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A review by Pennsylvania's elected financial watchdog concluded there were shortcomings in a state agency's oversight of fees paid to pharmacy benefit managers in the Medicaid program, but the ...
Pennsylvania has been accused of improperly receiving $551 million in Medicaid funds to go toward its school-based services. The U.S. Office of the Inspector General said in a report released ...
Prior to running for the Pennsylvania Senate, Rafferty served as an attorney in private practice focusing on education, real estate, zoning, business and estate law. As Deputy Attorney General for the Commonwealth from 1988 to 1991, he was assigned to the Criminal Law Division where his primary duty was investigating and prosecuting Medicaid fraud.
In the United States, Medicaid is a government program that provides health insurance for adults and children with limited income and resources. The program is partially funded and primarily managed by state governments, which also have wide latitude in determining eligibility and benefits, but the federal government sets baseline standards for state Medicaid programs and provides a ...
Aug. 25—A Pembroke woman has been indicted on felony charges for allegedly stealing more than $16,000 from the Medicaid program by filing fraudulent claims. A Merrimack County Grand Jury ...
In 2016, the company settled with the US Department of Justice for $32.7 million over claims of Medicare fraud through medically unnecessary procedures from 2006 through 2013. [ 5 ] [ 6 ] The company also settled with the Department of Justice in 2019 for $6.25 million over a similar issue.
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A part of the federal Medicaid statute known as the "anti-lien provision" preempted a North Carolina law. That state law had required Medicaid beneficiaries who received money from a tort judgment or settlement to give one-third of that money to the state to reimburse it for the free medical care it had provided to the person. Florida v ...