A Zachary home health care business owner accused of violating Louisiana’s sparingly used racketeering statute in an alleged Medicaid fraud scheme pleaded guilty this week to a racketeering charge and faces up to 50 years in prison when she is … Read More
What was a woman accused of 11 counts of dependent adult abuse and ongoing criminal conduct doing working for AmeriHealth Caritas Iowa, one of the three private, out-of-state Medicaid management companies hired by the state to serve low-income and disabled Iowans?That … Read More
ALBUQUERQUE (AP) – The last two of 15 mental health nonprofit providers under investigation for possible Medicaid fraud have been cleared by New Mexico’s top prosecutor. Attorney General Hector Balderas is sending a letter to state lawmakers Tuesday, informing them … Read More
WHY WE DID THIS STUDY The Office of Inspector General (OIG) oversees the activities of all Medicaid Fraud Control Units (MFCUs or Units). As part of this oversight, OIG conducts periodic reviews of all Units and prepares public reports based … Read More
Gov. Rick Scott of Florida has signed into law changes that bring back DMOs such as MCNA and Dentaquest into Florida’s dental Medicaid program if all goes well. Florida governor signs new bill relating to dental Medicaid Florida HB 819, … Read More
TALLAHASSEE — If there’s one subject that rivals the prominence of job creation in Gov. Rick Scott’s rhetoric, it’s Rick Perry.Scott has made a habit of mentioning the former Texas governor, a fellow Republican, in nearly all of his speeches … Read More
TALLAHASSEE — A controversial measure that removes dental care from the required list of benefits Medicaid HMOs must offer patients beginning 2019 and requires the state to enter a five- year, non-renewable contract with a separate vendor will be heard … Read More
March 28, 2016 — Florida Gov. Rick Scott has signed a bill that will study possible changes to the way Medicaid recipients receive dental care in that state. Currently, the state’s Medicaid managed-care system requires HMOs to cover dental services. … Read More
SANTA FE – A health care company that tried to root out fraud in New Mexico’s Medicaid program has now been accused of committing Medicaid fraud itself. Three lawsuits filed against OptumHealth Inc. this year accuse the company of malfeasance stemming … Read More
WILMINGTON, N.C. (WNCT) – Terry Lamont Speller, 38, was sentenced to 240 months in federal prison and three years of supervised release following his guilty plea to Medicaid fraud. The Winterville-native was also ordered to pay back the money he … Read More
A vast web of bribes, kickbacks, counterfeit hardware and a legislative loophole allowed one California spine surgeon to cash in on spinal fusion surgeries for which the state paid millions of dollars, according to an article by Los Angeles Magazine. … Read More
PIERRE, S.D. (AP) — A man accused of defrauding the South Dakota Medicaid program has been sentenced to two years of probation and ordered to pay back $990. Thirty-eight-year-old Tanka Bhujel pleaded guilty in state court to one count of … Read More
Commentary: U.S. Sens. Tom Udall and Martin Heinrich, and U.S. Reps. Ben Ray Luján and Michelle Lujan Grisham introduced the Medicaid Program Integrity Enhancement Act of 2016. The bill protects Medicaid patients by establishing clear guidelines that ensure that state agencies investigating … Read More
A former official with Arizona’s health care program for the poor pleaded guilty Tuesday to fraud and theft charges in a case in which he was accused of stealing millions in public money. Michael John Veit, the former chief procurement … Read More
Ohio Attorney General Mike DeWine said Thursday that Ohio’s Medicaid Fraud Control Unit ranks first in the nation for the number of convictions secured in fiscal year 2015, according to a statistical summary of Medicaid fraud control units in all … Read More
ATLANTA (WXIA) – Georgia State Senator Renee Unterman (R – 45th District, Sugar Hill/Buford) is chair of the Senate Health & Human Services Committee. She is also an executive with a health insurer that has a billion dollar a year … Read More
Federal prosecutors have accused Cherie R. Dillon of health care fraud and aggravated identity theft tied to her Payette business, Dental Healthcare with Heart. They say Dillon, 60, performed dental procedures that could only be carried out by a dentist. … Read More
ALBUQUERQUE – Democrats with the state’s congressional delegation are calling for a federal investigation into the withholding of Medicaid payments from 15 nonprofits that provided behavioral health services to needy New Mexicans. In a letter sent Friday to U.S. Health and … Read More
Follow the link below to a map of the country. Click on a state and the MFCU data for that state will open. Source: 2015 Interactive Map of Expenditures | MFCU | Office of Inspector General | U.S. Department of … Read More
WHY WE DID THIS STUDY OIG oversees 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. The reviews assess Unit … Read More
JACKSON, Miss. (AP) — A 31-year-old Louisville woman is going to prison for Medicaid fraud. Attorney General Jim Hood, in a news release Tuesday, said Labeatris Estes pleaded guilty to two counts of Medicaid fraud before Rankin County Circuit Court … Read More
James R. Dye, 66, of Independence, Missouri waived his right to a grand jury and pleaded guilty before U.S. Magistrate Judge David P. Rush to a federal information that charges him with health care fraud. In his plea, Dye admitted … Read More
The state said Schneider billed Medicaid more hundreds of thousands of dollars for procedures he didn’t actually perform. The Office of the Attorney General Medicaid Fraud Control Unit interviewed them as a part of their investigation into the pediatric dentist … Read More
A man pleaded guilty Wednesday to Medicaid fraud after being charged with orchestrating a kickback scheme from his jail cell.David Epps, 44, who had been in the Monroe County Jail on an unrelated charge, was sentenced to six months, according to the … Read More
A Boston dentist with offices in Malden, Everett and South Boston, has agreed to pay $650,000 to the state’s Medicaid program (MassHealth) to resolve allegations of improperly billing for dental work, Attorney General Maura Healey announced Thursday, Jan. 29. The … Read More
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. However, access to dental care for children with Medicaid has been … Read More
NEW YORK – Attorney General Eric T. Schneiderman today announced a $47 million settlement with CenterLight Healthcare and CenterLight Health System, resolving allegations that CenterLight Healthcare’s Select Medicaid Managed Long Term Care Plan (“MLTCP”) fraudulently billed Medicaid for services they … Read More
JACKSONVILLE, Fla. – Dr. Howard S. Schneider, the pediatric dentist who faced allegations of mistreatment of pediatric patients, will have a new judge in his Medicaid fraud case. Judge Angela Cox has taken over the case after Judge Mark Hulsey … Read More
ROCHESTER—Attorney General Eric T. Schneiderman announced the sentencing of Schmeka Morgan, a licensed practical nurse who stole $8,838 from the Medicaid program. Morgan, who provided private nursing services to a special needs young adult, was charged with billing for numerous hours … Read More
SOUTHINGTON – State officials have reached a settlement with a local dentist accused of defrauding Medicaid. The Attorney General’s office announced Monday that Dr. Thomas DeRienzo, owner of Plantsville Family Dental, will pay $55,000 to resolve the False Claims Act … Read More
ROCHESTER – Attorney General Eric T. Schneiderman today announced the arrest and guilty plea of Erica Viverette, a Rochester licensed practical nurse employed to provide private nursing services to a special needs young adult, for stealing nearly $5,000 from the … Read More
ALBANY – The State of New York is getting into the luxury car business courtesy of a pair of Medicaid scammers who were busted in Brooklyn. Officials are preparing to auction off two high-priced cars – including a 2013 Mercedes-Benz … Read More
Amanda Barry, holding her son Dominic who she claims was among the dozens of children brutally treated by dentist Howard Schneider, smiled on Monday hoping the arrest of the former Jacksonville dentist meant he could not harm any more children. … Read More
A federal jury on Thursday convicted a Bowie, Md., couple of orchestrating a multi-year campaign to defraud D.C. Medicaid of more than $80 million between 2009 and 2014, the largest local health-care fraud scheme ever prosecuted in the city. After a … Read More
CARSON CITY — A dentist who overbilled Nevada’s Medicaid program by $285,000 has moved out of state and is under scrutiny by federal officials, the Legislative Commission was told Tuesday. Legislative auditors earlier this year found that the dentist, who … Read More
A Santa Fe judge on Friday called a decision by Gov. Susana Martinez’s administration to withhold Medicaid funds from a behavioral health care agency “arbitrary, capricious or otherwise not in accordance with the law.” The decision by state First District … Read More
In what may be the largest example of medicaid fraud in Nebraska’s history, investigators missed red flags that could’ve potentially saved millions. Now, the state wants to make sure it never happens again. Two weeks ago we told you about … Read More
EAST ST. LOUIS — A Brighton woman pleaded guilty Tuesday to engaging in a scheme to defraud a health care program. In a press release Wednesday, U.S. Attorney Stephen R. Wigginton said sentencing for Jessica A. Teets, 27, has been … Read More
PULASKI COUNTY (KATV) — A 32-year-old man from Desoto, Texas, was arrested for Medicaid fraud. Arkansas Attorney General Leslie Rutledge announced the arrest of DeAndre L. Taybore Tuesday by the Attorney General’s Medicaid Fraud Control Unit. He is accused of … Read More
BROOKLINE, Mass., Oct. 13, 2015 /PRNewswire/ — Bharani Padmanabhan MD PhD, a multiple sclerosis neurologist practicing in theBoston area who is called Dr. Bharani by patients and colleagues, filed a lawsuit in Federal court alleging massive violations of the Computer Fraud … Read More
