Indian Health and Human Services
HHS, through its operating divisions, carries out health and human services programs for American Indians and Alaska Natives (AI/ANs).
The Indian Health Service (IHS), which has an approximately $7 billion budget, provides or funds a wide range of clinical, public health, and community services to approximately 2.8 million AI/ANs who are members of the 574 federally recognized Tribes located in 37 States. Tribally run facilities typically serve as Medicare or Medicaid providers for eligible AI/ANs, as does the IHS. Other HHS agencies award grants for Tribal human services programs ranging from Head Start to the Low Income Home Energy Assistance Program.
OIG provides oversight—through audits, evaluations, and investigations—of all HHS Federal health care programs and grant programs that serve AI/ANs, including the Sanitation Facilities Construction Program, which provides AI/AN homes and communities with essential water supply, sewage disposal, and solid waste disposal facilities. We are committed to helping protect the HHS programs in Indian Country from fraud, waste, and abuse so that Tribal beneficiaries receive the health and human services that are so important to their well-being.
Compliance & Quality of Care Trainings
Improving Health and Well-Being in American Indian and Alaska Native Communities Through Compliance
Published 05-17-2022
OIG offers the online training series Improving Health and Well-Being in American Indian and Alaska Native Communities Through Compliance. This series includes web-based trainings, job aids, and videos for grantees and health care providers who serve AI/AN communities to learn more about compliance; fraud, waste, and abuse; and health care quality.
These trainings are free and provide information and tools that you, at the option of your organization and based on its needs, can apply to help ensure your organization provides quality services to your community and complies with applicable statutes, regulations, and program requirements. Users will be able to download a certification of completion for each training completed.
Why OIG Created this Training Series
OIG's mission is to provide objective oversight to promote the economy, efficiency, effectiveness, and integrity of HHS programs, as well as the health and welfare of the people they serve, including members of the AI/AN community. OIG developed this training series to help meet the compliance needs of grantees and health care providers, including Tribes and Tribal organizations, that receive funds from HHS to serve AI/AN communities. While compliance fundamentals apply to all HHS programs, the Tribes' status as sovereign governments and as PL 638 contractors and compactors introduce legal and operational complexities. Similarly, the rules applying to Tribal recipients of HHS grants are not always identical to those of other HHS recipients.
Over the past years, OIG has had many opportunities to engage with Tribes and Tribal organizations about their needs as they relate to compliance, fraud, waste, and abuse, and quality of care. In these discussions, Tribal Leaders noted that information tailored to Tribes is helpful and requested training. With that goal in mind, this training program is specific to Tribal and Tribal organizations' needs.
How OIG Created this Training Series
OIG recognizes Tribal sovereignty and is cognizant of the government-to-government relationship between Tribes and the Federal government. Although HHS OIG cannot engage in formal consultation with Tribes with respect to oversight and fraud-related activities, we proactively and purposefully sought the input of AI/AN stakeholders in the development of the training program from inception to completion in a variety of ways.
HHS OIG has learned through our own audits and investigations a great deal about the breadth and nature of the program vulnerabilities which can interfere with the IHS's and Tribes' ability to maximize their programs' effectiveness. To learn more from those who are on the frontlines of providing benefits and services to AI/AN individuals, HHS OIG leadership and staff engaged with Tribal program officials over the several years preceding the development of this program. OIG HHS staff regularly attended Tribal meetings, conferences, and consultations sponsored by the Centers for Medicare and Medicaid Services, Administration for Children and Families, Indian Health Service (IHS), and other HHS Operating Divisions. HHS OIG leadership have made several trips to Indian Country to collect information on the needs of Tribes to inform our strategy and work planning to conduct oversight of AI/AN focused programs. OIG evaluators, auditors and attorneys have visited reservations, IHS hospitals and clinics, and Tribal health care facilities where we spoke to Tribal Leaders, community members, and hospital and clinic staff such as doctors, nurses, pharmacists, and compliance officers.
Additionally, these online trainings are an extension of our in-person trainings for grantees and health care providers who serve AI/AN communities held in South Dakota at the Crazy Horse Memorial in 2017 and in Oklahoma in 2018. At the conclusion of these trainings, we sought participant feedback which has been incorporated into this training series.
Finally, as we translated the content from in-person trainings and presentations to an online format, we formally sought user feedback on all courses from grantees and health care providers who serve AI/AN communities. As we received feedback, we amended content, wherever possible, to maximize the training's utility and value to AI/AN health and human services organizations.
Trainings by Subject
Trainings by Tract
Audits & Evaluations
Planned Work
The United States Public Health Service Commissioned Corps is a branch of the Nation's uniformed services committed to the service of public health. Commissioned Corps Officers (CCOs) advance the Nation's public health by serving in agencies across the Government as physicians, nurses, dentists, scientists, engineers, and other professionals to fight disease, conduct research, and care for patients in underserved communities across the Nation and throughout the world.
American Indian and Alaska Native (AI/AN) children are disproportionately represented among missing children and are more likely to go missing from a foster care placement than any other location. When children go missing from foster care, they may experience serious negative consequences, including a heightened risk of human trafficking, as well as poorer outcomes related to health, safety, education, employment, and subsequent criminal justice system involvement.
Under the Infrastructure Investment and Jobs Act, Congress allocated $3.5 billion to the Indian Health Service (IHS) Sanitation Facilities Construction (SFC) Program to provide American Indian and Alaska Native (AI/AN) homes and communities with essential water supply, sewage disposal, and solid waste disposal facilities. The IHS Sanitation Deficiency System (SDS) is an inventory of sanitation projects developed to address existing sanitation deficiencies in AI/AN communities.
The Indian Health Service (IHS) Sanitation Facilities Construction (SFC) Program works in partnership with Tribes to prevent the spread of disease by providing American Indian and Alaska Native homes and communities with essential water supply, sewage disposal, and solid waste disposal facilities. In fiscal year 2021, IHS identified a need of more than $3.4 billion for SFC projects affecting more than 248,000 new and existing homes. To address that need, Congress appropriated $3.5 billion to the SFC Program through the Infrastructure Investment and Jobs Act. We will assess IHS's capacity to establish agreements and contracts for administering the supplemental $3.5 billion, and to oversee the construction of projects paid for using that funding.
The Indian Health Service (IHS) provides a comprehensive health service delivery system for approximately 2.6 million American Indians and Alaska Natives who belong to 574 federally recognized Tribes in 37 States. IHS has a decentralized management structure that consists of two major components: headquarters offices in Rockville, Maryland, and 12 area offices.
IHS's National Supply Service Center (NSSC) serves as the distribution warehouse and supply distribution management center for IHS by providing supply support services and medical supplies to IHS Federal and Tribal Hospitals, Tribal health programs, and Urban Indian Organization health care centers in all 12 IHS areas. The NSSC Director reports to the Area Director of the Oklahoma City Area. Within IHS, but separate from NSSC, the Navajo Area operates a Regional Supply Service Center (RSSC), located in Gallup, New Mexico. The RSSC Director reports to the Area Director of the Navajo Area and has no reporting relationship to NSSC. RSSC provides medical supplies to the Navajo, Albuquerque, and Phoenix IHS areas. Facilities in these three areas can order and receive supplies from both NSSC and RSSC. In a related audit, we are examining NSSC's distribution of medical supplies and equipment during the COVID-19 pandemic.
Our objective is to determine whether IHS coordinated NSSC and RSSC operations to distribute supplies to facilities in an effective manner from January 1, 2019, through March 31, 2022.
COVID-19 has created unprecedented challenges for the U.S. hospital system, including Indian Health Service (IHS), Tribal, and Urban Indian Health Program (UIHP) facilities. American Indians and Alaska Natives (AI/AN) are particularly vulnerable to COVID-19 due to the relatively high rates of diabetes, cancer, heart disease, and asthma among these populations. These vulnerabilities can be heightened by the strong familial structures in AI/AN communities, in which families commonly live in multigenerational homes. Such socially cohesive communities provide a broad range of benefits to their members, but paradoxically these strong structures make it all the more difficult to maintain physical distancing during a pandemic.
IHS has received funding for medical supplies and equipment through the COVID-19 relief bills allocated to IHS, Tribal, and UIHP facilities. The objective of this audit is to determine whether IHS had adequate internal controls to ensure that medical supplies and equipment were effectively distributed to the National Supply Service Center's customers in response to the COVID-19 pandemic. Read the Work Plan Summary
The Indian Child Protection and Family Violence Prevention Act (P.L. No. 101-630) requires background checks, including Federal Bureau of Investigation fingerprinting, for individuals whose duties involve contact with children. Furthermore, Indian Health Service (IHS) appropriated funds may not be used to pay for services provided by individuals excluded from federally funded health care programs. Prior OIG audit work identified IHS and Tribal health facilities that did not meet Federal requirements for background verifications of employees in contact with children. We will determine whether IHS-operated health facilities met Federal requirements for background verifications of employees, contractors, and volunteers in contact with Indian children served by the facilities, and whether health care providers treating these children were appropriately licensed. Read the Work Plan Summary
The Substance Abuse and Mental Health Services Administration (SAMHSA) has awarded a series of grants to combat opioid use disorder. These grants include State Targeted Response to the Opioid Crisis grants (Opioid STR) with approximately half of $970 million awarded in fiscal year (FY) 2017 and the other half awarded in FY 2018. In FY 2018, SAMHSA also awarded more than $930 million in the State Opioid Response grants (SOR) and approximately $50 million in Tribal Opioid Response grants (TOR). The purpose of the Opioid STR, SOR, and TOR grants are to increase access to treatment, reduce unmet treatment need, and reduce opioid overdose related deaths. This post-award audit will determine how select States or Tribal agencies implemented programs under the Opioid STR, SOR, or TOR grants. We will also determine whether the activities of these agencies and subrecipients responsible for implementing the programs complied with Federal regulations and met grant program goals. Read the Work Plan Summary
The Indian Health Service's (IHS's) mission is to partner with American Indians and Alaska Natives to elevate their physical, mental, social, and spiritual health to the highest level. The goal of IHS is to ensure that comprehensive, culturally acceptable personal and public health services are available and accessible to all of the approximately 2.6 million members of the 573 federally recognized Tribes. In 1975, Congress recognized the importance of Tribal decision making in Tribal affairs and the nation-to-nation relationship between the United States and Tribes through the passage of the Indian Self-Determination and Education Assistance Act (ISDEAA) (P.L. No. 93-638). Under ISDEAA, federally recognized Tribes administer their own healthcare programs and services that IHS would otherwise provide through P.L. No. 93-638 funding agreements with IHS. In 2019, a pediatrician who worked at several IHS health facilities during a 21-year period was convicted of sexually abusing children served at these facilities. Congressional officials have expressed concerns about safeguards for Indian children and specifically about IHS failing to address this pediatrician's history of offenses at the various IHS health facilities where he was employed. The Indian Child Protection and Family Violence Prevention Act (P. L. No. 101-630), requires background checks, including Federal Bureau of Investigation fingerprinting, for employees whose job duties involve contact with children. Prior OIG audit work identified two Tribal health facilities that did not meet Federal requirements for background verifications for employees in contact with children. We will determine whether the tribally operated health facilities met Federal and Tribal requirements for background verification of employees, contractors, and volunteers in contact with children served by the facilities. Read the Work Plan Summary
The Federal government pays its share of a State's Medicaid expenditures based on the Federal Medical Assistance Percentage (FMAP), which varies depending on the State's relative per capita income. States' regular FMAPs range from a low of 50 percent to a high of 83 percent; however, States receive a 100-percent FMAP for expenditures related to services received through Indian Health Service (IHS) facilities. In Federal fiscal years 2016 through 2018, States claimed $6.6 billion in expenditures at the IHS services FMAP, all of which was federally funded. We will analyze selected States' methodologies for identifying expenditures claimed at the IHS services FMAP and determine whether the States claimed these expenditures in accordance with Federal requirements. Read the Work Plan Summary
IHS provides a comprehensive health service delivery system for approximately 2 million American Indians and Alaska Natives either by operating health facilities directly or by funding tribes through contracts or compacts to operate health facilities themselves. In certain cases, tribes may operate a facility known as a Federally Qualified Health Center (FQHC), which is certified by CMS to provide outpatient health services to rural areas or underserved populations. In addition to funding from IHS, the tribes may also receive health care funding from the Medicaid or Medicare programs. This report will build on OIG’s body of work identifying longstanding challenges that likely impact the quality of health care services provided to American Indians and Alaska Natives. We will review a tribally operated FQHC that is funded by IHS, to determine whether health services delivered to American Indians and Alaska Natives met applicable Federal requirements. Read the Work Plan Summary
Related Reports
Investigations & Enforcement Actions
Fighting fraud in Indian Health and Human Services programs is an OIG priority. OIG also investigates retaliation complaints filed by employees of HHS contractors and grantees who report fraud. Below are some examples of investigations and enforcement actions:
A North Carolina pediatrician applied for a job with the Indian Health Service while she was under investigation by the North Carolina Medicaid Board for having a sexual relationship with a male patient, among other allegations. She failed to disclose this on her credentialing application and was hired to work in an IHS hospital in August 2020. In January 2021, her medical license was indefinitely suspended. HHS OIG investigated, and she was indicted on two counts of False Statement by a federal grand jury in January of 2023. She pleaded guilty on June 10, 2024. was sentenced to time served, followed by one year of supervised release, and ordered to pay a $100 special assessment to the Federal Crime Victims Fund and $22,832.00 in restitution. “This physician sentenced in this case lied to conceal the fact that she was under investigation for sexual misconduct allegations when applying for a position in the Indian Health Service, thus jeopardizing patient safety through her dishonesty,” said Special Agent in Charge Linda T. Hanley of the Department of Health and Human Services Office of Inspector General (HHS-OIG). “HHS-OIG will continue to hold accountable those who undermine the integrity of federal health care programs to ensure that patients are provided quality care by appropriately licensed providers.”
https://www.justice.gov/usao-sd/pr/north-carolina-woman-sentenced-making-false-statements
On July 22, 2024, the former program manager and director of the Prairie Band Potawatomi Nation’s Diabetes Prevention Program made a court appearance following his indictment for thefts concerning a program receiving federal funds. According to court documents, between January 2023 and December 2023, he is accused of using his position to embezzle $5,000 or more in federal grant money. On July 22, 2024, the former program manager and director of the Prairie Band Potawatomi Nation’s Diabetes Prevention Program made a court appearance following his indictment for thefts concerning a program receiving federal funds. According to court documents, between January 2023 and December 2023, he is accused of using his position to embezzle $5,000 or more in federal grant money.
https://www.justice.gov/usao-ks/pr/topeka-man-charged-embezzlement
PHOENIX, Ariz. – Today, United States Attorney Gary M. Restaino announced criminal charges against seven defendants in connection with alleged schemes to defraud Medicare and Medicaid (specifically AHCCCS, the Arizona Health Care Cost Containment System). The charges filed in federal court are part of the Department of Justice’s 2024 National Health Care Fraud Enforcement Action. The charges in these cases stem from schemes to obtain, in the aggregate, hundreds of millions of dollars in fraudulent billings. For example, Rita Anagho, acting primarily though her company, Tusa Integrated Clinic LLC (“TUSA”), was charged for fraudulently billing AHCCCS approximately $69.7 million for behavioral healthcare services. ANAGHO primarily targeted AHCCCS’s American Indian Health Program (“AIHP”) and billed for services that were never provided or not provided as represented. AHCCCS provides health care services to Native Americans through AIHP, and there has been widespread fraud reported in which residential and outpatient treatment centers recruited Native Americans and other individuals to exploit the AIHP under AHCCCS. Many of the patients recruited for TUSA were Native Americans or other individuals who were enrolled in AIHP, and in some cases, patients were switched from their existing AHCCCS insurance plan to AIHP, regardless of whether the patient was Native American.
https://www.justice.gov/usao-az/pr/seven-charged-arizona-part-department-justices-2024-national-health-care-fraud
On June 20, 2024, Julian Bear Runner was sentenced to 22 months in federal prison, followed by three years of supervised release, and ordered to pay a $800 special assessment to the Federal Crime Victims Fund and $82,483.71 in restitution to the Oglala Sioux Tribe.
Between January of 2019 and January of 2020, at Pine Ridge, Bear Runner, while acting in his capacity as President of the Oglala Sioux Tribe, fraudulently submitted travel vouchers for official business travel and received payment for travel that he was not entitled to as he was not actually traveling. As a result of the fraudulently submitted travel authorizations, Bear Runner received more than $80,000 in advance travel payments but did not go on the travel. Instead, Bear Runner cashed the checks at a casino, gambled, and stayed in local hotels.
This case was brought pursuant to the Guardians Project, a federal law enforcement initiative to coordinate efforts between participating agencies, to promote citizen disclosure of public corruption, fraud, and embezzlement involving federal program funds, contracts, and grants, and to hold accountable those who are responsible for adversely affecting those living in South Dakota's Indian country communities. The Guardians Project is another step of federal law enforcement's on-going efforts to increase engagement, coordination, and positive action on behalf of tribal communities. Led by the U.S. Attorney's Office, the participating agencies include: the FBI; the Offices of Inspector General for the Departments of Interior, Health and Human Services, and other Federal OIGs.
https://www.justice.gov/usao-sd/pr/former-oglala-sioux-tribe-president-sentenced-federal-prison
A former Oglala Sioux Tribal President was convicted of stealing thousands of dollars in official travel funds for trips he did not take. Instead, he spent the funds to gamble at a local casino and stayed at local hotels. As the US Attorney for South Dakota stated, the former President, "[s]tole more than $80,000 from the Oglala Sioux Tribe, embezzling money that could have been used to improve life for those living throughout the Pine Ridge Reservation."
https://www.justice.gov/usao-sd/pr/former-oglala-sioux-tribe-president-convicted-wire-fraud-larceny-and-embezzlement
The complainant was employed by Tohono O'odham Nation Health Care (TONHC), a Tribal facility that has a Funding Agreement with IHS. He alleged that he raised concerns with TONHC management officials that staff received improper compensation for hours they did not work and that patients were transported to the radiology department in an unsafe matter. OIG investigators found that management officials denied complainant's retention bonus, issued a clarification of expectations letter, and subsequently constructively discharged him in retaliation for making protected disclosures. OIG's investigatory report, provided to the Secretary of HHS, included recommendations for appropriate action to compensate the complainant.
https://oig.hhs.gov/fraud/whistleblower/whistleblower-retaliation-investigation/findings-of-whistleblower-retaliation-by-indian-health-service-contractor-management/
On January 24 the United States Attorney for Wyoming announced the sentencing of the former Finance Director of Wind River Family and Community Health care to 36 months in prison for assault resulting in serious bodily injury. Separately, the defendant was sentenced to 24 months in prison for theft of an Indian organization. The sentences will be served concurrently. The defendant was also ordered to pay over $81,000 in restitution. According to court documents, from about October 1, 2022 through March 31, 2023, the defendant used a company credit card for personal expenses including firearms, furniture and groceries.
https://www.justice.gov/usao-wy/pr/arapahoe-man-sentenced-assault-resulting-serious-bodily-injury-and-theft-indian
On 1/31/2024 the U.S. Attorney's Office, District of Montana announced that the former operations manager of the Blackfeet Tribe admitted to stealing more than $78,000 of COVID-19 relief funds. The former staffer allegedly claimed repayment for buying COVID-19 supplies from Amazon for the Tribe. However, he never purchased the supplies and was paid from American Rescue Plan Act funds that had been allocated to the Tribe. https://www.justice.gov/usao-mt/pr/former-blackfeet-tribal-operations-manager-admits-stealing-tribal-covid-19-relief
On 2/27/23, the United States Attorney for South Dakota announced the indictment of a former President to the Oglala Sioux Tribe for wire fraud, larceny, embezzlement. and theft from an Indian Tribal Organization. According to the 7/21/22 indictment, "[b]eginning in January 2019 and continuing through January 2020," the former President "began scheduling official travel and receiving checks for related costs when in fact he was not traveling or incurring the costs of airline flights, hotels, or food. Despite knowing he had not traveled and that he was not entitled to the travel funds," he "fraudulently submitted vouchers claiming he was going to travel and was entitled to travel funds." He "would then take the travel checks and would use the embezzled funds for his own personal use, including cashing the checks and spending the funds at the Prairie Wind Casino on the Pine Ridge Reservation."
https://www.justice.gov/usao-sd/pr/former-oglala-sioux-tribe-president-indicted-wire-fraud-and-embezzlement
The Director of the Ponca Tribe's Domestic Violence Department was convicted of embezzlement and theft from an Indian tribal organization and ordered to serve 4 years' probation and pay $19,431.57 in restitution. The employee created false reimbursement requests indicating they were intended to pay for medical bills, grocery bills, and home furnishing and décor-related expenses for certain tribal domestic violence victims. She then signed the final authorization for the reimbursement of these bills from tribal grant funds provided by the federal government pursuant to the Victims of Crimes Act. In truth, the bills being reimbursed were not expenses incurred by tribal domestic violence victims. Instead, they were for her own personal bills.
https://www.justice.gov/usao-ne/pr/norfolk-woman-convicted-two-counts-embezzlement-and-theft-indian-tribal-organization
A Tribal member who worked for the Tribe was indicted for theft of funds from a Federal program and embezzling at least $5,000 from the Oglala Sioux Tribal Health Administration.
Pine Ridge Woman Pleads Not Guilty to Embezzlement and Theft from Indian Tribal Organization
A Tribal member was sentenced to 9 year in prison for obtaining and distributing fentanyl and hydrocodone pills on the Pine Ridge Indian Reservation.
https://www.justice.gov/usao-sd/pr/kyle-woman-sentenced-nine-years-federal-prison
A Tribal member was convicted of possession with intent to distribute a controlled substance after distributing hydrocodone on an Indian Reservation.
https://www.justice.gov/usao-sd/pr/rapid-city-man-sentenced-drug-distribution
A former IHS physician was sentenced to 10 years in prison followed by 5 years of supervised release, a $35,000 fine and a $500 special assessment for sexually abusing five female patients--- often after locking the door of the examination room. He also threatened to withhold medications or care from some of them unless they complied with his sexual demands. These incidents occurred between 2007 and 2018.
https://www.justice.gov/usao-sd/pr/former-indian-health-service-doctor-sentenced-120-months-imprisonment-abusive-sexual
A South Dakota tribal member was addicted to prescription controlled substances and was no longer able to obtain controlled substances as a result of her behavior. She assaulted other IHS beneficiaries, including her minor children, in order to obtain prescriptions from medical providers for the injuries she intentionally inflicted. As a result of her actions, three victims lost four fingers to amputation. She fabricated stories as to how the individuals received their injuries, and also provided false statements to health care providers in order to obtain controlled substances and health care benefits. Once the individuals received controlled substances, she took the controlled substances, despite the individuals having significant bodily injuries. On October 22, 2021, she was sentenced to 12 years in prison.
https://www.justice.gov/usao-sd/pr/mission-woman-sentenced-12-years-federal-prison
The former Executive Director of Ain Dah Ing, a Wisconsin halfway house serving Native Americans suffering from addiction and substance abuse disorders was sentenced to two years for theft of federal funds. The center's former bookkeeper received a one year sentence. Both defendants were ordered to pay $777,283 in restitution. The center was funded by an IHS contract and the defendants embezzled 67% of the programming funding over a ten-year period and gambled away most of the money.
https://www.justice.gov/usao-wdwi/pr/two-sentenced-embezzling-over-777000-native-american-addiction-counseling-center
A former paramedic pled guilty to stealing hundreds of vials of fentanyl, morphine and hydromorphone from the Rosebud Ambulance Service and Crow Creek Ambulance Service He consumed all the stolen substances. He was sentenced to one month in Federal prison, one year of supervised release, a special assessment to the Federal Crime Victims Fund in the amount of $100, and restitution in the amount of $4,428.98.
https://www.justice.gov/usao-sd/pr/rosebud-man-sentenced-obtaining-controlled-substances-deception
A former IHS doctor who managed the hospital's diabetes program, used his ability to prescribe an expensive diabetes drug that was unavailable in the IHS pharmacy, to obtain $45,540 in kickback from private pharmacies that filled the prescriptions. The doctor pled guilty to a federal conflict of interest violation and was sentenced to three months in prison, two years of supervised release, and a $10,000 fine.
https://www.justice.gov/usao-mt/pr/ex-indian-health-services-doctor-sentenced-prison-fined-drug-kickback-scheme-while
A tribal member was charged with assaulting five individuals with rocks on the reservation for the purpose of committing health care fraud. These assaults resulted in serious bodily injury and required three of the victims to suffer finger amputations. It is further alleged that she also committed health care fraud by giving fraudulent information concerning the intentional assaults in order to obtain services and controlled substances, namely Hydrocodone.
https://www.justice.gov/usao-sd/pr/pine-ridge-woman-charged-twenty-felonies
A former IHS physician pled guilty to conflict of interest charges. He had been in charge of the diabetes program at an IHS hospital in Montana and prescribed an expensive diabetes drug that was not on the IHS formulary and not available at the hospital's pharmacy. Court documents reflect that Dr. Devous solicited multiple pharmacies in Montana to fill expensive prescriptions in exchange for Dr. Devous receiving a "cut" of the profits and kickbacks. The pharmacy paid the doctor $45.540 during a six-month period. (September 10, 2020; U.S. Attorney's Office, District of Montana)
https://go.usa.gov/xGk3D
A former Blackfeet Tribal Chairman was sentenced to 10 months in prison and ordered to pay $174,000 in restitution for taking part in an overtime scheme to steal Tribal Head Start funds. His wife, the former Head Start personnel manager, was previously sentenced to 9 months in prison. The theft resulted in a loss of funds to pay for books, learning materials and nutritional programs. According to Court records, the former Chairman approved overtime claims that he know were false. Outside auditors questioned the overtime claims, identifying them as, " beyond necessary and reasonable," and lacking any supporting documentation. The Tribe also conducted a review and repaid $250,620 to HHS for disallowed costs and other expenses. In the press release, the United States Attorney for the District of Montana, remarked, "The theft of $174,000 hurt the children enrolled in Head Start by prohibiting the purchase of books, barring the ability to obtain teaching materials and cutting food nutrition programs for those who need it most. We will continue to ensure that federal funds are used for the needs of those intended, especially children."
https://www.justice.gov/usao-mt/pr/ex-blackfeet-tribal-leader-sentenced-prison-head-start-program-fraud
A former IHS doctor was indicted on four Counts of Sexual abuse and four Counts of Abusive Sexual Contact involving four adult patients. The alleged abuse took place in 2017 and 2018 at the Wagner Indian Health Service Clinic in South Dakota.
https://www.justice.gov/usao-sd/pr/former-indian-health-services-doctor-indicted-multiple-counts-sexual-abuse-and-abusive
A former IHS doctor was indicted for having a conflict of interest by prescribing a diabetes drug in exchange for kickbacks. The doctor allegedly prescribed a medication that was not on the IHS formulary and entered into a business arrangement with an outside pharmacy to sell the drug. Under the arrangement, the doctor, his wife and a person with whom he had been negotiating for future employment, would receive 80% of the profits from the sale of the drug. This arrangement resulted in a receipt of about $45,590.
https://www.justice.gov/usao-mt/pr/former-indian-health-services-doctor-charged-conflict-interest
After his September 2019 conviction in South Dakota for multiple sex offenses against children while serving as a pediatrician in the Indian Health Service, Stanley Patrick Weber was sentenced on 2/10/2020 to 5 consecutive life sentences in Federal prison for the five aggravated sexual abuse charges, and 15 years on each of the three counts of sexual abuse of a minor. Weber was also ordered to pay $800,000 in criminal fines and an $800 special assessment to the Federal Crime Victims Fund. After the sentencing, U.S. Attorney Ron Parsons stated, "[n]ow, as one nation, one community, and one family, we must come together and do everything in our power to ensure that nothing like this can ever be done to any of our precious children again."
https://www.justice.gov/usao-sd/pr/convicted-former-pine-ridge-indian-health-service-pediatrician-sentenced-five-consecutive
A former Northern Cheyenne Tribal President and Tribal Health Director who had pleaded guilty to wire fraud and false claims conspiracy for submitting fraudulent travel invoices to tribal, state and federal agencies, was sentenced to six months in prison and ordered to pay restitution. At the sentencing the judge stated that the defendant, "exploited his positions as the tribe's health director and then as its president to steal funds intended to benefit tribal members and programs for his own personal enrichment." The case is part of the Guardians Project, a multi-agency anti-fraud task force in Montana.
https://www.justice.gov/usao-mt/pr/ex-northern-cheyenne-tribal-president-sentenced-six-months-prison-travel-fraud-scheme
Idaho company All Around Sports, LLC, its owner, and two supervisors were sentenced on November 18, 2019 following their guilty pleas of Wire Fraud and Conspiracy to Commit Wire Fraud against the Oglala Sioux Tribe. The sales manager was sentenced to two years in prison while the other two defendants received sentences of home detention followed by probation. The company was sentenced to three years of probation and was ordered to pay a $42,000 fine. The owner, sales manager and company also were ordered to pay restitution to two Alaskan Native entities. The cases were brought pursuant to the South Dakota U.S. Attorney's Office's Guardians Project, a federal law enforcement initiative with coordinated efforts between participating agencies that investigates fraud involving federal program funds. The Oglala Sioux Tribe receives funding from the Indian Health Service.
https://www.justice.gov/usao-sd/pr/owner-and-supervisors-idaho-company-sentenced-federal-court-fraud-convictions
Former Indian Health Service pediatrician found guilty by a federal jury of five counts of Aggravated Sexual Abuse and three counts of Sexual Abuse of a Minor following a week-long jury trial in Rapid City, South Dakota. Evidence at trial established that Dr. Stanley Patrick Weber, while employed as a pediatrician with the Indian Health Service at Pine Ridge, sexually abused minors between 1999 and 2011.
https://www.justice.gov/usao-sd/pr/former-pine-ridge-indian-health-services-pediatrician-convicted-multiple-sex-offenses-0
A former Northern Cheyenne Tribal President and Tribal Health Director pleaded guilty to wire fraud and false claims conspiracy for submitting fraudulent travel invoices to tribal, state and federal agencies, including HHS. Prosecutors estimate that he received $20,000 in improper reimbursements.
https://www.justice.gov/usao-mt/pr/ex-northern-cheyenne-tribal-president-admits-travel-fraud-scheme
Boise, Idaho based sports poster company, All Around Sports, LLC, pleaded guilty to a federal wire fraud conspiracy charge involving the fraudulent transfer of funds from victim bank accounts located in South Dakota and Alaska. Additionally, the owner of All Around Sports, LLC pleaded guilty to wire fraud against the Oglala Sioux Tribe by unlawfully withdrawing $54,000 from the Tribe's bank account. The Tribe receives funding from the Indian Health Service.
https://www.justice.gov/usao-sd/pr/us-attorney-s-guardians-project-results-multiple-defendants-facing-federal-charges-and
Three former management employees of the Blackfeet Tribe's Head Start program were sentenced to prison and ordered to pay restitution for perpetrating a 15-month-long fraudulent overtime pay scheme. The theft of the Head Start funds resulted in the program not being able to purchase books and teaching materials. In addition, the program had to makes cuts in the children's nutrition program.
https://www.justice.gov/usao-mt/pr/three-ex-employees-blackfeet-tribe-s-head-start-program-sentenced-theft-fraud
On 9/24/2018, five former Tribal Council members and tribal employees, who had been convicted of using health care funds from an IHS contract to pay themselves bonuses, were sentenced to 5 years' probation and ordered to pay restitution. Subsequently on 10/17/2018, a former Tribal Chairman and three former Council members. who had pled guilty to using health care funds to obtain bonuses, were also sentenced to 5 years' probation and restitution. In both instances, the funds used to pay bonuses were supposed to be used for providing health care to tribal members.
- https://www.justice.gov/usao-ne/pr/former-omaha-tribal-council-members-and-employees-sentenced
- https://www.justice.gov/usao-ne/pr/former-omaha-tribal-chairman-and-council-members-sentenced
Two employees of the Blackfeet Tribe's Head Start Program pled guilty to stealing money by fraudulently claiming overtime. The tribe conducted an internal review and paid HHS for disallowed costs and other expenses.
https://www.justice.gov/usao-mt/pr/blackfeet-tribe-s-head-start-program-employees-admit-theft-fraud-charges
Former IHS employee was convicted of making a false statement on a Confidential Financial Disclosure Report in connection with a $5,000 payment from Dr. Stanley Patrick Weber.
https://www.justice.gov/usao-sd/pr/nebraska-woman-sentenced-making-false-statement
Former CFO of Rocky Boy Health Clinic sentenced for wire fraud in connection with issuing checks to herself from the clinic's employee loan programs.
https://www.justice.gov/usao-mt/pr/former-chief-financial-officer-rocky-boy-health-clinic-sentenced-prison
Patient sentenced for a falsely alleging that an IHS physician engaged in sexual conduct against him.
https://www.justice.gov/usao-sd/pr/kyle-man-sentenced-making-false-statement
The Confederated Tribes of the Colville Reservation voluntary settled allegations of false Medicaid claims and agreed to a Voluntary Tribal Compliance Agreement with the HHS OIG.
https://www.justice.gov/usao-edwa/pr/confederated-tribes-colville-reservation-enter-false-claims-act-and-voluntary
Indictment of Stanley Patrick Weber related to charges of sexually abusing minors while employed by IHS.
https://www.justice.gov/usao-sd/pr/spearfish-man-indicted-multiple-sex-offenses
A contractor working on the Rocky Boys Indian Reservation was convicted of Wire Fraud and Bribery for participating in a "pay to play" scheme whereby the contractor gave $50,000 to the tribal official after receiving a $200,000 progress payment of federal funds.
https://www.justice.gov/usao-mt/pr/billings-businessman-and-construction-company-convicted-pay-play-scheme-rocky-boy-s
A patient of the Fort Thompson Indian Health Service Hospital was convicted of False Statement Relating to Health Care Matters after altering his prescription in order to increase the number of opioids for dispensing at the hospital's pharmacy.
https://www.justice.gov/usao-mt/pr/billings-businessman-and-construction-company-convicted-pay-play-scheme-rocky-boy-s
Five tribal employees agreed to a civil False Claims Act settlement for taking federal funds from the Oglala Sioux Tribe's Low Income Home Energy Assistance Program (LIHEAP) and agreed to pay $84,000 in restitution. All five had previously been convicted of Conspiracy to Commit Theft of Federal Funds
https://www.justice.gov/usao-sd/pr/settlements-totaling-84000-reached-five-individuals-who-committed-fraud
Montana Man Sentenced For Health Care Fraud
(October 24, 2014; U.S. Attorney; District of South Dakota)
A Colstrip, Montana, man convicted of Health Care Fraud was sentenced on October 16, 2014. Dean L. Hodges, age 59, was sentenced to 2 years of probation, ordered to pay a $100 special assessment to the Federal Crime Victims Fund, and restitution in the amount of $686.
Read the Full News Release
Rapid City Man Sentenced For Theft From Indian Health Services
(October 16, 2014; U.S. Attorney; District of South Dakota)
A Rapid City, South Dakota, man convicted of Theft or Embezzlement in Connection with Health Care was sentenced on October 16, 2014. Michael Gray, age 59, was sentenced to 2 years of probation, ordered to pay a $100 special assessment to the Federal Crime Victims Fund, and restitution in the amount of $6,476.42.
Read the Full News Release
Four Individuals Sentenced In Federal Program Fraud Case
(July 24, 2014; U.S. Attorney; District of South Dakota)
Four individuals convicted of Conspiracy to Commit Theft Concerning Programs Receiving Federal Funds or Theft Concerning Programs Receiving Federal Funds have been sentenced. Gerald T. Roy, Special Agent in Charge, Health and Human Services/Office of Inspector General, Office of Investigations, Kansas City, MO, stated, "Individuals who choose to misappropriate HHS funds intended for those in dire need will continue to be pursued by the OIG and their law enforcement partners."
Read the Full News Release
(June 24, 2014; U.S. Attorney; District of Montana)
Former officials of the Blackfeet Tribe's Po'Ka Project, a multi-million dollar federally funded effort to address the needs of troubled youth on the reservation, were sentenced in federal court in Great Falls, MO.
Read the Full News Release
California Rural Indian Health Board Inc. Settles False Claims Act Lawsuit
(April 30, 2013; U.S. Attorney; Northern District of California)
The California Rural Indian Health Board Inc. (CRIHB), a nontribal entity and grantee of the U.S. Department of Health and Human Services Substance Abuse and Mental Health Services Administration (SAMSHA), agreed to pay the United States $532,000, and to be terminated from an existing SAMHSA grant, thereby relinquishing funds valued at over $4.6 million. In addition, CRIHB will be subject to certain administrative conditions imposed by SAMHSA, and will not be eligible to apply for any new SAMHSA funding opportunities for two federal fiscal years.
Read the Full News Release
Other Resources
Podcasts & Videos
- Eye on Oversight Video: Challenges in Indian Health Service Hospitals
- What is OIG's work in Indian Country? (August 11, 2016)
Compliance Program Guidance
Other
- HHS-OIG Flyer on Oversight and Collaboration with AI/ANs: OIG has prepared an informational flyer on resources related to program compliance and points of contact for reporting fraud, waste, and abuse in programs serving AI/ANs and Tribal communities, including the IHS Sanitation Facilities Construction Program and other funding.
- Vulnerabilities and Resulting Breakdowns: A Review of Audits, Evaluations, and Investigations Focused on Services and Funding for American Indians and Alaska Natives