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Transcript for audio podcast:
March 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 ( and on Twitter (@OIGatHHS).

The annual Health Care Fraud and Abuse Control Program report, issued jointly by the Departments of Health and Human Services and Justice, noted that $27.8 billion dollars has been recovered since the program's inception in 1997. In the fiscal year 2014 battle against healthcare fraud and abuse, $3.3 billion dollars was recovered. And the return on investment is worth noting: For every dollar spent, nearly $8 dollars is returned to the government.

Sandoz is to pay $12.64 million dollars to settle OIG allegations that the drug maker misrepresented pricing data to Medicare.

Gary Cantrell, deputy IG for Investigations, testified before the House Ways and Means Committee's Subcommittee on Oversight on the use of data analysis to identify trends and stop Medicare fraud.

Assistant IG for Evaluation and Inspections, Ann Maxwell, discussed the 340B drug discount program in an appearance before the House Energy and Commerce Committee's Subcommittee on Health. You can watch a video of each opening statement and read the full testimonies on the OIG website.

Regional Inspector General Robert Vito was interviewed on Federal News Radio about a high-profile report, "Federal Marketplace: Inadequacies in Contract Planning and Procurement."

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

In one review, OIG urged that steps be taken to ensure quality of care for Medicaid children treated with antipsychotic drugs. Check out the infographic with this report.

And don't miss the related podcast. Visit our website.

In another review, OIG urged Maryland to refund $28.4 million dollars that it misallocated to health insurance Marketplace grants.

In another study, OIG found that nearly one-third of foster children in Medicaid did not receive at least one required health screening. Don't miss the infographic with this report.

And you can listen to a related podcast.

In a fourth report, OIG found that Medicare could save billions if swing-bed services were reimbursed at skilled nursing facility rates.

Don't miss the podcast, "Medicare Payments for Swing-Bed Services at Critical Access Hospitals."

Three childcare centers in Minnesota reviewed by OIG did not always comply with the state's health and safety rules.

And some childcare home providers in Minnesota also did not follow state health and safety requirements, OIG found.

Two men entered guilty pleas in an $80 million dollar Michigan pharmacy scam that included illegal restocking and redispensing of recycled drugs and false billing of Medicare, Medicaid and private insurers. Eighteen defendants have been convicted in the scheme.

A New York nonprofit, Narco Freedom, and its executives face charges that they ran an organized crime ring to exploit patients and steal $27 million dollars from Medicaid.

20 people, including doctors and nurses, were charged in Louisiana in a $30 million dollar Medicare home health scheme that, according to authorities, included phony doctor orders and records, fake diagnoses, bogus services and kickbacks.

A Louisiana clinic owner and an accountant admitted taking part in a $50 million dollar fraudulent billing scam, which included false certifications by doctors that Medicare patients qualified for home care.

A Massachusetts home nursing agency owner was sent to prison for nearly eight years in a $27 million dollar Medicare fraudulent billing scheme. The man must pay more than $7 million dollars as well as forfeit the proceeds of the scam, including an $850,000 dollar home.

A California physician who is a patient safety consultant is to pay $1 million dollars to settle allegations that he sought and took monthly payments in exchange for influencing National Quality Forum recommendations. Authorities also allege that the doctor recommended, promoted and/or arranged for the purchase of a product made by the company from which he was said to be receiving the payments.

Two men were sentenced to long prison terms after committing extensive ambulance fraud in the Philadelphia area; restitution of nearly $2 million dollars was ordered. The scam included ineligible patients, phony records and kickbacks.

In separate cases, two Medicare beneficiaries in Philadelphia admitted taking cash and using ambulance services for which they were ineligible. Each defendant could get a long prison term and a fine of at least a million dollars.

Barbaro Ortega and Raul Camejo, indicted in a $3.3 million dollar Medicare fraud case, were added to the OIG Most Wanted Fugitives list.

And on a final note, check out OIG's 2015 Compendium of Unimplemented Recommendations -- the top 25 recommendations that OIG believes would yield the most savings or program improvements.

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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