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Transcript for audio podcast:
February 2015 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).

Chief of Staff Christi Grimm talked with Bloomberg BNA about OIG priorities in the 2015 Work Plan, including oversight of health insurance marketplaces, Medicaid expansion and beneficiary quality of care. Watch the BNA video on our website.

And OIG's Ronald Kerr talked with ABC News about ambulance companies that rip off taxpayers. Check out that video on our website.

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

Three licensed daycare centers in Arizona reviewed by OIG did not always comply with health and safety rules for children.

In a related report, OIG found that some family childcare home providers in Arizona also did not always follow state health and safety rules.

In a separate report, OIG noted that competitive bidding for durable medical equipment could mean millions in savings for New York Medicaid.

Community Health Systems Professional Services Corporation and three of its affiliated hospitals in New Mexico are to pay $75 million dollars to settle a false claims case. Community Health Systems, of Franklin, Tennessee, manages more than 200 hospitals in 29 states.

Drugmaker AstraZeneca is to pay $7.9 million dollars to resolve civil claims that it paid kickbacks to pharmacy benefit managers to boost profits.

Ageless Men's Health LLC is to pay $1.6 million dollars to resolve allegations that it overbilled for testosterone-therapy office visits.

A Miami home health agency owner was put behind bars for nearly nine years and must repay, with a co-conspirator, $21 million dollars in a scam that included kickbacks and bribes and unneeded or never provided care.

Another Florida home health company owner admitted bilking Medicare out of $5.7 million dollars. The scam included paying for referrals, prescriptions, plans of care and certifications for unneeded care, all of which were used to submit fraudulent bills.

Four Floridians were imprisoned for a total of more than 30 years and together must repay over $9.5 million dollars in a long-running home health scheme that included false claims, bogus services, phony records and kickbacks and bribes.

A South Florida home health agency owner was jailed for 10 years and must pay more than $11 million dollars for his role in a long-running Medicare fraud. A patient recruiter was put behind bars for two years and will pay more than $200,000 dollars in the same scam.

A Kentucky physician was charged with prescribing serious pain medications without medical purpose, resulting in five deaths. If convicted, he could be sentenced to life behind bars.

Authorities said that an Alabama pharmacist -- indicted in a $50,000 theft from Medicaid -- conspired with the mother of dying child to bill Medicaid for drugs meant for the child but not dispensed. The druggist allegedly would then give the mother cash.

Four were charged in Texas with billing Medicare and Medicaid $28 million dollars for numerous unneeded patient tests.

Three more New Jersey physicians are paying a high price for accepting bribes in exchange for patient referrals to Biodiagnostic Laboratory Services LLC. An internist was jailed for 16 months and must pay a $50,000 dollar fine. Two other doctors pleaded guilty. One of them generated more than $1.7 million dollars, the other $800,000 dollars for the clinical lab. Both are to be sentenced in May. Together the three doctors are to forfeit nearly $345,000 dollars. Thirty-five people - 24 of them doctors - have pleaded guilty in the scheme, which involved millions of dollars in bribes and resulted in more than $100 million dollars in payments to the lab from Medicare and private insurers.

See the associated news releases:

A former OIG Most Wanted fugitive, Vivian Yusuf, was jailed for more than seven years in a multimillion-dollar medical supplies scam in Texas. Yusuf had been on the run for several years before her capture in Houston in 2014.

And the new Connecticut Public Corruption Task Force, which includes OIG, will investigate corruption, fund misuse and other crimes in the state.

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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