Earlier this week, the Office of Inspector General released its “Year in Review” OIG Podcast highlighting the OIG’s major accomplishments for 2017. The OIG podcast reported 881 criminal actions, 826 civil actions and over $4 billion in recoveries. OIG also excluded 3,244 from participating in federal health care programs during the year.
Interestingly, the podcast cites the $155 million False Claims Act settlement with an electronic health records vendor as one of the year’s major accomplishments. The investigation focused on misrepresentations made by the defendant regarding the capabilities of the company’s software, and the settlement was reported to be the first of its kind with an electronic records vendor. As stated in a prior OIG podcast, “accurate medical records, including electronic health records, or EHR, are the foundation of providing quality healthcare to patients.”
The July takedown in which 412 defendants were charged with $1.3 billion in false billings to Medicare and Medicaid was the next accomplishment cited in the podcast. The massive, coordinated takedown involved 350 agents in 41 judicial districts, and charges were brought against 115 doctors, nurses and other licensed professional. The takedown also included opioid – related charges against 120 individuals, and 295 exclusion notices related to the use and abuse of controlled substances were issued. On the day of the takedown, the OIG released a data and information on its concerns about questionable prescribing and extreme use of opioids. Click here to listen to the remarks of IG Levinson’s Remarks at the 2017 Health Care Fraud Takedown Press Conference
The podcast next cited the OIG’s released of its “Early Alert” warning citizens of “potential cases of patient neglect and abuse suspected abuse in skilled nursing facilities.” These, as cited in the alert, involved “potential cases involve failure to provide necessary medical care to patients and even occurrences of physical abuse and sexual assault.” The Early Alert noted that the OIG discovered 134 instandces of potential abuse and negelect in 33 states dring the course of it’s review. (Click here for access for a copy of the report and access to other materials.
Finally, the podcast mentioned year end testimony before Congress discussing IT security, the personal care program, and Medicare and Medicaid program integrity concerns.
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About the Author
Paul Weidenfeld is a long time health care lawyer who has specialized in litigation arising out or, or relating to healthcare fraud and the False Claims Act. A former federal prosecutor and National Health Care Fraud Coordinator for the Department of Justice, Paul is a frequent speaker who has earned recognition both as a Federal Prosecutor and as a member of the private bar. Paul is also a co-founder of Exclusion Screening, LLC, a company that offers providers a simple, cost effective way to meet their exclusion screening obligations.