Transcript for the audio podcast:
OIG Update January 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 at oig.hhs.gov and on Twitter (@OIGatHHS).
Since our last podcast, OIG issued a number of reports.
One report recommended changes to improve the fraud-fighting efforts of Medicare drug integrity contractors in Parts C and D.
In another, OIG urged improved fraud detection in community mental health centers in fraud-prone areas.
Go to our website to listen to a podcast about this report.
And OIG found, in another review, that Medicaid risks not recovering $4 billion dollars from third-party health insurers.
If you'd like to hear a podcast about the third-party-insurer report, go to our website.
Based on OIG recommendations in a fourth report, Medicare agreed to changes to detect and recover millions spent for services for unlawfully present beneficiaries.
On the basis of a companion report, Medicare agreed to take action to recover improper payments for services for incarcerated beneficiaries.
Listen to a podcast on our website about the millions spent for services for unlawfully present and incarcerated Medicare beneficiaries.
A sixth report found that Arizona improperly claimed at least $11.7 million dollars for unallowable Medicaid school-based administrative costs.
A Washington State man, Kenneth Jones, who authorities say owes more than $259,000 dollars in child support, has been named OIG's Most Wanted deadbeat parent. Jones is believed to be in Australia or Hong Kong.
American Sleep Medicine is to pay $15.3 million dollars for alleged improper billing to Medicaid and other programs for ineligible diagnostic services.
Victory Pharma of San Diego is to pay more than $11 million dollars to settle allegations that it gave doctors event tickets, expensive dinners and spa, golf, and ski outings in promoting four drugs.
A mental health clinical director in Florida was jailed for more than 8 years for his role in a $50 million dollar fraudulent billings Medicare scam. The clinic, its owners, and more than 25 defendants have pleaded guilty or been convicted at trial.
The former director of an HIV infusion clinic in Miami was sentenced to more than 6 years in prison in a $26.2 million dollar Medicare fraud that included bribes, kickbacks, false claims and services that were not necessary or never provided. He was ordered to pay more than $17 million dollars in restitution.
In California, a former director of nursing was jailed for 3 years for "convenience drugging" - the use of drugs to quiet elderly patients. Her actions hastened the deaths of three people and harmed 23 others.
A Texas nursing home chain is to pay more than $600,000 dollars to settle allegations that it fraudulently billed Medicare for inadequate and worthless wound care that harmed residents.
A husband and wife from Miami were sent to prison for more than 11 years and four years, respectively, after they were convicted of Medicare fraud and money laundering; restitution of more than $15 million dollars was ordered.
The owner of adult day care centers in the Detroit area and his wife pleaded guilty in a $13.2 million dollar Medicare psychotherapy scam that included submission of more than 185,000 claims for services that were not provided. The doctor at the center of the scam also pleaded guilty. Sentencing is set for April.
A Massachusetts nurse was charged with fraudulently billing Medicaid, claiming to provide children's care when, authorities say, she was at the horse track.
Acupuncturist Won Suk Lee, charged in a $2.1 million dollar Medicare fraud, was added to OIG's Most Wanted Fugitives list. He is believed to be in South Korea.
Also added to the Most Wanted list were 3 woman allegedly involved in a nationwide $40 million Medicare scam...
...and Raed Awad Almasri, charged in a $20 million dollar scheme.
OIG Most Wanted fugitive Leonard Nwafor, on the run for several years after being convicted in a $1.1 million dollar Medicare scheme, was arrested in Toronto and is awaiting extradition to the United States.
"OIG Update" is expanding its coverage. Soon you will be able to read about other actions not included in this podcast. Look for this new feature on our website.
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 2014 Work Plan
OIG projects planned for 2014.
Significant OIG activities in 6-month increments.