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Transcript for audio podcast: OIG Update July 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.

Since our last podcast, OIG issued a number of reports, including one that found Medicare could be paying twice for prescription drugs for beneficiaries in hospice.

Another report noted that most OIG-reviewed nursing home assessments failed to fully meet standards for patients on antipsychotic drugs.

One report noted that Indiana Medicaid saved more than 1 million dollars in just 6 months after setting up a blood-glucose test strip rebate program.

Another report found that Delaware failed to report Medicaid overpayments, and OIG urged that the state refund 10 million dollars to the Federal Government.

And OIG found, in another report, that over a 3-month period, 35 states kept 25 million dollars in increased Recovery Act funding to which they were not entitled.

In yet another review, it was noted that most cases of harm to hospital patients were not reported to state adverse event monitoring systems. Go to our website for a related Spotlight article and podcast. And, in a first for OIG, the podcast is also available in Spanish.

In the largest health care settlement in U.S. history, pharmaceutical giant GlaxoSmithKline agreed to plead guilty and pay 3 billion dollars to resolve criminal and civil liability in a wide-ranging fraud case. Inspector General Dan Levinson said, "Our five-year integrity agreement with GlaxoSmithKline requires individual accountability of its board and executives. For example, company executives may have to forfeit annual bonuses if they or their subordinates engage in significant misconduct… and sales agents are now being paid based on quality of service rather than sales targets."

NextCare, an urgent-care chain, is to pay 10 million dollars to resolve allegations of false claims.

In a case of voluntary self-disclosure, a Tennessee hospital is to pay 3.59 million dollars to settle false claims allegations.

In other actions, 48 people have been charged in a 500 million dollar Medicaid fraud scheme that diverted and trafficked in secondhand prescription drugs in a national, underground market.

Two women admitted taking part in a 63 million dollar scam through the Health Care Solutions Network.

A Michigan man entered a guilty plea in a 13.8 million dollar home health care scheme involving forgery, falsified records, false claims, and kickbacks and bribes.

Four suspects in Texas were indicted in a medical equipment scheme that submitted 11 million dollars in Medicare and Medicaid billings, 80 to 90 percent of which were alleged to be fraudulent.

Two people were charged in Detroit in a series of home health scams that led to more than 8.8 million dollars in fraudulent claims to Medicare.

The owner of two health care companies was convicted in Washington, D.C., of submitting more than 7 million dollars in phony Medicaid claims.

A fourth defendant in the 45 million dollar City Nursing health care scheme in Houston was sentenced to 12˝ years in prison and ordered to pay more than 19 million dollars in restitution.

In a related development in the City Nursing case, OIG Most Wanted fugitive Godwin Chiedo Nzeocha, also charged in the scam, was arrested June 27 in Houston after having been extradited from Nigeria.

Enrique Gonzalez, an OIG Most Wanted health care fugitive charged in a 26 million dollar Medicare scheme, was arrested in Peru July 25 and extradited to the United States.

Ehsan Rana, charged in a 5.5 million dollar Medicare fraud scheme, has been added to OIG's Most Wanted list of health care fugitives.

In a child support enforcement case, former NFL wide receiver Andre Rison must pay nearly 323,000 dollars in restitution for failure to pay child support.

Julio Antonio Garcia Encarnacion, a high-profile jockey, was arrested July 2 in New Jersey by OIG agents from the New York Regional Office. He was charged with failing to pay $166,000 in child support.

And, in South Dakota, a man who failed to make child support payments was ordered to pay nearly 67,000 dollars in restitution.

In a similar case, Martin Zaic, charged with failing to pay more than 38,000 dollars in child support and listed on OIG's Child Support Enforcement webpage, was arrested July 12 in Kentucky.

Don't miss OIG's new Consumer Alerts section on our website. You will find there a Spanish-language version of OIG's diabetes fraud alert.

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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