Home-Health Agency Owners Indicted For Stealing $13 Million From Medicare

Posted on November12, 2015
The owners, the director of nursing of patient recruiters of a home-health agency based in Houston were arrested this morning for their alleged roles in conspiracies to defraud Medicare, to pay illegal healthcare kickbacks and to commit money laundering.  The defendants were charged in an indictment unsealed on November 10, 2015. According to the indictment, Ebong Tilong, 51, and Marie Neba, 51, both of Sugar Land, Texas, used the Texas-based, home-health agency that they owned to bill Medicare for home-health services…
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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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On health-care fraud, US is pennywise, poundfoolish

Posted on September23, 2013
While the GSK case is a high-water mark, it isn't unusual for health-care fraud cases to recoup millions of dollars. Louis Saccoccio, president of the National Health Care Anti-Fraud Association, a private-public partnership, said the cut to OIG's budget "doesn't make any sense." Cantrell noted that in 2011 Miami resident Duran was sentenced to 50 years in prison for a $205 million Medicaid scam involving his community mental health company American Therapeutic. Please view the entire article at the CNBC website.
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Home Health Agency Owner Pleads Guilty for Role in $13.8 Million Medicare Fraud Scheme

Posted on July24, 2013
Detroit-area resident Javed Rehman pleaded guilty on Mon. for his role in a $13.8 million Medicare fraud scheme, announced Acting Assistant Attorney General Mythili Raman of the Justice Department’s Criminal Division; U.S. Attorney for the Eastern District of Barbara L. McQuade; Special Agent in Charge Robert D. Foley III of the FBI’s Detroit Field Office and Special Agent in Charge Lamont Pugh III of the Chicago Regional Office for the U.S. Department of Health and Human Service’s Office of Inspector…
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The OIG: What you don’t know about fraud can hurt you

Posted on March20, 2013
The Office of the Inspector General (OIG) is a 1,700-member institution within the U.S. Department of Health and Human Services (HHS) that is charged with detecting fraud and abuse and “holding accountable those who do not meet program requirements or who violate Federal laws.” In other words, the OIG is the investigative and enforcement arm of HHS and its programs, including but not limited to the Centers for Medicare & Medicaid Services and the FDA. The OIG spends most of…
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Fugitive behind $1 million Medicare fraud nabbed in Canada

Posted on January03, 2013
An American fugitive convicted in a $1-million health-care fraud scheme in California was arrested Wednesday in Canada.  Police said Leonard Nwafor was detained on an extradition warrant at his Toronto residence. The U.S. Marshals Service contacted Toronto authorities in August to seek their help in finding Nwafor and issued the extradition warrant last month.  Nwafor was convicted on two counts related to health-care fraud for submitting false claims to Medicare through his Los Angeles-based company in 2008. According to the…
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U.S. Department of Health & Human Services OIG announces Outlook 2013 Webcast

Posted on October24, 2012
OIG will launch its OIG Outlook 2013 webcast on October 24 at 11:00 a.m. EST.  This is a free event. Hear OIG top executives discuss emerging trends in combating fraud, waste, and abuse in Federal health care programs, OIG's top priorities for 2013, and upcoming projects outlined in the newly released OIG Work Plan. Sign up is not necessary. Who Should Tune In?  Health care providers, compliance officers, health care lawyers, trade association staff, health care program grant recipients, local,…
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Understand the OIG Compliance Program Guidance

Posted on March25, 2010
The Compliance Program Guidance was issued to assist physicians in developing compliance programs for their practices and prevent fraud and abuse against government health care programs.  According to this article, fraud and abuse can include: Billing for services, procedures and/or supplies that were not provided. Misrepresentation of what was provided; when it was provided; the condition or diagnosis; the charges involved; and/or the identity of the provider recipient. Providing unnecessary services or ordering unnecessary tests. Unbundling of claims: billing separately for…
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