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Transcript for the audio podcast:
OIG Update February 2013

From the Office of Inspector General of Department of Health and Human Services

https://www.oig.hhs.gov

Welcome to one of a continuing series of podcasts highlighting the work of the Office of Inspector General.

This is Mike Kane, inviting you to follow us on our website at (oig.hhs.gov) and on Twitter @OIGatHHS.

Since our last podcast, OIG issued a number of reports.

One report found that the Republic of Namibia, in southern Africa, did not always properly manage U.S. AIDS-relief funds or meet program goals.

A second report from the same region noted that CDC's South Africa office did not always properly monitor the use of AIDS-relief funds.

Read OIG's latest "Spotlight" on oversight and management of Department of Health and Human Services grants totaling hundreds of billions of dollars.

A third review found that the Food and Drug Administration lacks data to determine whether risk strategies improve drug safety. Don't miss our podcast on this report.

OIG found, in another report, that Indiana improperly claimed $5.8 million dollars from Medicaid for a psychiatric hospital that did not meet requirements.

In a fifth report, OIG found that Medicare could save millions on drugs infused through durable medical equipment.

The Centers for Medicare & Medicaid Services has collected most Medicaid overpayments, but millions of dollars are still out there, OIG noted in another report.

The latest Health Care Fraud and Abuse Control Program report has been posted on our website. In fiscal year 2012, the program recovered $4.2 BILLION dollars. For every dollar the program spent in the last 3 years, 7 dollars and 90 cents was recovered. It is the highest three-year average return on investment in program history.

Check out Deputy Regional Inspector General Blaine Collins' blog on AIDS.gov about a recent OIG report on HIV testing.

Eleven people and two corporations were charged in a complex multimillion-dollar home health Medicaid fraud scam in New Jersey. One of the defendants in the case was recorded allegedly saying, "You know, it's just free money... coming in."

A Florida man used a barn in Tennessee as a health care provider address to bill Medicare Advantage program insurance companies. He was jailed for more than 5½ years and must pay restitution for medical ID theft.

In New York, OIG Most Wanted deadbeat parent Robert Sand, a fugitive for more than a decade, admitted fleeing to avoid paying child support of $1.2 million dollars. Sand is to be sentenced in May.

Cooper Health System in New Jersey is to pay more than $12 million dollars to settle allegations of improper payments to physicians.

A Maryland hospital is to pay $4.9 million dollars to settle a Medicare/Medicaid false claims case involving unnecessary admissions.

A hospital in Manhattan is to pay $2.3 million dollars in another false claims case that included double-billing and seeking payment for non-reimbursable costs.

The leader of an organization engaged in an extensive range of criminal offenses, including the operation of a $100 million dollar Medicare fraud ring in New York, was imprisoned for more than three years and fined $60,000 dollars.

A former registered nurse who routinely fabricated records that were used in a $63 million dollar mental health care scam in Florida was jailed for more than 9 years.

The owner and operator of 26 pharmacies in metropolitan Detroit was jailed for 17 years and must repay Medicare and Medicaid $28.8 million dollars for health care fraud and drug offenses. An OIG special agent in charge called the scheme "deplorable, inexcusable and dangerous."

Of the 26 defendants charged in this case, 20 have pleaded guilty or been convicted at trial. Six are scheduled for trial in June.

To settle kickback and false billing allegations, a Florida doctor is to pay more than $26 million dollars and is excluded as a provider from Federal health care programs. It is one of the largest false claims settlements with an individual in U.S. history.

A North Carolina counselor convicted of fraud submitted a bill to Medicaid claiming that she had provided 69 hours of therapy on a single day.

Arrested in Great Falls, Montana, OIG Most Wanted deadbeat parent Dennis Thomas owes more than $68,000 dollars in child support, authorities said. Thomas' son was also arrested. He was charged with obstruction of justice, police said, after attempting to prevent his father's arrest.

Anush Sahakyan and Karo Blkhoyan, charged in a million-dollar Medicare fraud case, were added to OIG's Most Wanted Fugitives list. They are believed to be in the Los Angeles area.

Tigran Asaryan, charged with identity theft and medical equipment fraud, also has been added to the Most Wanted list.

Since fiscal year 2008, OIG has reported nearly $22 billion dollars in expected recoveries stemming from work by its Office of Investigations.

For links to these reports and stories and more, go to our website or follow us on Twitter.

Thanks for listening.

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