Transcript for audio podcast:
January 2015 OIG Monthly Update
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 has issued a number of reviews.
In one report, OIG found inadequacies in Centers for Medicare & Medicaid Services' contract planning, procurement and oversight for the federal health insurance Marketplace.
In a second review, OIG recommended that the Centers for Medicare & Medicaid Services reform Medicare payments to reduce hospices' incentive to target beneficiaries who may offer the greatest financial gain.
Don't miss our podcast on this report: Medicare hospices have financial incentives to provide care in assisted-living facilities.
In another review, OIG found that power mobility device claims without the required patient-doctor face-to-face exams cost Medicare $35.2 million dollars in 2010.
In a fourth study, OIG urged training in recognized safe-practice standards for those who oversee compounded drugs used in hospitals.
Are you into stats? Listen to a podcast on statistical sampling in OIG reviews.
Pennsylvania is to pay nearly $50 million dollars to resolve allegations that it illegally provided benefits to ineligible aliens.
Global pharma firm Daiichi Sankyo is to pay $39 million dollars to settle claims that it paid kickbacks to physicians. The company allegedly padded speaker fees to doctors to induce them to prescribe several drugs. IG Dan Levinson said, "Schemes such as this are particularly abhorrent."
Ansun Biopharma of San Diego is to pay $2 million dollars to resolve allegations of overbilling; the company allegedly doctored timesheets on National Institutes of Health contracts.
Hospice owners in Indiana have agreed to pay more than $2.5 million dollars to settle OIG allegations of Medicare claims submitted for ineligible patients.
A Denver hospital system is to pay more than $52,000 dollars to settle OIG allegations that it filed Medicare claims for people who were in jail.
A pair of doctor-owners of a Houston mental health clinic were imprisoned for more than 12 years and 10 years in a $97 million dollar Medicare fraud scheme that ran from 2006 through 2011. Restitution of more than $8 million dollars was ordered.
An Arkansas woman was sent to jail for 10 years and must pay more than $370,000 dollars in restitution and fines after submitting 1,063 fraudulent claims for speech pathology services to Medicaid.
A Michigan doctor was jailed for 15 months and must repay more than $1.3 million dollars for her participation in a home health fraud scheme. The scam included false documentation and bogus certifications and referrals of Medicare patients for care that wasn't needed or provided.
A physician's assistant admitted writing medically unnecessary prescriptions for more than 125,000 oxycodone pills at a clinic in Staten Island, N.Y. The scheme included bribes and phony cash-only doctor visits that usually lasted only a minute or two.
A former clinic owner in North Carolina was jailed for two and a half years and must repay more than $3.1 million dollars in a mental health services scheme. The man spent proceeds from the scam on luxury cars and a diamond ring.
A Missouri podiatrist entered a guilty plea in a healthcare fraud case; he billed Medicare, Medicaid and private insurers thousands of times for draining abscesses when he merely clipped toenails.
Syed Jawed Akhtar-Zaidi, an Ohio doctor believed to have fled the United States after allegedly running a $10 million dollar pill mill, was added to the OIG Most Wanted Fugitives list.
Raymond Payne, charged with failing to pay more than $63,000 dollars in child support, was added to OIG's list of deadbeat parents. He is believed to be in Charlotte, North Carolina.
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.
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