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Transcript for audio podcas: OIG Update March 2012

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

http://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.

The Office of Inspector General-auditors, evaluators, investigators, and attorneys examines and seeks to improve Health and Human Services programs. OIG pursues criminal and civil cases, with our law enforcement partners, including state authorities, against those accused of victimizing Federal health care programs and preying on those who benefit from them.

Recently posted on our website were four reports, one dealing with an Atlanta hospital getting manufacturer credits for replaced cardiac devices and reporting those credits to Medicare. A second study focused on a university's use of Recovery Act funds. A third report showed that nearly a quarter of home health agency claims were in error in 2008, resulting in $432 million in improper Medicare payments. The fourth report, on independent diagnostic testing facilities, found that just 9 percent of IDTFs in high-utilization areas provided 90 percent of diagnostic services. That finding led the Office of Inspector General to recommend monitoring questionable IDTF claims. In another posting, OIG updated its list of individuals and entities excluded as providers from Federal health care programs. The LEIE database can be accessed from our website.

In recent website postings, three clinic owners in the Detroit area pleaded guilty in a $5.4 million Medicare bribery scheme. A Chicago doctor who submitted false claims for unnecessary tests was convicted of defrauding Medicare and a private insurer. And in Texas, a power wheelchair scam resulted in a prison term of nearly four years and a restitution order of nearly $500,000. The owner of a Houston medical equipment company was jailed for two and a half years and ordered to pay $471,000 in restitution for engaging in a Medicare scam involving orthotic devices, including so-called "arthritis kits," that patients did not need or were not provided. In another case, a social worker is charged with scheming to defraud Medicaid and private insurers of more than $100,000. According to the indictment, claims were submitted for periods when no services were rendered to patients; for more sessions with clients than were provided; for inflating the length of client sessions; and for family sessions when none were held.

In another case, two doctors and four nurses were among 11 new defendants charged in a $20 million home health care swindle. False claims were allegedly submitted for services never provided to Medicare patients, or that were not needed. Authorities say the proceeds were used for gambling, to buy cars, jewelry, and real estate, and to perpetuate the alleged scheme by paying bribes and kickbacks. The resolution of another case saw a Florida man plead guilty for his role in a Medicare kickback scam that resulted in $200 million in fraudulent claims.

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

A fraud alert has been issued for people who have diabetes. If a caller offers you free diabetic supplies, in exchange for personal information, including your Medicare number, do not provide it. Report the call to the Office of Inspector General hotline, 1-800-HHS-TIPS or online at oig.hhs.gov, where you click on the link to our alert.

Check your Medicare summaries and bills for accuracy. And remember, do not accept items you did not order. Keep a record of the sender's name and the date you returned the items to help catch any future illegal billing. The full fraud alert is available on our website.

A one-stop source of free information, recently posted on our website, helps health care providers, practitioners, and suppliers understand health care fraud and abuse laws and the consequences of violating them. Check out Compliance 101 at oig.hhs.gov. Thanks for listening.

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Office of Inspector General, U.S. Department of Health and Human Services | 330 Independence Avenue, SW, Washington, DC 20201