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Transcript for audio podcast:
August 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).

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

OIG found that Texas claimed $57.9 million dollars in unallowable supplemental payments made to University of Texas health institutions over three years.

In a second review, OIG noted that Colorado received $38.3 million dollars in unallowable Children’s Health Insurance Program bonus payments for fiscal years 2010 through 2013.

In another study, OIG found that Arizona made incorrect electronic health record incentive payments, totaling $14.8 million dollars, to 24 OIG-reviewed hospitals.

OIG’s latest “Eye on Oversight: Critical Incidents in Group Homes” is on our website now. When officials fail to alert states about potential abuse or neglect, residents are put at risk. To watch the video, visit our website.

What role does OIG play in Indian Country -- among the nation’s 2.2 million American Indians and Alaska Natives? Visit our website for a podcast that will give you the answer!

A licensed practical nurse who owned an assisted-living facility in Florida was charged with aggravated manslaughter of an 80-year-old resident by culpable negligence. Authorities said that the nurse, among other things, failed to adequately treat the resident’s ulcers. Over several months, the resident’s condition worsened. Eight days after being hospitalized, authorities said, the resident died.

A New York pharmacist was convicted of distributing diverted HIV medications and paying millions of dollars in bribes. He could get as much as 25 years in prison in the black market drug scheme that illegally billed Medicaid and others $274 million dollars.

A former community health clinic CFO in Alabama was sent to prison for 17 years and must forfeit nearly $2 million dollars in a complex fraud scheme.

A Miami-Dade psychiatrist was jailed for more than 12 years in healthcare schemes and other scams that cost the government $62.8 million dollars. His false diagnoses earned bribes and kickbacks from thousands of people who sought to cheat the Social Security Administration and U.S. Citizenship and Immigration Services. Authorities said the psychiatrist submitted false claims to Medicare and Medicaid for office visits that were not needed and not provided. And the psychiatrist issued prescriptions for medications to support false disability claims. Medicaid paid for those unneeded medications.

Three Miami residents were given long prison terms – one of them more than 15 years – in a $40 million dollar fraud, money laundering and kickback scheme, which authorities said was the largest Medicare loss to a fraud scheme prosecuted in the Southern District of Florida in 2015.

A New York doctor was convicted of submitting more than $25 million dollars in false and fraudulent claims for surgeries he did not perform.

A husband and wife in New Jersey who falsified over 10,000 medical diagnostic testing reports in a $4.8 million dollar health care fraud case each was sent to prison for more than six years.

A South Carolina hospital is to pay $17 million dollars to resolve allegations that it violated the physician self-referral law by maintaining improper financial arrangements with 28 doctors.

An Illinois doctor was sent to prison for two years for taking kickbacks in exchange for referring elderly patients to a Chicago hospital. The scheme earned the now-closed hospital millions of dollars in reimbursements from Medicare and Medicaid.

A physician in California was sentenced to four years in prison after falsely certifying that at least 79 Medicare and Medicaid patients were qualified for hospice care because they were terminally ill. Authorities said most of the patients were not dying. The doctor was also ordered to repay more than $1.3 million dollars.

The owner of a New Orleans medical equipment company was jailed for 80 months in a $3.3 million dollar false billing case. He is to repay more than $2 million dollars.

A Louisiana doctor was charged with illegally dispensing drugs and threatening to kill law enforcement officers.

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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