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Transcript for audio podcast:
February 2016 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).

Olympus, the nation's largest endoscope distributor, and a subsidiary are to pay $646 million dollars to resolve criminal charges and civil claims relating to a scheme to pay kickbacks to doctors and hospitals in the United States and Latin America. Olympus agreed that the criminal complaint is true, and the subsidiary admitted foreign bribery. Olympus also agreed to make reforms and enter into a corporate integrity agreement with OIG. Visit our website to read the corporate integrity agreement.

The Health Care Fraud and Abuse Control Program Annual Report for fiscal year 2015 is on our website now! According to the report, the Federal Government won or negotiated more than $1.9 billion dollars in healthcare fraud judgments and settlements in fiscal 2015. And as a result of efforts in fiscal 2015 and prior years, $2.4 billion dollars has been recovered.

The fiscal year 2017 budget request for OIG includes $419 million dollars to strengthen oversight of Department of Health and Human Services programs. For more, visit our website.

Inspector General Dan Levinson is the recipient of the AGA's 2016 Distinguished Federal Leadership Award. The organization, also referred to as the Association of Government Accountants, recognized the IG for his outstanding leadership of OIG auditors whose work promotes accountability and integrity in Department of Health and Human Services programs.

OIG is offering a new monthly video series, "Eye on Oversight," bringing into focus the continuing battle against healthcare fraud, waste and abuse. "Eye on Oversight" is on our website now. Don't miss it!

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

In a case study, OIG identified management lessons from the poor launch of Healthcare.gov.

In separate reports, OIG found that in the District of Columbia and in Minnesota not all healthcare marketplace controls ensured that applicants were enrolled in Affordable Care Act health plans according to federal requirements.

The Colorado marketplace protected personal information, but improvements are still needed for its information security controls, OIG noted in another report.

Nevada did not allocate the costs of setting up a marketplace according to federal requirements, OIG found in another review.

In one study, OIG noted that New Jersey claimed an estimated $47.3 million dollars in Medicaid reimbursement for some unallowable long-term-care waiver services.

OIG recommended in another report, that the University of Minnesota Medical Center refund an estimated $3.3 million dollars in Medicare overpayments.

And OIG urged Puerto Rico to return $12.5 million dollars in improperly claimed childcare and development funds.

A Maryland healthcare provider, who bilked Medicare and Medicaid out of more than $7.5 million dollars, was convicted in the deaths of two patients. Both died, authorities said, because their X-rays were not interpreted by a qualified radiologist. The provider was also convicted of false billing, creating false healthcare records and forgery.

Fifty-one hospitals in 15 states agreed to settle allegations linked to the implantation of cardiac devices; the facilities together are to pay more than $23 million dollars. Commenting on the settlements, Inspector General Dan Levinson said: "We will not stand idly by while Medicare coverage rules are ignored."

Adventist Health System Sunbelt Healthcare Corporation is to pay more than $2 million dollars to settle allegations that patients received portions of chemotherapy drugs that were left over after the drugs were administered to other patients.

The owner/manager of three Miami-area home health agencies was convicted in a $57 million dollar Medicare fraud scheme that included kickbacks and bogus services.

Eleven Floridians were arrested and charged, one man was still being sought, and a purported "pill mill" was shut down, authorities reported. They asserted that doctors and others issued illegal prescriptions for more than 1 million units of painkillers, including oxycodone and hydrocodone. The street value of the pills was estimated at more than $16 million dollars.

Three were arrested and authorities were looking for two others in a half-million dollar Medicaid case in Florida. False billing and misuse of provider and recipient information has been alleged.

Four doctors and two compounding pharmacies in Florida are to pay $10 million dollars to settle allegations of false claims for prescriptions.

A Miami physician admitted playing a part in a $20 million dollar scam. He took kickbacks and bribes in exchange for prescriptions for unneeded home healthcare.

A New Jersey woman admitted taking part in a scheme with her sister and a lawyer to steal millions of dollars from the elderly clients of an in-home senior care company.

A New Jersey doctor and his two companies are to pay $5.25 million dollars to settle allegations that they falsely billed federal health care programs for tests that were never administered.

OIG Most Wanted fugitive Manuel Garcia, accused of home healthcare fraud, was taken into custody in Miami.

John Hagg, director of Medicaid audits for OIG's Office of Audit Services, testified before the House Committee on Energy and Commerce Subcommittee on Health. He discussed Medicaid and CHIP's Federal medical assistance percentage. 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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