Transcript for the audio podcast:
OIG Update April 2013
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 oig.hhs.gov and on Twitter @OIGatHHS.
Since our last podcast, OIG issued a number of reports.
In one report, OIG found that better use of surety bonds could enable Medicare to recover millions of dollars from medical equipment suppliers.
In a second review, OIG noted that New York improperly claimed $27 and a half million dollars from Medicaid for family-based treatment rehabilitation services.
And another review noted that 62% of OIG-surveyed hospitals made or planned to make changes in how they acquired compounded drugs after the 2012 meningitis outbreak.
Medicare could have earned more than $111 million dollars in interest in 1 year, OIG found in another report, had Part D prepayment rules been different.
Several new podcasts and videos have been posted on our website:
- On hospital compliance, with links to related audit reports.
- On the Department of Health and Human Services' compliance with the Improper Payments Information Act.
- And on private health insurance submissions to healthcare.gov's Plan Finder.
In an updated training video for providers, OIG Chief Counsel Gregory Demske provides guidance for health care boards to promote quality of care and embrace compliance with the law.
Amgen, a California-based pharmaceutical company, is to pay $24.9 million dollars to settle civil allegations that it paid kickbacks to pharmacies to switch Medicare and Medicaid beneficiaries from a competitor's drug to its drug, Aranesp.
Intermountain Health Care, which operates the largest health system in Utah, has agreed, as part of a self-disclosure, to pay $25 and a half million dollars to settle claims that it maintained improper financial ties with referring physicians.
OIG and other federal agents arrested and charged the owner, the CFO, and four doctors at Chicago's Sacred Heart Hospital in an alleged kickback scheme that involved patient referrals to the hospital.
A fifth doctor at Sacred Heart was also charged; authorities allege that he prescribed hydrocodone when he did not have a license to prescribe controlled substances.
OIG agents took part in the arrest of four charged in a multimillion-dollar cash-for-referral scheme in New Jersey. A lab allegedly bribed doctors for blood sample referrals and to order unneeded tests. Authorities said that over the course of the conspiracy, millions of dollars were spent on a high-end apartment, cars, private jet charters, sports event tickets and retail merchandise.
A New Jersey cardiologist admitted subjecting thousands of patients to unneeded tests and possibly life-threatening treatment in a $19 million dollar fraud. A U.S. attorney said, "After years of prominence in his field," the doctor "will now be remembered for his...fraud."
A New York pharmacist was charged in a huge drug diversion case; authorities said he bought $5,000 dollars to $10,000 dollars a month in prescriptions that were resold as new. Authorities said that by reselling second-hand prescription pills to unsuspecting patients, and fraudulently seeking Medicaid and other reimbursement, the pharmacist could potentially reap hundreds of thousands of dollars in unlawful profits.
Fentahun Ferede, indicted in a $900,000 dollar Medicare fraud, and Jorge Caro, charged in a $5 million dollar fraud, were added to OIG's Most Wanted Fugitives list. Ferede is believed to be in Hong Kong, and Caro in Cuba.
Inspector General Dan Levinson delivered the keynote address at the opening session of the Health Care Compliance Association's 17th Annual Compliance Institute.
See our website for a Special Fraud Alert on physician-owned distributorships that sell implantable medical devices.
And OIG also posted a proposed rule for an electronic health records safe harbor under the anti-kickback statute.
OIG's Medicaid Integrity Program Report for fiscal year 2012 has been posted.
Also on our website is OIG's budget document for fiscal year 2014.
And on a final note, it takes a team to cut health care waste: Go to our website to read an op-ed from IG Dan Levinson that first appeared in the AARP Bulletin.
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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Unimplemented OIG recommendations summarized.
FY 2013 Work Plan
OIG projects planned for 2013.
Significant OIG activities in 6-month increments.