Dental chain may be booted from Medicaid program

By David Heath

Small Smiles, under federal scrutiny for performing unnecessary dental treatments on children, could be barred from the Medicaid program.

Excerpts from this story referencing "Kool Smiles":

"… ic Integrity and PBS Frontline exposed similar practices at another chain, Kool Smiles, in a 2012 report titled “Dollars and Dentists.” Small Smiles’s own …"

ObamaCare oversight among health watchdog cuts

By Fred Schulte

Trims include ObamaCare oversight

Senate report recommends ouster of large dental chain from Medicaid program

By David Heath

Small Smiles should be removed from Medicaid for encouraging dentists to perform unnecessary treatments to boost profits, investigators say.

Excerpts from this story referencing "Eric Holder":

"… to settle charges of overbilling state Medicaid programs. Attorney General Eric Holder said at the time, “Many of these centers performed unnecessary and often …"

Feds tighten scrutiny of health records

By Fred Schulte

Feds increase scrutiny of how electronic systems affect billing

IMPACT: Cabinet officials signal crackdown on Medicare billing abuse

By Fred Schulte and Joe Eaton

Sebelius, Holder signal new scrutiny in wake of Center series

How doctors and hospitals have collected billions in questionable Medicare fees

By Fred Schulte and David Donald

Center investigation suggests cost from upcoding and other abuses likely tops $11 billion.

Excerpts from this story referencing "California":

"… . In May 2011, Medicare contractor Palmetto GBA notified more than 11,000 California doctors that it would begin auditing their claims for office visits after …"

"… icare patients if the government doesn’t back off. In December of 2011, California Medical Association president Dr. James T. Hay fired off a letter to feder …"

Judgment calls on billing make 'upcoding' prosecutions rare

By Fred Schulte

Authorities typically settle, and doctors often continue treating Medicare patients

Excerpts from this story referencing "consultant":

"… s, experts said.Upcoding “is a big problem,” said Charlene Frizzera, a consultant who spent three decades at the federal Centers for Medicare and Medicaid S …"

Medicare fraud: What you need to know

By Sarah Whitmire

Last week's biggest-ever Medicare fraud bust nabbed 107 care providers, but how does this effort stack up?

Probe finds hospital chain inaccurately diagnoses infections

By Christina Jewitt and Lance Williams

A California hospital chain under scrutiny over Medicare billing now faces questions about misdiagnoses of a blood infection

Excerpts from this story referencing "Medicare":

"… rnia hospital chain under investigation for allegations of overbilling the Medicare system has inaccurately diagnosed patients with a blood infection known as …"

"… wed signs of having urinary tract infections, a far less serious condition.Medicare pays bonuses of several thousand dollars per case for treating elderly pat …"

"… e state health department probe is the latest to focus on issues involving Medicare billings at Prime, a fast-growing hospital chain based in Southern Califor …"

"… onal Union. The study said Prime hospitals reported septicemia rates among Medicare patients that were more than triple the national average.Two members of Co …"

Medicare fraud included phantom services, equipment

By Laurel Adams

A sampling of Medicare providers who were overpaid by $206 million in 2007-08 showed some billed the government for phantom services or for

Medicare fraud out of control

By The Center for Public Integrity

Medicare fraud runs rampant but no government crackdown yet, despite bipartisan support