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Transcript for audio podcast: OIG Update April 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.

Coming soon is an OIG report examining Medicaid rates paid to New York State Intermediate Care Facilities for the developmentally disabled. Be sure to check our website for this report.

Don't miss Inspector General Dan Levinson's testimony before the Senate Finance Committee in which he describes how OIG conducts health care fraud investigations and coordinates national Strike Force takedowns. See our website for more details.

Since our last update, OIG has released a number of reports.

One showed that gaps remain in nursing home emergency preparedness and disaster response. Another found that a Medicare Part B claim modifier did not prevent more than 300 million dollars in unallowable payments for durable medical equipment. In another report, OIG found that the Medicaid Data Match Program produced limited results in identifying fraud.

Pharmaceutical giant Merck, Sharp & Dohme, which had pleaded guilty to violating the Food, Drug and Cosmetic Act, was fined more than 321 million dollars for introducing a misbranded drug, Vioxx, into interstate commerce. The company promoted the drug as a treatment for rheumatoid arthritis before that use was approved by FDA. Total criminal and civil recoveries in the case are nearly 1 billion dollars.

WellCare Health Plans is to pay 137 and a half million dollars to the Federal Government and 9 states to resolve lawsuits alleging a number of schemes to submit false claims to Medicare and Medicaid. The resolution of these suits brings the total recoveries from WellCare to 217 and a half million dollars.

Tenet Healthcare Corporation agreed to pay almost 43 million dollars to settle allegations that it violated the False Claims Act by overbilling Medicare for the treatment of patients at its independent rehabilitation facilities.

In another action, OIG added Iftikhar Ghouri, indicted in a 9 million dollar Medicare kickback and false billing scheme, to the OIG Most Wanted Fugitives list. Investigators believe that Ghouri went to Canada in 2007 and has since returned to his native Pakistan.

In a podcast, available on our website, Gary Cantrell, OIG's Deputy Inspector General for Investigations, discusses how diabetic-supplies schemes work and what you should do if you suspect you're being targeted by scammers.

Other postings on our website include these actions:

Walgreens has paid nearly 8 million dollars to resolve a false prescription billing case. The settlement resolves allegations that the company offered government health care beneficiaries illegal inducements, including 25 dollar gift cards, when they transferred a prescription to Walgreens. And while the company's advertising acknowledged that the offer was not valid with any government program, it was alleged that Walgreens employees frequently handed gift cards to customers who were not eligible for them.

In another case, a Georgia man - who has been convicted of fraud - stole nearly 33 million dollars from Federal health care programs as residents in three of his nursing homes "lived in filth." While residents went hungry and lived in "horrendous conditions," authorities say, the defendant purchased real estate and planned to build a hotel, using the millions he received from Medicare and Medicaid.

In another development, IG Dan Levinson has appointed Greg Demske as Chief Counsel to the Inspector General, following the retirement April 1 of Lew Morris.

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