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Transcript for audio podcast: September 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).

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

OIG reviewed IT security at three health insurance marketplaces. For a summary of our results, visit our website.

Listen to a podcast on health insurance marketplace IT security.

OIG found in one review that manufacturers' safeguards may not prevent the use of copayment coupons for Part D drugs.

Visit our website for a podcast on this report.

Note, too, that OIG has posted on our website a special advisory bulletin on copayment coupons for Part D drugs.

OIG found in another report that Medicare Part B prescription drug dispensing-fee payments are higher than those of Part D and Medicaid; lower rates could save millions.

Visit our website for a podcast on this report.

In a separate report, OIG noted that hospitals' experiences during Superstorm Sandy revealed emergency planning gaps that might apply across the United States.

Check our website for a podcast on the Superstorm Sandy report.

A Detroit-area hematologist-oncologist, Dr. Farid Fata, admitted administering chemotherapy to patients who did not need it in a $225 million dollar Medicare scheme. The doctor pleaded guilty to fraudulent billing, soliciting kickbacks and money laundering. "Dr. Fata's utter disregard for his patients' welfare was quite simply deplorable," said OIG's Lamont Pugh III. At sentencing, Fata could get as much as 175 years in prison.

Omni Surgical, doing business as Spine 360, a manufacturer of devices used in spinal surgery, and a surgeon are to pay $2.6 million dollars to settle allegations that the firm paid the doctor to induce him to use the company's products.

Two New Jersey physicians admitted taking bribes in a long-running $100 million dollar test-referrals scheme; they are to forfeit a total of $339,000 dollars. Thirty-one defendants - including 20 doctors - have now pleaded guilty in the scam.

A psychiatrist in Louisiana was imprisoned for more than seven years, must repay $43.5 million dollars and forfeit the proceeds of the Medicare fraud scheme in which he took part. A 30-month prison term was imposed on a facility administrator, and a therapist is to serve 10 months in the same scam. The administrator and therapist are to repay more than $14 million dollars. Nineteen defendants have been convicted in this $258 million dollar scheme.

A healthcare fraud conviction put a Michigan doctor in jail for two years; and she is to repay more than $285,000 dollars and forfeit two offices and two luxury cars. The value of the forfeitures was put at $550,000 dollars. The scheme included taking kickbacks for referrals and accepting cash for signing medical marijuana certifications. The doctor was also convicted of falsifying an income tax return.

A Californian was jailed and must repay $2,000 dollars for his part in a multimillion-dollar health insurance scheme that recruited foreign students in the United States to open bank accounts for dozens of phantom medical clinics. Later, conspirators submitted fictitious claims to Medicare, and Medicare deposited payments into the accounts. The students had pre-signed checks so that conspirators could withdraw the deposited funds.

Former OIG Most Wanted fugitive Vivian Yusuf entered a guilty plea in a $3.4 million dollar durable medical equipment Medicare fraud case.

Karo Blkhoyan, an OIG Most Wanted fugitive who was indicted in a $1.1 million dollar Medicare scam, was taken into custody at San Francisco International Airport.

In other news, the Office of Inspector General, Agents Omar Perez and Reginald France and our partners at the Department of Justice accepted the Samuel J. Heyman Service to America Homeland Security and Law Enforcement Medal. The award recognizes the hard work and dedication of our Miami Medicare Fraud Strike Force Team which, along with our other Strike Force Teams across the nation, work tirelessly to catch and prosecute fraudsters who steal from Medicare and Medicaid and take advantage of our most vulnerable citizens. The Sammies, as they are called, are one of the most prestigious awards dedicated to honoring America's civil servants for outstanding achievements that improve the lives of Americans and others around the world.

Don't miss our latest Spotlight, in which OIG examines a trend in state policies that results in the federal government -- and taxpayers -- paying more than their share of Medicaid expenditures.

And, OIG is seeking second- and third-year law students for spring 2015 legal extern positions; that application deadline is Oct. 20, 2014.

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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