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Transcript for audio podcast:
January 2014 OIG Monthly Update

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 (oig.hhs.gov) and on Twitter (@OIGatHHS).

In fiscal 2013, the Medicare Fraud Strike Force set record numbers for health care fraud prosecutions, and Inspector General Dan Levinson said: "...Our Strike Forces are successfully fighting back - holding criminals accountable and recovering stolen dollars."

Listen to Gary Cantrell, Deputy Inspector General for Investigations, who was interviewed recently on Federal News Radio about OIG's fraud-fighting efforts.

Since our last podcast, OIG has issued a number of reviews.

OIG noted in one report that Medicare contractors received limited guidance about fraud vulnerabilities in electronic health records.

Go to our website for a podcast about safeguards against fraud in electronic health records.

Medicare administrative contractors should be monitored to ensure that they meet all quality assurance standards, OIG recommended in another review.

Listen to a podcast on the performance of Medicare administrative contractors.

In another report, OIG found that Medicare could have saved millions if organ procurement organizations correctly reported double lungs as two organs.

Medicare and its beneficiaries could save millions of dollars if payment rates for vacuum erection systems were reduced, OIG found in another review.

In a separate report, OIG urged Medicare to ensure that contractors submit clear plans for reducing their payment error rates.

And don't miss a podcast discussion of a review of Maryland's federal Medicaid withdrawals. Check our website.

In another report, OIG found that 4.2 million Medicare claims summary notices were not delivered to beneficiaries in 2012, weakening a tool used to fight fraud.

CareFusion, a medical technology company based in California, is to pay more than $40 million dollars to settle allegations that it paid kickbacks -- including $11 million dollars to one doctor, authorities said -- and promoted products for unapproved uses.

Hi-Tech Pharmaceutical is to pay $25 million dollars to resolve allegations that it reported inflated generic drug prices to Medicaid.

The Manhattan U.S. attorney charged that Novartis Pharmaceuticals orchestrated an extensive kickback scam with Bioscrip, a specialty pharmacy; Bioscrip has agreed to pay $15 million dollars to resolve claims. In a lawsuit, authorities said that Novartis provided kickbacks, in the form of patient referrals disguised as rebates, to Bioscrip. In exchange, the specialty pharmacy recommended refills of the drug Exjade to patients. Authorities also allege that, as a result of the scheme, Medicare and Medicaid paid tens of millions of dollars linked to false, kickback-tainted claims.

In other cases, Abbott Labs has agreed to pay nearly $5.5 million dollars to resolve allegations that it paid doctors to induce them to implant its products.

In a self-disclosure, a Pennsylvania medical center is to pay more than $2.3 million dollars because it improperly administered some physician-income-guarantee agreements. The U.S. attorney recognized OIG's Sandra Sands and Bernard Siegel for their handling of the case.

In another self-disclosure case, a health care group in Colorado and one of its hospitals, in Montana, are to pay $3.5 million dollars to resolve allegations that they improperly provided incentives for doctor referrals.

New York City is to pay $1.375 million dollars in a civil settlement linked to alleged false Medicaid claims for psychological services for children. The U.S. attorney recognized OIG Special Agent Elysia Doherty for work on the case.

A Maryland firm is to pay $500,000 dollars to resolve allegations that it filed improperly documented Medicaid claims. The Maryland attorney general thanked OIG Special Agent Sharnell Thomas for work on the case.

A California woman admitted orchestrating a $25 million dollar false billing scheme linked to medically unneeded services and supplies, including power wheelchairs and diagnostic tests.

Abubakar Durrani was added to OIG's Most Wanted Fugitives list; authorities said the surgeon billed Medicare, Medicaid, and private insurance companies millions of dollars for unnecessary and potentially harmful spinal surgeries.

OIG posted a final rule amending the electronic health records safe harbor. Check our website.

And on a final note, OIG excluded from Federal health care programs a diabetes supplies firm, a telemarketer and three executives, alleging that the companies and their executives violated the Civil Monetary Penalties law by paying and receiving kickbacks and causing the submission of fraudulent Medicare claims for durable medical equipment. Those claims stemmed from illegal telemarketing, OIG said. $472,000 dollars was recovered.

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

And for more on the fight against health care fraud, waste and abuse, click "More News" on the podcast webpage.

Thanks for listening.

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