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Transcript for audio podcast:
May 2016 OIG 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).

OIG's Spring 2016 Semiannual Report to Congress is on our website now. Check it out.

Don't miss the video of Inspector General Dan Levinson's HCCA keynote speech. It, too, is posted on our website.

During a video interview with Bloomberg BNA, OIG Principal Deputy Inspector General Joanne Chiedi discussed OIG's use of data analysis in investigations and OIG's role in preventing prescription drug abuse. Go to our website to watch the video.

Ann Maxwell, Assistant Inspector General for the Office of Evaluation and Inspections, testified before a House subcommittee about provider enrollment in Medicare and Medicaid and the fight against improper payments. Visit our website to watch or read the testimony.

Don't miss the latest Eye on Oversight, featuring Assistant Inspector General for Legal Affairs Rob DeConti, discussing providers who pay and doctors who receive kickbacks for referrals. Visit our website to watch the video.

OIG CIO Chris Chilbert was interviewed on Federal News Radio. He discussed OIG's mission and mission-critical IT systems. He also talked about tools that his team is providing to OIG subject matter experts to leverage data. Go to FederalNewsRadio.com to listen to the interview.

Special Agent in Charge Scott Lampert appeared on CNBC's "American Greed" and talked about OIG's involvement in the 2009 Bay Medical case in New York. Bay Medical is a Brooklyn-based health care provider convicted in a $77 million dollar Medicare fraud scheme. Go to the "American Greed" website to watch the video.

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

In related reviews:

OIG found vulnerabilities that could allow potentially fraudulent providers to enroll in Medicare.

OIG reviewed early implementation results of enhanced enrollment screening of Medicare providers. You can read the review and listen to a podcast on the report. Visit our website.

OIG noted that States' implementation of Affordable Care Act screening of high- and medium-risk Medicaid providers is incomplete.

OIG urged the Centers for Medicare & Medicaid Services to work with states to correct gaps in their collection of required Medicaid provider ownership information.

In another review, OIG faulted Connecticut's critical incident reporting involving developmentally disabled Medicaid recipients in group homes.

A report by contractor Ernst & Young, whose audit work OIG monitored, found that the Department of Health and Human Services met many requirements but did not fully comply with the Improper Payments Information Act of 2002 for fiscal year 2015. A key example of noncompliance was a Medicare fee-for-service error rate of 12 percent, which exceeds the 10 percent compliance threshold for improper payments. HHS reported $43 billion dollars in fee-for-service improper payments, which reflects the 12 percent error rate. Also for fiscal 2015, HHS reported a total of $89.7 billion dollars in improper payments.

OIG examined licensure data in Round 2 of the durable medical equipment Competitive Bidding Program. Visit our website to read the review and listen to a podcast on the report.

Pharmaceutical firms Wyeth and Pfizer are to pay nearly $785 million dollars to settle allegations that Wyeth wrongfully avoided paying hundreds of millions of dollars in rebates to Medicaid from 2001 to 2006. Pfizer acquired Wyeth in 2009.

Byram Healthcare, a supplier of medical products, and Hollister, Incorporated, a manufacturer of disposable health care products, together are to pay $20 million dollars to resolve allegations of a kickback scheme designed to increase sales and profits.

A North Carolina doctor, who believed Medicaid wasn't paying him enough for his services, was sent to jail for 18 months in a $467,000 dollar fraud scheme.

A Kentucky anesthesiologist was imprisoned for more than eight years for fraud and money laundering and unlawful distribution of controlled substances.

A New York physician was charged in a 114-count indictment with illegally issuing hundreds of thousands of prescriptions for controlled substances.

OIG Most Wanted Fugitive Maikel Gomez, charged in a $13.9 million dollar Medicare fraud case, is now in custody in Florida.

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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