Transcript for audio podcast:
December 2014 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).
Since our last podcast, OIG has issued a number of reports.
Slightly more than half of the healthcare providers in a study sample could not offer appointments to Medicaid managed care enrollees, OIG found in one report, raising questions about whether Medicaid access-to-care standards are being met.
For a podcast on access to Medicaid managed care, visit the OIG website.
Agencies of the Department of Health and Human Services did not accurately report some fiscal year 2012 conference costs. Although most of the costs that the agencies incurred for the four conferences that OIG audited were allowable, some were not; unallowable costs of $32,000 dollars were found. OIG recommended that the department give its agencies more guidance and that it direct them to provide greater oversight of conference costs.
OtisMed Corporation and its former CEO admitted distributing knee replacement surgery cutting guides that had been rejected by the Food and Drug Administration. OtisMed was fined $34 million dollars and must forfeit more than $5 million dollars. The company also is to pay a civil settlement of $40 million.
The Research Foundation for the State University of New York is to pay $3.75 million dollars to resolve allegations of manipulated audits and false statements related to New York State's Medicaid and Children's Health Insurance programs.
The United States sued Omnicare - the nation's largest provider of drugs and pharmacy consulting services to nursing homes - alleging that it solicited and received millions in kickbacks from Abbott Laboratories in exchange for promoting Depakote for dementia patients in nursing homes serviced by Omnicare. The complaint includes allegations that Abbott paid for Omnicare's management meetings on a Florida island and offered tickets to sporting events.
Rite Aid paid nearly $3 million dollars to settle allegations that it used gift cards to attract Medicare and Medicaid business.
A New York pediatrician was jailed for 37 months and fined $75,000 dollars for accepting bribes for referrals in a $100 million dollar New Jersey lab scam. In this scheme, 33 defendants have pleaded guilty - 22 of them doctors.
Ten people were charged in a $70 million dollar scheme to defraud Medicare and Medicaid. Authorities said three clinics in Brooklyn and Queens, N.Y., paid the poor and homeless to pose as patients so that the clinics could bill for bogus services.
A New York medical practice and the doctor who owned it entered into a nearly $700,000 dollar settlement to resolve OIG allegations of false physical therapy claims.
A New York nurse was charged with slapping an 83-year-old wheelchair-bound dementia patient in a nursing center. The alleged abuse was caught on a surveillance camera, authorities said.
Falsified records, ineligible patients and phony services were used to cheat Medicare out of more than $20 million dollars in a Massachusetts nursing agency's "wellness clinic" fraud. The scheme ran for about seven years.
A Miami-area nursing assistant was sent to prison for 12.5 years and must repay more than $18 million dollars for his role in the long-running $200 million dollar American Therapeutic Corporation Medicare fraud scheme.
A Florida businessman was jailed for 11 years and must repay more than $14 million dollars in an extensive Medicare physical therapy false billing scam that included kickbacks, identity theft, forgery, sham clinic owners and bogus services.
The organizer of a $56 million dollar Medicare fraud scheme and his accomplice - a doctor - pleaded guilty in Louisiana. The scam included kickbacks, fraudulent referrals, bogus prescriptions and false billing.
OIG Most Wanted Fugitive Luis Marin, charged in a $16 million dollar Medicare physical therapy and home healthcare scam, was captured in Florida by Miami-Dade police.
A former OIG special agent admitted that he stole thousands of rounds of ammunition from an OIG armory in Dallas. Sentencing is scheduled in 2015.
Don't miss OIG's latest Semiannual Report to Congress. It's on our website. The report notes that nearly $5 billion dollars is to be returned to taxpayers as a result of OIG work in fiscal year 2014.
And finally, OIG has alerted tribes and tribal organizations to be careful in using Indian Self-Determination and Education Assistance Act funds. Check our website.
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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