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Transcript for audio podcast:
November 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).

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

In one review, it was found that New Mexico was paid $15.9 million dollars more in Medicaid bonus payments than it was due. OIG urged that the money be returned to the Federal Government.

In related reviews, OIG noted that some South Carolina family childcare homes did not always comply with state health and safety requirements.

And that some South Carolina childcare centers did not always comply with state health and safety licensing requirements.

The latest Semiannual Report to Congress, highlighting OIG's work for fiscal year 2015, has been posted on our website. Check it out!

Don't miss OIG's 2015 Top Management and Performance Challenges facing the Department of Health and Human Services. Visit our website!

Novartis Pharmaceuticals agreed to a $390 million dollar civil fraud settlement for a kickback scheme linked to its distribution of the drugs Exjade and Myfortic. The Government alleged that Novartis gave kickbacks in the form of patient referrals and rebates to Bioscrip and Accredo to induce those pharmacies to recommend Exjade refills. The Government alleged that Novartis gave rebate contracts to specialty pharmacies to induce them to recommend that doctors switch patients to Myfortic from competitor drugs.

Warner Chilcott has agreed to plead guilty to healthcare fraud and pay $125 million dollars to settle criminal and civil liability. The company admitted that it paid doctors across the United States to

Four hundred fifty-seven hospitals in 43 states are together to pay more than $250 million dollars to settle allegations linked to cardiac devices, which were implanted in Medicare patients in violation of coverage rules.

The United States intervened in lawsuits alleging that SavaSeniorCare, a chain of skilled nursing facilities, submitted false claims to Medicare for rehabilitation therapy that was not medically reasonable and necessary.

A former pediatric dentist in Florida was charged with 11 counts of Medicaid provider fraud. He allegedly billed for procedures performed without parental consent, and he was accused of rendering substandard care to children. If convicted, he could be imprisoned for as much as 55 years.

In the nation's capital, two home health agency owners - one an excluded provider - were convicted of taking part in an $80 million dollar fleecing of Medicaid. The fraud scheme, described as "massive and systematic," billed Medicaid for services that were never provided.

A former medical director and three therapists were given long prison terms - one of them 16 years -- in the $63 million dollar Health Care Solutions Network Medicare/Medicaid fraud scheme in Florida. Twenty-two defendants have been convicted in the scam.

The owner of two New York clinics admitted her role in a $55 million dollar patient kickback fraud scheme and is to forfeit $29 million dollars. At least 10 others have pleaded guilty in the scheme.

A Connecticut doctor was imprisoned for seven years for fraud and illegally prescribing narcotics. One patient died of an overdose. Authorities said the physician ignored warnings and prescribed narcotics well outside the scope of accepted medical practice. Along with the jail time, the doctor was ordered to pay more than $497,000 dollars in restitution and to forfeit $550,000 dollars.

Two physicians in Massachusetts together must repay more than $445,000 dollars to settle allegations that they forced addicts to pay cash for treatment that was already covered by Medicaid.

An Illinois doctor was put behind bars for giving addicts controlled substances "for a price." The physician was fined and ordered to forfeit to the United States a building he owns, along with more than $34,000 dollars.

OIG's Gloria Jarmon, Deputy Inspector General for the Office of Audit Services, testified on Capitol Hill about health insurance co-ops. Visit our website to watch or read the testimony.

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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