Medicaid

Glaxo-Smith Kline falsely priced Medicaid-covered drugs, repays Texas $1.4 million

November 16, 2007 -- AUSTIN – Texas Attorney General Greg Abbott today settled a fraudulent drug pricing case with pharmaceutical giant Glaxo-Smith Kline, its parent company, SmithKline Beecham Corp., and a subsidiary. Under the settlement, the defendants agreed to repay almost $1.4 million for charging the state inflated prices for three prescription drugs from 1994 to 2002.    » read more »

Aaron R. Binder of Fresno guilty of felony theft

November 16, 2007 -- HOUSTON – A Fresno man was sentenced Thursday to five years in prison after pleading guilty to first-degree felony theft, admitting to a scheme that defrauded the Medicaid program of approximately $600,000 in taxpayer funds.    » read more »

GAO finds that up to $160 million could have been recouped in 2006 alone if payments to Medicaid practitioners were levied

November 14, 2007 -- Continuing their efforts to root out waste, fraud and abuse of taxpayers’ dollars, Senator Norm Coleman (R-MN), Ranking Member of the Permanent Subcommittee on Investigations (PSI), and Subcommittee Chairman Carl Levin (D-MI) will be holding a hearing today at 3:30 p.m est entitled, Medicaid Providers That Cheat on Their Taxes and What Should Be Done About It.    » read more »

November 13, 2007 -- TRENTON - New Jersey Attorney General Anne Milgram and Criminal Justice Director Gregory A. Paw announced today that two owners and the medical director of a Trenton mental health clinic were indicted today for their roles in a conspiracy to fraudulently over-bill the Medicaid and Medicare programs by more than $160,000.    » read more »

Nov. 9, 2007 -- WASHINGTON – Four members of the same family, who owned and operated a series of Miami Durable Medicare Equipment companies and Comprehensive Outpatient Rehabilitation Facilities have each been sentenced to 57 months in prison for Medicare fraud, Assistant Attorney General Alice S. Fisher of the Criminal Division and U.S. Attorney R. Alexander Acosta of the Southern District of Florida announced today.    » read more »

Sigifredo Flores convicted of sexually abusing patients in his care; faces additional fraud charge

November 8, 2007 -- MCALLEN – A Hidalgo County jury today sentenced licensed professional counselor Sigifredo Flores, 52, of Progreso Lakes, to 27 years in prison for sexually assaulting patients in his care. An investigation by Texas Attorney General Greg Abbott’s Medicaid Fraud Control Unit (MFCU) revealed that Flores sexually abused two children and two adults during counseling sessions.    » read more »

November 9, 2007 -- "This agreement in principal - the result of an unprecedented investigative partnership between Connecticut and the U.S. Attorney's Office in Philadelphia - will return millions of dollars to the Medicaid program. If it becomes final, the Cephalon settlement by no means ends Connecticut's intensive ongoing investigation into the company's off-label marketing.    » read more »

October 26, 2007 -- Connecticut Attorney General Richard Blumenthal, responding to public inquiries about a federal investigation and raid at WellCare Health Plans, Inc., confirmed that his office has been conducting a months-long investigation into an affiliate company, WellCare of Connecticut, Inc.

WellCare is one of four managed care companies that administers the state's Medicaid program, including the Husky program for children.    » read more »

NEW YORK, NY (October 25, 2007) -- New York Attorney General Andrew M. Cuomo today announced arrests in connection with “Operation Home Alone,” the sweeping investigation of fraud in the home health industry. The arrests include 16 home health aides, two registered nurses and a home care patient alleged to have defrauded Medicaid through improper billing and no-show jobs.    » read more »

October 17, 2007 -- TRENTON - New Jersey Attorney General Anne Milgram and Criminal Justice Director Gregory A. Paw, announced that an Essex County pharmacist and the pharmacy he operated were convicted in absentia yesterday of health care claims fraud and Medicaid fraud for submitting more than $15,000 in phony prescription claims to the Medicaid program.    » read more »

October 9, 2007 -- (MONTGOMERY) — Alabama Attorney General Troy King announced the conviction today of a Montgomery woman for identity theft. Kwantrice M. Thornton was arrested August 6 on a warrant brought by Attorney General King's Medicaid Fraud Control Unit, and this morning she pleaded guilty as charged, in an information document filed with the Montgomery County Circuit Court.    » read more »

Seniors’ Care Most Negatively Impacted in IL, NJ, WI, MN, VT, NH, MO, DE, WA and MA; Researchers Warn Medicaid Shortfall Undermines Medicare Stability

October 3, 2007 -- Washington, DC – “A new independent analysis of the nation’s Medicaid program by the accounting firms BDO Seidman/Eljay,LLC estimates states are underfunding the actual cost of providing seniors’ critical nursing home care by at least $4.4 billion annually, or, $13.15 per patient day – representing a dramatic 45% increase from 1999 ($9.05) through 2007.    » read more »

Arrest is first by NY State-Nassau County Medicaid fraud task force

MINEOLA, NY (October 1, 2007) - New York Attorney General Andrew M. Cuomo and Nassau County District Attorney Kathleen M. Rice today announced the arrest of a home care agency operator and an associate for a litany of Medicaid-related crimes that were committed to bankroll extravagant lifestyles. The arrests were the result of an investigation by the Medicaid fraud task force Attorney General Cuomo and the District Attorney Rice launched in January.    » read more »

September 28, 2007 -- COLUMBUS -- Ohio Attorney General Marc Dann announced today that he and his counterparts from across the country have reached an agreement in principle with Bristol-Myers Squibb Company (“BMS”) to repay that states’ Medicaid programs more than $400 million. The settlement will resolve allegations that the company participated in various activities that resulted in overpayments by the Medicaid programs.

The specific allegations being resolved include the following:    » read more »

September 26, 2007 -- TRENTON - New Jersey Attorney General Anne Milgram and Criminal Justice Director Gregory A. Paw announced that an Essex County chiropractor has pleaded guilty today for his role in an insurance fraud scheme.

According to Insurance Fraud Prosecutor Greta Gooden Brown, Samuel Sbarra, 49, Nutley, pleaded guilty before Superior Court Judge Donald J. Volkert, Jr. in Essex County to a criminal accusation charging him with third-degree attempted theft by deception.    » read more »