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Transcript for the audio podcast:
OIG Update June 2013

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

http://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.

OIG testified on Capitol Hill on Medicare Part D vulnerabilities, oversight, and prescription drug abuse. Read the testimony on our website.

OIG also issued a pair of reports related to Part D. One found that Medicare paid for drugs ordered by people who clearly did not have prescribing authority, raising safety issues.

The other review found questionable prescribing patterns for potentially addictive and other drugs in the Part D program.

Don't miss our latest OIG Spotlight - focusing on the epidemic of drug diversion, a form of prescription drug abuse.

And you can go to our website to listen to a podcast on drug diversion.

An OIG report contributed to the successful prosecution of Pedro Espada Jr., the former New York Senate majority leader.

Espada was jailed for five years for thefts from clinics that served the poor in the Bronx. He was also convicted of filing a false tax return and must repay hundreds of thousands of dollars.

In another report, an OIG rate comparison showed that Medicare could save more than $900 million dollars on lab tests.

In another, OIG found that New York claimed an estimated $54 million dollars from Medicaid for unallowable traumatic brain injury waiver program services.

Go to our website to listen to a podcast on the traumatic brain injury waiver program report.

To learn about OIG oversight of community block grant spending at a Connecticut nonprofit, listen to a separate podcast, also on our website.

OIG found in another report that improvements are needed to ensure that Medicare provider enrollment data are accurate, complete and consistent.

And yet another review noted that Medicare could save millions by implementing a hospital transfer policy for early hospice discharges.

ISTA Pharmaceuticals is to pay $33.5 million dollars to resolve criminal and civil liability linked to its marketing, distribution and sale of the drug Xibrom.

U.S. Renal Care is to pay $7.3 million dollars to resolve allegations that it submitted false claims to Medicare for dialysis drugs given to patients.

Seven in New Jersey admitted taking part in a conspiracy to pay physicians millions of dollars in bribes over a number of years in exchange for blood sample referrals that brought a clinical laboratory more than $100 million dollars.

A former dentist, excluded as a provider from participation in federal health care programs, admitted using an elaborate scheme to defraud Connecticut Medicaid of more than $20 million dollars. He also pleaded guilty to tax evasion and has agreed to forfeit property and cash, pay back taxes, interest and penalties of nearly $2 million dollars and pay $9.9 million dollars in a civil settlement.

Two Texas doctors, a married couple, were ordered to pay over $37 million dollars in restitution plus a money judgment of more than $37 million dollars for their decade-long scam of billing for injection procedures that they did not perform.

A Kentucky cardiologist admitted falsely recording patients' conditions and fraudulently billing Medicare for stent procedures. He is the third cardiologist in the nation to be federally prosecuted for heart stent surgery fraud.

OIG Most Wanted fugitive Won Suk Lee, charged in $2.1 million dollar Medicare false claims case, was arrested in Los Angeles.

Omar Decendario, charged in a $20 million dollar Medicare scam, was added to the fugitives list, as was Ji Hae Kim, a registered nurse believed to be in South Korea. She is accused in a $5.1 million dollar scheme.

A multijurisdictional task force in Orange County, N.Y., rounded up 42 deadbeat parents who, authorities say, together owed more than $1.4 million dollars in child support.

Among them was Dee Dee Riggs, an OIG Most Wanted deadbeat parent. Authorities say Riggs, who was being held in Orange County in lieu of bail, owes more than $329,000 dollars.

Also being held in Orange County was Michael Diviesti, who authorities say owes more than $48,000 dollars. http://oig.hhs.gov/fraud/child-support-enforcement/status.asp#diviesti

Another OIG Most Wanted deadbeat parent, Joe Romero, surrendered in Colorado; he is said to owe more than $33,000 dollars.

And a California man, David Jackson, was ordered to pay nearly $30,000 dollars in restitution in a South Dakota child support case.

And George Ely, charged with failing to pay $10,000 dollars, was arrested in New Jersey.

OIG has upgraded its Exclusions database. Go to our website and take a look.

Check our website, too, for OIG's Spring Semiannual Report to Congress.

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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