Good morning to all from Washington, DC. Today OIG posts two reports, updates the CIA list and provides news about a captured fugitive and other enforcement actions. As always, you can use the links provided to go directly to the new material. Report Recap What Where How Much Medicaid Family Planning North Carolina $663,000 Medicaid Personal Care Services West Virginia $20,000 ------------------------------------------------------------------------------ North Carolina Incorrectly Claimed Enhanced Federal Reimbursement for Some Medicaid Waiver Services That Were Not Family Planning (A-04-10-01091) http://go.usa.gov/vQa The Division of Medical Assistance made unallowable Medicaid payments totaling $663,000 for non-family-planning pharmacy waiver claims, $2,000 for non-family-planning sterilization, and $2,000 non-family-planning clinic and practitioner waiver claims that were reimbursed at the enhanced rate. ------------------------------------------------------------------------------ West Virginia Complied With Certain Federal Requirements for Most of the Personal Care Services Claimed for Its Aged and Disabled Waiver Program (A-03-11-00205) http://go.usa.gov/vQ1 West Virginia complied with certain Federal requirements for all of the nurse assessment and oversight services and most of the Medicaid personal care services in our sample. However, for 6 sampled beneficiary-months, West Virginia paid providers for more personal care services than provided. Based on our sample results, we estimate that West Virginia claimed approximately $20,000 in unallowable costs. ------------------------------------------------------------------------------ Corporate Integrity Agreements List Update http://go.usa.gov/vQj The Bay Area Sleep Associates, LLC (d/b/a SomnoMedics) CIA has been added to list. ------------------------------------------------------------------------------ CAPTURED: Irina Shelikhova http://go.usa.gov/vQx Irina Shelikhova and her co-conspirators were charged in 2011 with Conspiracy to Commit Health Care Fraud, Conspiracy to Pay Health Care Kickbacks, Health Care Fraud, Money Laundering, and Money Laundering Conspiracy. Investigators believe that Shelikhova was the primary player in a scheme to defraud Medicare of more than $70 million. ------------------------------------------------------------------------------ June 20, 2012; U.S. Department of Justice Detroit-Area Clinic Owner Pleads Guilty to $16 Million Psychotherapy Fraud Scheme http://go.usa.gov/yWn ------------------------------------------------------------------------------ June 20, 2012; U.S. Attorney; Northern District of Alabama Ambulance Company Agrees to Pay $5.4 million to Settle Claims of Fraudulent Medicare Billing http://go.usa.gov/yWn ------------------------------------------------------------------------------ State Enforcement Actions Updated http://go.usa.gov/pqp ------------------------------------------------------------------------------ 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 Make it a great day! Marc Wolfson – Office of External Affairs OIG’s privacy policy can be found at http://oig.hhs.gov/notices/privacy-notice.asp
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OIG Posts 2 Reports, Updates the CIA List and Provides News about a Captured Fugitive & Other Enforcement Actions - 6/21
