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Transcript for audio podcast:
November 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 latest Semiannual Report to Congress, highlighting our work for fiscal year 2016, has been posted on our website. Don't miss it! https://oig.hhs.gov/reports-and-publications/semiannual/index.asp

OIG's fiscal year 2017 Work Plan, a compilation of planned reviews for the coming year, is also available. Visit our website.

And check out OIG's Top 10 Management & Performance Challenges facing the Department of Health and Human Services. They, too, are on our website.

Tune in to our latest podcast: Reporting Tips & Complaints to the OIG Hotline. You can listen on the OIG website.

Check out the latest Eye on Oversight: watch the video detailing challenges in Indian Health Service hospitals.

Since our last podcast, OIG has issued a number of reports. OIG found in one review that New York failed to follow federal rules in allocating millions of dollars to health insurance marketplace establishment grants.

In one report, OIG urged Minnesota to refund nearly $1.3 million dollars after the state failed to properly charge some costs to grants for its health insurance marketplace.

In another review, OIG recommended that North Carolina refund more than $15 million dollars after the state improperly claimed federal reimbursement for some Medicaid transport services.

An OB/GYN from New Jersey agreed to a 20-year exclusion from federal healthcare programs, including Medicare and Medicaid, to settle allegations of false claims. The OIG exclusion follows a False Claims Act settlement with the physician in which he agreed to pay $5.25 million dollars.

In Illinois, a psychiatrist is to pay more than $900,000 dollars to settle civil allegations of false claims for medical services. The psychiatrist agreed to a 10-year exclusion from federal healthcare programs.

Medical device maker Biocompatibles, a subsidiary of BTG, admitted misbranding its embolic device LC Bead and agreed to pay more than $36 million dollars to resolve criminal liability and civil false claims allegations. The device is used to treat liver cancer, among other diseases.

A New York radiology company entered a guilty plea in a healthcare fraud case and is to forfeit $2.4 million dollars. The company also agreed to pay more than $8 million dollars to settle civil fraud allegations and entered into a corporate integrity agreement with OIG. The government said the company illegally performed and billed for procedures that were not ordered by treating physicians.

A medical equipment company owner in Maryland admitted extortion and conspiracy to commit healthcare fraud. A man who owed money to the owner was killed, and a co-defendant was convicted of murder in the case.

A Detroit-area home health care owner was imprisoned for 30 years in a $33 million dollar Medicare fraud scheme; the businessman is to repay more than $40 million dollars. The scam included kickbacks, falsified and stolen records and money laundering. The co-owner, sentenced separately, was sent to prison for eight years and must repay more than $38 million dollars.

In Florida, a woman and her son were given long prison terms - 10 years and 2.5 years -- in a $9.5 million dollar pharmacy fraud case involving Medicare Part D. The scam included false claims, kickbacks and money laundering, authorities said. Together the mother and son are also to repay $11 million dollars and forfeit the same amount.

A Texas nursing home chain is to pay $5.3 million dollars and enter into a corporate integrity agreement with OIG to resolve false claims allegations. The case centered on allegedly substandard nursing services.

A doctor in Georgia was jailed for more than three years and must repay more than $1.1 million dollars for filing false claims for surgical monitoring services. Authorities said the physician had an unqualified medical assistant monitor surgeries for him. OIG's Derrick Jackson, commenting on the case, said the doctor's "utter disregard for patient safety and his extreme greed stand out. His arrogance in billing for fraudulent services performed by an unqualified employee on patients undergoing surgery is truly shocking."

A Virginia man admitted concealing his grandmother's death for months to fraudulently obtain her Social Security benefits. He admitted hiding the body in a freezer and later in a barrel. Investigators discovered the body after the man's landlord became suspicious about the barrel.

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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