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Transcript for the audio podcast:
OIG Update March 2013

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

https://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 of the reviews raised serious concerns about quality of care and care planning in skilled nursing facilities. Don't miss an OIG "Spotlight" article and a podcast related to this report. Both are on our website.

In a second review OIG urged stronger oversight of conflicts of interest in Medicare prescription drug coverage decisions. Check our website for a podcast on this report.

OIG noted in another report that the Department of Health and Human Services met many requirements of the Improper Payments Information Act but was not fully compliant.

New Jersey-based Par Pharmaceuticals pleaded guilty and must pay $45 million dollars to resolve criminal and civil liability in the off-label promotion of a drug for AIDS patients.

Hospice of Arizona and related organizations must pay $12 million dollars to resolve allegations of submission of false claims for ineligible services. An OIG special agent in charge said: "When providers place more importance on the bottom line, than on the care of these vulnerable patients, they can expect to face serious penalties."

An Armenian national was imprisoned for nearly 3½ years and must repay more than $182,000 dollars in a wide-ranging Medicare fraud. The Georgia prosecution is part of a multijurisdictional investigation, authorities said, involving more than $200 million dollars in phony health care claims. More than 35 people have been arrested, and charges have been filed in several cities.

A former clinic director in Florida pleaded guilty in a $63 million dollar mental health services scam involving defunct provider Health Care Solutions Network. Twelve defendants have pleaded guilty in the case.

The medical director of a Miami clinic was imprisoned for 12 years for his role in a $50 million dollar mental health treatment scam. More than 25 defendants have pleaded guilty in the scheme or have been convicted at trial.

2 owners of Miami health care firms were sentenced to long prison terms and fined; together they must also repay $35 million dollars in an extensive false claims scam.

The former owner of mental health centers in Florida and North Carolina was jailed for 14 years for fraud and must repay more than $28 million dollars.

A Miami pharmacy owner was imprisoned for 14 years and fined $100,000 dollars for his role in a $23 million dollar Medicare/Medicaid kickback scheme.

Seven doctors and four pharmacists were among 44 indicted in Michigan in a healthcare fraud and drug distribution scheme. The U.S. attorney for eastern Michigan said: "The merger of healthcare fraud and drug trafficking is a disturbing trend."

In a separate but similar case, 13 new defendants were charged in a scheme at more than 20 pharmacies in the Detroit area. Of the 26 defendants originally charged in this case, six were tried and convicted, and 15 entered guilty pleas. The other five are set for trial in June.

In Texas, a Richmond businessman was convicted in a $19 million dollar diagnostic testing and physical therapy scam.

In McAllen, three were convicted in an $11 million dollar equipment fraud scheme that included ID theft.

And a McAllen urologist and his wife were charged with conducting a health care billing scam from 2003 to 2012. They were also charged with conspiracy to violate the Iran sanctions, allegedly transferring about $1.1 million dollars to Iran to invest in real estate there. Authorities said some of that money came from the alleged health care fraud scheme.

A New York doctor was charged with health care fraud. Authorities said he bribed Medicaid patients, overcharged Medicare and Medicaid and prescribed HIV drugs that were later sold on the black market.

OIG Most Wanted fugitives Orisbel Hernandez and Jorge Reyes were captured in Florida and in Canada, respectively. And five other fugitives, all of whom are believed to have fled the U.S., have been added to the Most Wanted list.

And Pawel Steczkowski, charged with owing more than $50,000 dollars in child support, has been added to OIG's list of Most Wanted Deadbeat Parents. He is believed to be in Poland.

Inspector General Dan Levinson testified before a House Appropriations subcommittee about Top Management Challenges facing the Department of Health and Human Services. His testimony is on our website.

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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