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Transcript for audio podcast: June 2014 OIG Monthly Update

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

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 ( and on Twitter (@OIGatHHS).

In companion reports related to its mandated work on the Affordable Care Act, OIG identified deficiencies in controls meant to ensure proper enrollment in the Federal, California and Connecticut insurance marketplaces. OIG also found that health insurance marketplaces faced early challenges in resolving inconsistencies in applicant data.

To listen to a podcast on these reports, visit the OIG website.

Since our last Update podcast, OIG has issued a number of other reviews.

OIG noted in one report that Illinois licensing rules could not ensure quality care or adequate protection for Medicaid hospice beneficiaries.

OIG found in another review that California licensing surveys of nursing homes did not ensure quality care for Medicare and Medicaid patients.

Visit our website for a podcast on the California report.

In one study, OIG found that Zambia's Ministry of Health did not always properly manage AIDS relief funds or meet program goals.

Visit the OIG website for a podcast on oversight of AIDS relief funding.

OIG's Gary Cantrell, Deputy Inspector General for Investigations, and Gloria Jarmon, Deputy Inspector General for Audit Services, appeared before the House Energy and Commerce Committee's Subcommittee on Oversight and Investigations and discussed screening out errors, fraud and abuse in Medicare. For more, visit our website.

In an Illinois law enforcement sweep, 10 were arrested and 14 charged in personal care services Medicaid fraud cases.

A Kentucky medical center is to pay nearly $41 million dollars to settle claims that it falsely billed Medicare and Medicaid for unneeded heart procedures, and that doctors falsified medical records to justify the unnecessary procedures.

Minnesota-based Medtronic is to pay nearly $10 million dollars to settle allegations that it paid doctors as incentive to implant pacemakers and defibrillators.

In a civil action, the United States sued the California-based hospitalist company IPC, alleging that it overbilled millions of dollars for physician services.

An owner-operator of community mental health centers in Baton Rouge, Louisiana, and a patient recruiter for a related facility in Houston, Texas, were convicted in a $258 million dollar fraud scheme.

A dietitian from Georgia was sent to prison for 16 years after defrauding Medicaid of more than $4 million dollars. She stole the identities of Head Start children, faked patient files, falsified prescriptions and filed bogus claims. Full restitution was ordered.

A New Jersey internist was sentenced to 21 months in jail for taking kickbacks for referrals from a diagnostic center; another doctor, a pediatrician/internist, was sent to jail for 20 months after taking cash for referrals from the same facility. Eighteen defendants, including 16 doctors, now stand convicted in connection with illegal payments from Orange Community MRI in Orange, N.J.

A Pennsylvania hospice owner was jailed for more than 14 years and must repay more than $16 million dollars in an extensive Medicare fraud scam.

Two scientists were charged in Florida with fraudulently obtaining federal government contracts worth $10 million dollars. Authorities allege aggravated identity theft, falsification of records and wire fraud.

A former Oklahoma State University professor was convicted in Montana of a multimillion-dollar grant-related fraud linked to a Native American tribe. OIG auditors played a key role in uncovering the fraud.

The owner of three Ohio pain clinics was jailed for 14 years and must forfeit more than $6.3 million dollars in what was termed a "pill tsunami." Customers traveled hundreds of miles and paid cash for "cocktails" of controlled substances, authorities said.

A Detroit-area home health agency owner was jailed for six years in a $13.8 million dollar scam. Restitution was ordered.

Vivian Yusuf, an OIG Most Wanted fugitive charged in a $3.4 million dollar fraud case, was taken into custody at Houston International Airport after arriving from Nigeria.

Two fugitives have been added to the OIG Most Wanted list: Firas Alky is charged in an alleged $31.2 million dollar home health Medicare fraud in Michigan; Errol Elrington, a doctor, is charged in a separate Michigan case that allegedly included more than $400,000 dollars in false billing.

Steven Jordan, "Love & Hip Hop: Atlanta" star Stevie J, was charged with failing to pay more than $1 million dollars in child support. The U.S. attorney praised OIG work in the investigation of the reality TV star.

OIG deadbeat parent Glen Sheppard admitted reneging on his child support obligations; he now must pay nearly $298,000 dollars.

And on a final note, OIG's Dwayne Grant was interviewed on Federal News Radio about a finding that $6.7 billion dollars in improper evaluation and management payments were made to physicians.

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

And for more on the fight against health care fraud, waste and abuse, click "More News" on the podcast webpage.

Thanks for listening.


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