Tag Archives: Medicaid

Medicaid Under Mandate to Cover Autism Treatment

The federal government is ordering state Medicaid programs to pay for comprehensive autism services, but some details remain unclear. When Yuri Maldonado’s 6-year-old son was diagnosed with autism four years ago, she learned that getting him the therapy he needed … Continue reading

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CMS Proposes Adoption of Updated Life Safety Code

The Centers for Medicare & Medicaid Services (CMS) today announced a proposed rule on the adoption of updated life safety code (LSC) that CMS would use in its ongoing work to ensure the health and safety of all patients, family … Continue reading

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Woman Sentenced to Ten Years in Prison for Medicaid Fraud

On Friday, February 28, 2014, a Clayton County jury convicted Catherine Pinkard, of Clayton County, Ga., of one felony count of Medicaid Fraud (O.G.G.A. § 49-4-146.1(b)) and one felony count of Theft by Taking (O.C.G.A. § 16-8-2) for fraudulently billing … Continue reading

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Tenet Faces Fraud Investigation Into Payments Made To Women’s Clinics

A federal investigation into kickbacks allegedly paid by Tenet Healthcare Corp. marks the latest fraud inquiry involving the Dallas-based hospital giant over the last decade. The disclosure this week comes as Tenet has tried to reshape its image and operations … Continue reading

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New York Radiology Practice Pays $15.5M

NEW YORK CITY, Feb. 25, 2014 — A chain of medical radiology facilities has agreed to pay the federal government and the states of New York and New Jersey a total of $15.5 million to settle three whistleblower lawsuits – … Continue reading

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Indian-American Diagnostic Imaging Firm to pay $15M to Resolve Fraud Claims

A diagnostic firm founded by an Indian-American physician, will pay over USD 15 million to the federal government to resolve allegations that it falsely billed for health tests that were never performed. Diagnostic Imaging Group (DIG) has agreed to pay … Continue reading

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Pharmacist Sentenced To Two Years in Prison For Health Care Fraud

A Salem, Ohio, pharmacist was sentenced to two years in prison and ordered to pay more than $300,000 in restitution after previously pleading guilty to health care fraud, said Steven M. Dettelbach, United States Attorney for the Northern District of … Continue reading

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FORMER CHIROPRACTOR INDICTED ON HEALTH CARE FRAUD AND AGGRAVATED IDENTITY THEFT CHARGES

David Lee Killen, age 42, a resident of Covington, Louisiana, was charged today in a thirty-count health care fraud and four-count aggravated identity theft indictment by a Federal Grand Jury for his submission of fraudulent claims to Medicare, Medicaid and … Continue reading

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South Carolina Medicaid Overpaid Hospitals for Some Inpatient Services That Medicare Paid

South Carolina overpaid some Medicaid inpatient claims from hospitals that had received Medicare payments for the same services. Of the 1,136 overpayments ($2.3 million Federal share) that we reviewed, the hospitals had refunded 532 prior to our audit. However, the … Continue reading

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New York State Made Unallowable Medicaid Fee-for-Service Payments

NEW YORK STATE MADE UNALLOWABLE MEDICAID FEE-FOR-SERVICE PAYMENTS FOR BENEFICIARIES ALSO ENROLLED IN MEDICAID MANAGED CARE The New York State Department of Health (State agency) did not prevent separate Medicaid fee-for-service payments from being made for beneficiaries also enrolled in … Continue reading

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