Attorney Sentenced to 70 Months In Jail For $28 Million Medicare Fraud Scheme

Posted on August15, 2014
A disbarred Florida attorney was sentenced in federal court in Tampa, Florida today to serve 70 months in prison in connection with her role in a $28.3 million Medicare fraud scheme involving false claims for physical and occupational therapy services.  The case is being investigated by HHS-OIG and the FBI and was brought as part of the Medicare Fraud Strike Force, under the supervision of the Criminal Division’s Fraud Section and the U.S. Attorney’s Office for the Middle District of…
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OIG proposed rule: no statute of limitations on certain exclusion actions and other significant changes to exclusion authority

Posted on June30, 2014
Using the proposed rule, the OIG intends to update its exclusion regulations to codify changes made by the Affordable Care Act and other statutory authorities. Chief among the OIG’s proposals is an unlimited time period for bringing an affirmative exclusion action under Section 1128(b)(7) of the Social Security Act(7)). Read the entire article at Lexology
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OIG: Duke University Hospital Overbilled Medicare $626k

Posted on May05, 2014
A new report from the HHS Office of Inspector General found Duke University Hospital, the 924-bed teaching facility in Durham, N.C., and flagship of Duke Medicine, must repay $626,133 in Medicare overpayments. Read the entire article at Becker's Hospital Review
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OIG Wants Further Reach for Medicare Frauds

Posted on June21, 2010
This article describes why the OIG of the Department of Health and Human Services is urging congress to allow them to have authority over people who leave a company that has commited Medicare fraud.  Currently, an executive can leave a company and find a new job while the fruad falls only on the company itself.
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FDA Falls Short According to Investigation

Posted on April09, 2010
"WASHINGTON, D.C.—According to a recent report by the inspector general of the Department of Health and Human Services, between 2004 and 2008, FDA inspected fewer than half of the 51,229 facilities under its regulation. During that same time period, the number of regulatory actions triggered by inspections fell from 614." Read the article in its entirety, here.
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Review heightens concerns over Medicare billing at nursing homes

Posted on March29, 2010
This Washington Post article reads, "More than a decade ago, Congress set out to squeeze the fraud out of Medicare billing at nursing homes, requiring more precise justifications for costs. It created new 'ultra-high' billing categories intended to be used for only 5 percent of the patients needing highly specialized care and rehabilitation." But, over the years the nursing homes have been flooded with patients put in this category and facilities have been billing for more services than are being…
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