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Bringing about a higher level of transparency and accountability in provincial and federal governments to help protect taxpayers from abuse

Bringing about a higher level of transparency and accountability in provincial and federal governments to help protect taxpayers from abuse.

Chadron mental health therapist ordered to pay over $300,000 to state

Attorney General Doug Peterson announced today that a judge has ordered a Chadron-area mental health therapist to pay more than $300,000 to the state due to her improper billing practices.

Dawes County District Judge Travis O’Gorman ordered Anna Young to pay $308,866.80 after an investigation by the Attorney General’s Medicaid Fraud and Patient Abuse Unit found that she had billed Nebraska Medicaid $102,955.60 for mental health services. Young admitted that she knowingly failed to maintain documentation to support the submission of the claims, as required by law. She was ordered to repay triple the amount that she billed to Medicaid, per the Nebraska False Medicaid Claims Act.

read more at The Hemingford Ledger

A major Medicare fraud ring was busted in May, and a Houston doctor will not be psyched when he does his time for the crime

Earlier this year, Houston psychiatrist Riaz Mazcuri was found guilty for his involvement with a $158 million Medicare fraud scheme being run out of Riverside General Hospital.

He was convicted in May by a federal jury on one count of conspiracy to commit healthcare fraud and five counts of fraud, and his sentencing is set for October.

read more at rare.us

Agency Owner Sentenced in $400 Million Home Health Fraud

The owner of a home health agency in Dallas has been sentenced to 17 years in prison for his role in the nation’s largest home health care fraud scheme in history—a nearly $400 million scam, the Justice Department announced Tuesday.

Wilbert James Veasey, Jr., 65, was sentenced to 210 months in federal prison and ordered to pay more than $23 million in restitution to Medicare and more than $500,000 to Medicaid. Veasey, along with several others involved in the scheme, was found guilty last year. He has been in custody since early 2016.

read more at homehealthcarenews.com

Florida Doctor Receives 10-Year Sentence For Sober Home Scheme

A Florida doctor has received a 10-year federal prison sentence for the role he played in a sober-home fraud scheme that prompted widespread investigation.

Donald Willems, 41, pleaded guilty to conspiracy to commit healthcare fraud and received the maximum sentence, according to The Palm Beach Post. According to court documents, Willems signed off on unnecessary drug, allergy and DNA tests during his time as the medical director at Reflections Treatment Center in Margate, Florida.

read more at thefix.com

American Medical Association opposes Medicaid funding caps, adopts new policies

The American Medical Association’s House of Delegates voted to adopt new policies during the national physician organization’s annual meeting this week, and in the process reaffirmed its opposition to caps on Medicaid funding, eyeing a possible healthcare overhaul by Congress and the Trump administration.

Carl A. Sirio, MD, said in a statement that capping Medicaid funding would be “disastrous” for patients because it would limit medical responses to unforeseen events and medical innovations.

read more at healthcarefinancenews.com

Trump tells Senators new GOP healthcare bill is ‘mean’

During a lunch meeting with GOP senators on Wednesday, President Donald Trump called the House-version of the American Health Care Act “mean,” and urged them to make it more generous.

Trump reportedly talked about having a bill come out of the Senate that protects people with preexisting conditions and having a tax credit that works for low income elderly Americans, according to the story originally reported by the Associated Press.

read more at healthcarefinancenews.com

3 Whistleblower Suits Net over $60 Million in Medicare Fraud

June 12, 2017 – Whistleblower lawsuits alleging Medicare fraud have been settled against two diagnostic testing companies, and a California doctor who was alleged to have falsely diagnosed cancer as a means to bill Medicare for expensive surgeries.

Medicare fraud remains a prominent issue that has recently garnered renewed calls for increased federal audits and investigation. A key factor for the prosecution of these suits comes from the involvement of whistleblowers, who were central to these three recent settlements.

read more at healthpayerintelligence.com

Woman gets 5-year sentence for health-care fraud

BOISE — A Fruitland woman will serve five years in prison for her role in health-care fraud and aggravated identity theft.

Cherie R. Dillon, 62, of Fruitland, was sentenced Wednesday to five years in prison to be followed by three years of supervised release for health-care fraud and aggravated identity theft, Acting U.S. Attorney Rafael Gonzalez announced in a news release.

Read more at argusobserver.com

U.S. Falls Behind China & Canada In Advancing Healthcare With A.I.

The United States leads the world in artificial intelligence, but lags behind other countries in applying technical innovations to the field of healthcare. Globally, machine learning is used to increase efficiency, lower error rates, and decrease medical costs, but the fragmented marketplace and lack of universal healthcare in America disincentivize adoption of new technology as buyers often prioritize economics over patient care.

Sally Daub, CEO of Enlitic, a frontrunner in providing AI-based healthcare solutions, illuminates why healthcare technology adoption is stunted. “Here the conversation revolves around ‘Who is going to pay for this? What are the economic incentives to use this technology?’ rather than ‘Will this technology result in better outcomes for patients?’,” she explains. Payoff structures may even discourage insurers from footing the bill for early intervention treatments. If insurers don’t approve a new technology, they don’t issue insurance procedure codes necessary for healthcare providers to be reimbursed for services, which means providers won’t adopt the solution either.

Read more at forbes.com

Wyoming psychologist indicted on $6.8 million in healthcare fraud

Cheyenne, Wyo. – A federal grand jury returned an indictment on May 19th charging Powell psychologist Gibson Condie with 234 counts of health care fraud involving approximately $6.8 million in fraudulent bills submitted to Wyoming Medicaid.

That’s according to the U.S. Attorney’s Office for the District of Wyoming and the Federal Bureau of Investigation.

This indictment was the result of an investigation by the FBI, the United States Department of Health and Human Services’ Office of Inspector General, and the Wyoming Medicaid Fraud Control Unit.

Read more at kgwn.tv