Transcript for audio podcast:
April 2016 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).
Inspector General Dan Levinson presented the keynote address at the Health Care Compliance Association's 20th Annual Compliance Institute in Las Vegas. During the address, the IG announced new revised Exclusions guidance. And several representatives from OIG took part in Compliance Institute breakout sessions. For more, visit our website.
OIG and other partners joined the Department of Justice in launching 10 Regional Elder Justice Task Forces to fight substandard nursing home care.
OIG's 2016 Compendium of Unimplemented Recommendations is on our website now. The top 25 recommendations are priorities that, if implemented, would yield positive results for Department of Health and Human Services programs.
Special Agent in Charge Lamont Pugh was interviewed by Andrea Day on CNBC's "Nightly Business Report' about OIG's investigation of cardiologist Harry Persaud, who performed invasive procedures on patients who did not need them. He was convicted and sent to prison for 20 years.
Don't miss the latest Eye on Oversight, focusing on opioid abuse and the human and financial toll it takes. Visit our website to watch the video!
Drugmaker Warner Chilcott is to pay $125 million dollars to resolve criminal and civil liability tied to the illegal promotion of seven drugs and various formulations of those drugs. From 2009 to 2013, Warner Chilcott, among other things, remunerated physicians to induce them to prescribe the company's drugs.
PremierTox, a drug urine screening company, is to pay $2.5 million dollars to settle allegations that it submitted false claims.
In a separate, unrelated case, two lab professionals from Tennessee were convicted in Virginia of billing more than $14 million dollars for unnecessary drug urine testing.
A Dallas doctor and three others were convicted in a sophisticated $375 million dollar home health care fraudulent billing scheme that, among other deceptions, authorities said, recruited the homeless for unneeded care. In discussing the case, OIG's C.J. Porter, special agent in charge in Dallas, said, "... The fraud was unprecedented in scope.' The verdict is "incredibly significant' and "...will send a message to the home health industry.'
A retired administrative law judge, a lawyer and a psychologist were charged in a scheme to fraudulently obtain more than $600 million dollars in Medicare and Medicaid payments and disability payments for thousands of claimants in Kentucky. The three defendants are alleged to have received more than $5 million dollars during the nearly eight-year scheme, authorities said.
A Chicago couple who own a physical therapy business were charged in a $45 million dollar Medicare fraud scheme allegedly involving bribes and kickbacks and falsified medical records. They were also charged with conspiring to employ a woman against her will.
The head of a home health company in Illinois was convicted of seeking to defraud Medicare of millions of dollars. In a recording played during the trial, the manager tells a doctor to "paint the picture,' making it appear that patients were confined to their homes when, in fact, they were not.
In one of several home health care fraud cases in the Detroit area, an agency owner pleaded guilty in a $4 million dollar scheme. He paid a doctor and patient recruiters to refer Medicare beneficiaries to his agency and to falsely certify that they needed home health care.
- https://oig.hhs.gov/fraud/enforcement/criminal/index.asp#CEA2016041202
- https://oig.hhs.gov/fraud/enforcement/criminal/index.asp#CEA2016042001
- https://oig.hhs.gov/fraud/enforcement/criminal/index.asp#CEA2016040601
- https://oig.hhs.gov/fraud/enforcement/criminal/index.asp#CEA2016041301
- https://oig.hhs.gov/fraud/enforcement/criminal/index.asp#CEA2016032501
A Miami doctor was sent to prison for nine years for participating in a $30 million dollar scam that included kickbacks and bribes, bogus prescriptions for home health care and falsified records. Restitution and forfeiture were ordered.
The head of a Miami transportation business was jailed for five years and must pay nearly $27 million dollars and forfeit the same amount for his role in a scheme involving three mental health centers.
A Houston psychiatrist was sent to prison for 12 years in a $158 million dollar false billing-bogus services scheme.
Also in Houston, a healthcare fraud conspiracy netted a physician a 42-month prison term. The doctor and others billed Medicare and Medicaid for numerous vestibular tests, used to diagnose vertigo or dizziness and usually needed only once or twice in a lifetime. One patient was billed for 1,200 tests after seeing the doctor only once.
Three more OIG Most Wanted Fugitives are now in custody. After 20 years on the run, convicted Medicare fraudster Robert Allen Lopez was taken into custody in Florida. And two others charged with Medicare fraud, Jose Portillo and Tomas De Armas, were captured, one near the Bahamas and the other in Florida.
- https://oig.hhs.gov/fraud/fugitives/captured_profiles.asp#lopez
- https://oig.hhs.gov/fraud/fugitives/captured_profiles.asp
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.
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