Fwd: OIG posts a report, congressional testimony, and news about enforcement actions

---------- Forwarded message ----------
From: HHS Office of Inspector General <donotreply@subscriptions.hhs.gov>
Date: Tue, Jul 29, 2014 at 7:44 AM
Subject: OIG posts a report, congressional testimony, and news about enforcement actions
To: iammejtm@gmail.com

Good morning from Washington DC. Today OIG posts a report, congressional testimony, and news about enforcement actions. As always, you can use the links provided to go directly to the new material. ------------------------------------------------- Indiana State Medicaid Fraud Control Unit:  2013 Onsite Review (OEI-07-13-00250) http://go.usa.gov/5zSY WHY WE DID THIS STUDY OIG oversees the activities of all Medicaid Fraud Control Units (MFCUs or Units).  As part of this oversight, OIG conducts periodic reviews of all Units and prepares public reports based on these reviews.  The reviews assess Unit performance in accordance with the 12 MFCU performance standards and monitor Unit compliance with Federal grant requirements. HOW WE DID THIS STUDY We conducted an onsite review in May 2013.  We based our review on an analysis of data from seven sources:  (1) a review of policies, procedures, and documentation on the Unit's operations, staffing, and caseload for fiscal years (FYs) 2010 through 2012; (2) a review of financial documentation for that timeframe; (3) structured interviews with key stakeholders; (4) a survey of Unit staff; (5) structured interviews with the Unit's management; (6) an onsite review of a sample of case files that were open in FYs 2010 through 2012; and (7) an onsite observation of Unit operations. WHAT WE FOUND From FYs 2010 through 2012, the Unit reported combined civil and criminal recoveries exceeding $110 million and 105 convictions.  The Unit did not exercise proper fiscal controls over claimed expenditures and program income, and it did not maintain adequate internal controls of the equipment in its possession.  Documented supervisory approval to open cases was missing in an estimated 77 percent of the case files, and documented supervisory approval to close cases was missing in an estimated 18 percent of the closed-case case files.  In addition, the Unit did not maintain a training plan that included an annual minimum number of training hours for each professional discipline and the Unit's MOU with Indiana's State Medicaid agency did not reflect current law and practice.  Finally, the Unit did not timely refer 25 convictions to OIG for the purpose of program exclusion. WHAT WE RECOMMEND We recommend that the Unit work with OIG's MFCU oversight division to ensure compliance with the 12 performance standards.  The Indiana Unit concurred with all five of our recommendations. ------------------------------------------------- Congressional Testimony - Examining the Federal Government's Failure to Curb Wasteful State Medicaid Financing Schemes http://go.usa.gov/5zSB John Hagg, Director of Medicaid Audits, Office of Inspector General, U.S. Department of Health and Human Services before the House Committee on Oversight and Government Reform Subcommittee on Energy Policy, Health Care and Entitlements ------------------------------------------------- July 28, 2014; U.S. Department of Justice Physician Assistant and Certified Nursing Assistant Convicted in $200 Million Medicare Fraud Scheme http://go.usa.gov/9SrT ------------------------------------------------- July 28, 2014; U.S. Department of Justice Vascular Solutions Inc. to Pay $520,000 to Resolve False Claims Allegations Relating to Medical Device http://go.usa.gov/9SrT ------------------------------------------------- July 28, 2014; U.S. Attorney; Eastern District of Missouri Local In-Home Healthcare Provider Sentenced on Fraud Charges http://go.usa.gov/9SrT ------------------------------------------------- July 28, 2014; U.S. Attorney; Eastern District of Pennsylvania Ambulance Company Owner Sentenced to Eight Years for Medicare Fraud http://go.usa.gov/9SrT ------------------------------------------------- That's all we have for today. If we can be of any further assistance, please send an email to public.affairs@oig.hhs.gov. OIG's privacy policy can be found at http://oig.hhs.gov/notices/privacy-notice.asp Follow us on Twitter: http://twitter.com/OIGatHHS Inquiries? Contact us: Public.Affairs@oig.hhs.gov Manage your OIG subscriptions: update your preferences or unsubscribe Questions about this service? Visit subscriberhelp.govdelivery.com This email was sent to iammejtm@gmail.com using GovDelivery, on behalf of the U.S. Dept. of Health & Human Services · 200 Independence Avenue SW · Washington DC 20201 · 1-877-696-6775

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Jeremy Tobias Matthews