Transcript for audio podcast:
May 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).
Stay in tune with OIG: The midyear Work Plan Update is on our website now. OIG has added more than 20 new reports to the fiscal year 2015 Work Plan. Check it out!
IG Dan Levinson's keynote address at the 2015 Health Care Compliance Association's Compliance Institute is on our website. Read the transcript, listen to the podcast or watch the video.
Don't miss a CNN report - based on OIG audits and evaluations on pediatric dentistry. Anderson Cooper 360 took a look at a Florida dentist accused of harming children and performing unnecessary procedures.
OIG's Gerry Roy, Special Agent in Charge in Kansas City, talked with KMOV, St. Louis, about a podiatrist who defrauded Medicare of nearly $1 million dollars. See the video on our website.
And OIG's Nancy Harrison was interviewed about hospice care on American Public Media's "Marketplace."
Since our last podcast, OIG has issued a number of reports.
Questionable billing and quality of care are among the issues raised in an OIG study of pediatric dentistry in California Medicaid.
OIG found in one report that incorrect place-of-service coding by physicians resulted in potential overpayments that cost Medicare millions.
The Food and Drug Administration improved its oversight and inspections of manufacturers of generic drugs, OIG found in a third report.
And OIG noted in another study that the Department of Health and Human Services complied in many respects with the Improper Payments Information Act of 2002, but it did not fully comply for fiscal year 2014.
A New York doctor and clinics owner was convicted of overseeing the illegal distribution of $165 million dollars' worth of oxycodone pills. Doctors employed at the clinics wrote 35,000 medically unneeded prescriptions. And crowds of up to 100 people gathered daily at one of the clinics, clamoring for the illegal prescriptions.
Two doctors, a nurse and an office manager were convicted in a $50 million dollar home health scheme in Louisiana that cheated Medicare for more than 10 years.
Accredo Health Group is to pay $60 million dollars in a civil fraud settlement over a kickback scheme linked to the drug Exjade. And the U.S. intervened in a lawsuit against Novartis, which allegedly paid Accredo kickbacks for increased refills of Exjade. The government also alleged that the defendants understated the drug's potentially life-threatening side effects.
PharMerica, a pharmacy corporation that dispenses medications to residents of long-term-care facilities, is to pay $31.5 million dollars to settle allegations that it dispensed Schedule II drugs without valid prescriptions and filed false Medicare claims. The corporation also agreed to enter into a five-year corporate integrity agreement with OIG.
Westchester Medical Center in New York is to pay nearly $19 million dollars to settle civil fraud claims tied to violations of the Anti-kickback Statute and the Stark Law. OIG Special Agent in Charge Scott Lampert said, "Westchester Medical Center's aggressive, intricate kickbacks and other fraud schemes in this case threatened the impartiality of medical referrals, the financial integrity of Medicare, and the public's trust in the health care system."
Sixteen hospitals, mostly in the South, are, together, to pay nearly $16 million dollars to resolve allegations that they billed Medicare for unneeded psychotherapy.
A Georgia medical center is to pay $20 million dollars to settle allegations that it billed for more expensive patient services than it should have.
The ringleader of a New Jersey Medicaid scam involving imaging centers that he owned pleaded guilty to bribing dozens of doctors for referrals. He is to be imprisoned for 10 years, and repayment of $1 million dollars has been ordered. He will also be barred for life as a Medicaid provider. Three more doctors were jailed - two of them for more than three years -- in a massive bribes-for-referrals laboratory scam in New Jersey; the three physicians must pay fines and forfeitures totaling more than $1.2 million dollars.
- https://oig.hhs.gov/fraud/enforcement/criminal/index.asp#CEA2015050602
- https://oig.hhs.gov/fraud/enforcement/criminal/index.asp#CEA2015051802
A Miami home health company owner was imprisoned for 10 years in a $13 million dollar Medicare kickback and bribery scam; full restitution was ordered.
Five California ambulance firms are to pay more than $11.5 million dollars to settle civil claims linked to alleged kickback schemes. Authorities said the companies gave hospitals and nursing homes discounts in exchange for Medicare patient referrals.
A billing fraud scheme put the former CEO of a Nevada endoscopy center behind bars, and it cost her $8.1 million dollars in fines, forfeiture and
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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