Medicaid

August 20, 2007 -- LANSING - Michigan Attorney General Mike Cox announced today that his Health Care Fraud Division and the United States Attorney's Office for the Eastern District of Michigan have negotiated a settlement of health care fraud allegations against Ciena Health Care Management Inc. The settlement includes Medicare and Medicaid reimbursement of $1.25 million and a comprehensive chain-wide corporate integrity agreement (CIA).    » read more »

Crouch's Health Care Experience Will Continue KyHealth Choices' Success

August 20, 2007 -- Kentucky Cabinet for Health and Family Services (CHFS) Secretary Mark D. Birdwhistell announced today that Shawn Crouch has been appointed the new commissioner of the Department for Medicaid Services, effective Sept. 1.

Crouch has served most recently as the chief of staff for CHFS, and prior to that as theexecutive director for the Office of Health Policy and executive officer to the Undersecretary for Health.    » read more »

August 17, 2007 -- TALLAHASSEE, FL – Florida Attorney General Bill McCollum today announced the arrest of an Indian River county woman for stealing more than $3,000 from Florida’s Medicaid program. Alina Leyva was arrested by law enforcement officers with the Attorney General’s Medicaid Fraud Control Unit with the assistance of deputies from the Indian River County Sheriff’s Office.    » read more »

August 15, 2007 -- BOSTON – Today, Massachusetts Attorney General Martha Coakley's Office reached a settlement agreement with Missouri-based ETHEX Corporation, a seller of generic pharmaceuticals, to resolve litigation pending in the U.S District Court in Boston. In that litigation, ETHEX was one of thirteen generic drug manufacturers sued by the Commonwealth for allegedly inflating the drug prices that they reported to national price reporting services.    » read more »

August 10, 2007 -- LANSING - Michigan Attorney General Mike Cox announced that Billy Shee Lim, D.D.S., age 57, of Rochester Hills has been sentenced before 30th Judicial Circuit Court Judge William Collette following his guilty plea to two counts of Medicaid fraud.    » read more »

August 10, 2007 -- Kansas Attorney General Paul Morrison announced today that Peggy and Johnnie Franklin-El were sentenced to 92 months in prison for making false claims to Medicaid. The Franklin-Els were also ordered to pay total losses of $1.24 million in restitution to Medicaid.

"We're happy with the outcome in this case and proud of the coordinated effort to crack down on those who scam the Medicaid system," Morrison said. "This sentence sends a message that individuals who abuse the Medicaid system and steal money face the tough penalties they deserve."    » read more »

New Report Finds Young Adults In Low-Income Families Most Likely to Lack Coverage; Raising SCHIP/Medicaid Eligibility Age an Important Solution

New York City, August 8, 2007—Since 2003, 16 states have enacted legislation requiring insurance companies to provide health insurance coverage to dependent young adults on their parents' health plans beyond age 18 or 19, according to a new report from The Commonwealth Fund.    » read more »

ALBANY, NY (August 6, 2007) – New York Attorney General Andrew M. Cuomo today announced approximately $7 million in duplicate claim payments have been recovered from two managed care organizations (MCOs) as part of a series of joint audits and investigations.    » read more »

August 7, 2007 -- Jefferson City, Mo. — Missouri Attorney General Jay Nixon announced today that the Missouri Medicaid program will be receiving $462,926 from a pharmacy in DeKalb County that is under investigation for Medicaid fraud. Nixon said the Medicaid Fraud Control Unit in his office has recovered the money from the Randolph Drug Store in Maysville.    » read more »

August 6, 2007 -- (MONTGOMERY) — Alabama Attorney General Troy King announced today that an investigation conducted by his office, the U.S. Attorney's Office for the Middle District of Alabama, the Internal Revenue Service and the Federal Bureau of Investigation, has resulted in the arrest of a Montgomery woman for identity theft.    » read more »

- Westchester dentist, wife arrested for money laundering in connection with $2.8 million Medicaid fraud
- Former Bronx nursing home owner to pay $6 million, spend 2 - 6 years behind bars

02/27/2007 -- In a day-long series of meetings with members of Congress and Bush Administration officials, Governor Arnold Schwarzenegger lobbied for California's fair share of federal funding. The Governor emphasized the critical importance of the State Alien Assistance Program (SCAAP), the States Children's Health Insurance Program (SCHIP), Medicare and Medicaid. He also called for more funding for education, first responder and law enforcement grants and assistance for victims of the January 2007 freeze.    » read more »

Defendant stole personal identification information from more than 40 victims

July 16, 2007 -- INDIANAPOLIS, IN – Indianapolis resident Osman Abdalla has agreed to plead guilty to health care fraud in United States District Court Southern District of Indiana. Under the terms of the agreement accepted by the Court July 13, Abdalla will reimburse the Medicaid program approximately $60,000 for fraudulently billing the program for providing wheelchair transportation for Medicaid participants when the participants were not in wheelchairs.    » read more »

July 06, 2007 -- A new method of setting limits on what the federal government will reimburse state Medicaid agencies for prescription drug payments — aimed at reigning in inflated drug product payments — was announced today in a final rule put on display at the Federal Register.

“This new payment formula allows Medicaid to pay more appropriately for prescription drugs dispensed to Medicaid beneficiaries,” said Leslie V. Norwalk, Esq., acting administrator of the Centers for Medicare & Medicaid Services (CMS).    » read more »