday July 30,2013. Photo by Delcia Lopez via In Medicaid, docs guilty … Read More
A Travis County judge has awarded more than $22,000 in legal fees to an Amarillo law firm that helped expose more than $1 million in Medicaid fraud at a local orthodontics clinic. Amarillo attorney Phil Russ, who represented three former … Read More
Harlingen Family Dentistry has won a tremendous legal victory this week. Travis County District Court Judge Amy Clark Meachum has granted HFD’s motion for a writ of mandamus to force the Office of Inspector General to return more than $1 … Read More
Back on September 5th, the Texas Tribune hosted a conversation on the future of Latino health care with Dr. Esteban López, a regional president for Blue Cross Blue Shield of Texas, Dr. Amelie Ramirez, director of the Institute for Health … Read More
This past week State Office of Administrative Hearings (SOAH) Judge Roy G. Scudday ruled that Christine Ellis and her qui tam lawyers had no standing to appear in a hearing regarding an HHSC-Office of Inspector General payment hold placed on … Read More
The following was in the latest HHSC newsletter “In Touch.” HHSC’s Office of Inspector General (OIG) will hire 127 new employees over the next year, two-thirds of whom will be in enforcement as the division looks to speed up fraud … Read More
South Texas Dental, which operates family dental centers in Houston, Dallas, Fort Worth and San Antonio, has acquired the 12 offices of the All Smiles general dentistry practice in North Texas. Financial terms of the transaction were not released. Three … Read More
State lawmakers approved a wide range of measures in the 83rd legislative session that will affect Texans’ medical care. Use this interactive to take a look at 31 ways those laws will change Texas health policy. Full story click below. … Read More
Karen Nelson is no longer with the Office of Inspector General. The former Deputy Inspector General for the HHSC-OIG is now working for the Austin office of the DLA Piper law firm. Nelson apparently left OIG last month. One can … Read More
Hearing Transcripts Now Available for Download Antoine Dental Clinic vs. HHSC-OIG – Vol. 1 Antoine Dental Clinic vs. HHSC-OIG – Vol. 2 Antoine Dental Center v. THHSC, OIG – Vol. 3 Antoine Dental Center v. THHSC, OIG – Vol. 4 … Read More
This week the staff of the Committee on Finance and Committee for Judiciary for the U.S. Senate released a negative report about DSOs entitled the “JOINT STAFF REPORT ON THE CORPORATE PRACTICE OF DENTISTRY IN THE MEDICAID PROGRAM.” The report suggested that one … Read More
The following is information on upcoming court hearings that are vitally important to this whole dental Medicaid provider issue. On August 13 at 9:00 a.m., an HHSC Appeals Judge will hear M&M Orthodontics of San Antonio’s Plea to the Jurisdiction. … Read More
Last week, Antoine Dental Centers of Houston and Harlingen Family Dentistry of Harlingen brought a motion before the Travis County District Court to unseal the massive Christine Ellis qui tam suit filing that in redacted form appears to have 46 … Read More
TDMR has learned that Harlingen Family Dentistry has filed a lawsuit against HHSC and the OIG challenging their authority to impose a payment hold on Medicaid providers for a simple program violation. The case, styled Harlingen Family Dentistry, P.C. vs. … Read More
As was reported in the media, on June 25th, 2012, Texas orthodontist Christine Ellis filed a qui tam suit against dental chain All Smiles with the Dallas firm of Waters and Kraus acting on her behalf. Ellis has been one of the … Read More
