โToo good to be trueโ: Surprise packages could be a sign youโre a fraud victim
When packages you didnโt order arrive with your name on them, that is a red flag, especially if whatโs inside is something medical-related. Amy Davis has the warning about fraud that is happening in the Houston area.
United Memorial Medical Center to pay $2M for alleged false claims violations, double-billing for COVID tests
United Memorial Medical Center has agreed to pay $2 million and to make additional contingent payments to resolve alleged False Claims Act violations, the United States Department of Justice announced Wednesday.
Company in Harris County to pay $5.7M after submitting false claims to Medicare to receive travel reimbursements
BestCare Laboratory Services LLC, will pay $5.7 million to settle an outstanding False Claims Act judgment after the company lied to Medicare to receive travel reimbursements, the United States Department of Justice said in a news release.
3 arrested in $142M genetic testing fraud scheme using Houston company; $7.1M in assets seized
The Office of the Attorney Generalโs Medicaid Fraud Control Unit has arrested three people associated with the genetic testing company ApolloMDx for their alleged involvement in a major healthcare fraud scheme to fraudulently bill Medicare approximately $142 million.
Looking to save money? You might qualify for free weatherization updates for your home
We are always looking for ways to save you money. The Texas summer heat means you are probably using more electricity to cool off your home. Viewer Don Conger emailed Investigator Amy Davis and said his utility bills are sky-high. Heโs looking for a company that will do a home energy audit to show him things he can do in his home to conserve electricity.
Richmond man sentenced to nearly 5 years in Medicare home health fraud scheme, agrees to pay back $1.4M in restitution
A 47-year-old home health company owner has been sentenced to nearly five years in prison for a $1.4 million Medicare home health fraud scheme, the United States Department of Justice announced Tuesday.
Ask Amy show notes: New tricky ways thieves are targeting senior citizens
Thieves work overtime to target everyone, but especially our aging parents. From free health screenings to calls about medical devices or easy part time jobs - Jennifer Salazar, Executive Director of The Better Business Bureau Education Foundation, explains what you need to know to avoid falling victim.
Medicare enrollees warned about deceptive marketing schemes
With Medicareโs open enrollment underway, health experts are warning older adults about an uptick in misleading marketing tactics that might lead some to sign up for Medicare Advantage plans that donโt cover their doctors or prescriptions and drive up their out-of-pocket costs.
Ask Amy show notes: Medicare 101
Whether you are helping a parent or you need it yourself - healthcare, as you get older, is a topic we get a lot of questions about. In this weekโs episode, Amy Davis and Guest Alex Rischan from the Houston-Galveston Area Agency on Aging break down what we need to know about Medicare.
Ask Amy: How to get help figuring out the best healthcare coverage options as we age
Topic: healthcare coverage as we get older. You may need it or you might be helping a parent. Investigator Amy Davis gets answers to common questions about Medicare. Are those TV ads legit? Plus, learn how to apply for free help.
Houston woman sentenced to federal prison after creating bills for fake patients in $10M Medicare fraud scheme, DOJ says
A 59-year-old Houston woman has been sent to federal prison following her conviction of committing and conspiracy to commit health care fraud, the U.S. Attorneyโs Office announced.
Go-broke dates pushed back for Social Security, Medicare
A stronger-than-expected economic recovery from the pandemic has pushed back the go-broke dates for Social Security and Medicare, but officials warn that the current economic turbulence is putting additional pressures on the bedrock retirement programs.
Missouri City couple, who owned Houston group home, convicted in $1 million Medicare fraud scheme: DOJ
A Missouri City couple, who owned a group home in Houston, was convicted by a federal jury for a $1 million Medicare fraud scheme, including violations of the federal Anti-Kickback Statute, according to the U.S. Department of Justice.
Houston pharmacy owner and accountant indicted in $134M health care fraud scheme
HOUSTON โ Two Houston area men are now in custody on charges of conspiracy to commit health care fraud relating to a pharmacy fraud scheme, U.S. Attorney Jennifer Lowery announced Tuesday. According to the eight-count indictment, Mokbel is the owner of several Houston area pharmacies, while Elsafty is his accountant. Mokbel also transferred and controlled over $6 million in health care fraud proceeds in certificate of deposit accounts at banks, according to the allegations. AdMokbel and ElSafty have been charged with one count of a conspiracy to commit health care fraud, three counts of health care fraud and four counts of money laundering. The use of telemarketing to target people over 55 as a means to commit health care fraud has an additional penalty of 10 years.
4 Houston medical workers charged in $32M health care fraud scheme
HOUSTON โ Four Hillcroft Physician medical workers, including a medical director and operator, are in custody in connection with a $32 million health care fraud scheme, the U.S. Attorneyโs Office announced. Farrah Forough Farizani, 57; Hamid Reza Razavi, 60; Elie Hanna Hajjar, 48; and Juan Acuรฑa, 64, have been charged with conspiracy to commit health care fraud. Farizani, Razavi and Hajjar are also charged with five counts of making false statements relating to health care matters. Farizani and Razavi are also accused of directing Hajjar and Acuรฑa to pose as licensed medical professionals, according to the indictment. According to the indictment, the group submitted $31 million in claims to Medicaid, in which Medicaid paid $12.2 million.
Bidenโs Medicare pick would be 1st Black woman to hold post
The agency oversees government health insurance programs covering more than 1 out of 3 Americans and is a linchpin of the health care system. CMS also plays a central role in the nationโs $4 trillion health care economy, setting Medicare payment rates for hospitals, doctors, labs and other service providers. The agency also sets standards that govern how health care providers operate. โShe is well-respected and liked by the department veterans who have worked with her in the past.โYears ago, Brooks-LaSure worked with Biden's nominee to run HHS, California Attorney General Xavier Becerra. AdUnder Biden, Brooks-LaSure will be expected to grow Obamacare enrollment by promoting HealthCare.gov and trying to persuade holdout states to adopt Medicaid expansion.
Trump plan to curb drug costs dealt setback in court
The Trump regulation would tie what Medicare pays for certain drugs administered in a doctor's office to the lowest price paid among a group of economically advanced countries. Some opponents have likened the Trump policy to a form of socialist price controls. Trump came into office accusing drug companies of โgetting away with murderโ and promising to slash costs for American patients. Even if the Trump rule is ultimately blocked, the idea of using international prices to lower costs for Americans is very much alive. It's at the heart of House Speaker Nancy Pelosi's legislation to empower Medicare to negotiate drug prices.
Trump tries to revive stalled election-eve drug discounts
FILE - In this Oct. 10, 2020, file photo, President Donald Trump speaks from the Blue Room Balcony of the White House to a crowd of supporters in Washington. (AP Photo/Alex Brandon, File)WASHINGTON โ The Trump administration is trying to revive the president's stalled election-eve plan to send millions of Medicare recipients a $200 prescription discount card. White House spokesman Judd Deere confirmed the administration is continuing to move forward. โItโs simply good policy, and demonstrates President Trump is continuing to deliver on his promises to our nationโs seniors to lower drug prices." Pallone dismissed the latest White House push.
Trump makes late-term bid to lower prescription drug costs
It is adamantly opposed by critics aligned with the pharmaceutical industry who liken it to socialism. The Trump administration disputes that and says its rule could potentially result in 30% savings for patients. It also would allow private insurance plans for workers and their families to get Medicare's lower prices. Trump has taken other action to lower prescription drug costs by opening a legal path for importing medicines from abroad. Also, Medicare drug plans that cap insulin costs at $35 a month are available during open enrollment, currently underway.
Harris County doctor sentenced in $16M Medicare fraud scheme, authorities say
HOUSTON โ A Texas physician was sentenced to five years in prison Wednesday for a $16 million Medicare fraud scheme, federal officials said. Hamilton was convicted by a federal jury of one count of conspiracy to commit health care fraud, one count of conspiracy to solicit and receive health care kickbacks, and two counts of false statements relating to health care matters in October 2019. Members of the conspiracy paid the patients to receive the home health care services, which were often medically unnecessary, not provided, or both, the news release said. Hamilton typically would not release the home health care paperwork until the home health care companies or their marketers paid her the kickback, authorities said, citing evidence from the case. Federal authorities said the scheme resulted in approximately millions in false and fraudulent claims for home-health services to Medicare and in Hamilton receiving over $300,000 in kickbacks.
Biden has room on health care, though limited by Congress
And just like the Trump administration, Biden is expected to aggressively wield the rule-making powers of the executive branch to address health insurance coverage and prescription drug costs. With COVID-19 surging across the country, Biden's top health care priority is whipping the federal governmentโs response into shape. โWeโre going to work quickly with the Congress to dramatically ramp up health care protections, get Americans universal coverage, lower health care costs, as soon as humanly possible,โ the president-elect said earlier this week. A factor that may work in Biden's favor is that many Republicans want to change the subject on health care. Coronavirus relief legislation could provide an early vehicle for some broader health care changes.
Feds issue coverage plan for COVID-19 vaccine and treatments
The regulations from the Centers for Medicare and Medicaid Services, or CMS, will also increase what Medicare pays hospitals for COVID-19 treatments. Under Wednesday's announcement:โ Seniors with traditional Medicare will pay nothing for COVID-19 vaccines, and any copays and deductibles are waived. โ The government will pay private Medicare Advantage plans to administer the vaccine to seniors. โ Workplace and individual health insurance plans will cover the COVID-19 vaccine as a preventive service, with no cost sharing. โ State Medicaid and Children's Health Insurance plans will have to provide vaccines for free for the duration of the coronavirus public health emergency.
Medicare finalizing coverage policy for coronavirus vaccine
WASHINGTON โ Medicare will cover the yet-to-be approved coronavirus vaccine free for older people under a policy change expected to be announced shortly, a senior Trump administration official said Tuesday. It's questionable under normal circumstances if Medicare can pay for a drug that receives emergency use authorization from the Food and Drug Administration, as expected for the eventual coronavirus vaccine. A White House-backed initiative called โOperation Warp Speedโ is pushing to have a vaccine ready for distribution in the coming months. States have already begun submitting their plans for vaccine distribution to the federal government. Initially, it's expected vaccines will go to people in high-risk groups such as medical personnel, frontline workers and nursing home residents and staff.
How to help your parents with Medicare open enrollment and avoid scams
Medicare open enrollment is here. Medicare open enrollment is the time of year when your parents get the chance to shop around for a new plan to save money on prescriptions or change up doctors. Agent/broker prohibited behaviorsAgents may not state they are from Medicare or use the term โMedicareโ in a misleading manner. Cannot ask beneficiaries for a referral list (list of friends or family who may be interested in a plan). Tips on how to stop fraud during open enrollment