Health Care Fraud Report Index-Summary

IDAHO

– Drug price inflation, Sandoz settles Medicaid case (Idaho Dist. Ct.), 855
– Hospital billing, discovery of DOJ memos (D. Idaho), 169
– Mental health services, field trips billed, director sentenced (D. Idaho), 454
– Speech pathologists, false claims, trial needed (D. Idaho), 248

IDENTITY THEFT

– DME, provider identity theft, indictment (S.D. Tex.), 171; guilty plea, 218
– Wheelchairs, doctor identification numbers used, firm owner charged (E.D. Pa.), 423

See INSPECTOR GENERAL (IG), HHS

ILLINOIS

– Chiropractors

– – Maywood, indictments (N.D. Ill.), 260
– – RICO, billing fraud, fact questions exist in insurer's suit (N.D. Ill.), 168; bad faith counterclaims disputed, 253

– Home health care, miscoding alleged, some claims revived (7th Cir.), 457
– Pharmaceuticals

– – Controlled substance, illegally dispensing, doctor sentenced (S.D. Ill.), 294
– – Drug switch suit, consumer fraud charges inadequate (N.D. Ill.), 222

– Self-referrals

– – Doctor-owned enterprise, IG settlement, 571
– – Rush Univ. hospital settles Stark law claims (N.D. Ill.), 249

– State regulations, financial exploitation allegations/persons with disabilities, 431

IMAGING SERVICES

See RADIOLOGY SERVICES

IMMIGRATION

– Guilty plea, motion to vacate untimely (E.D.N.Y.), 508
– Physician sentenced for immigration fraud (E.D. Mich.), 802

IMPORTATION

– Medical devices, unapproved, settlement, 15

INDIANA

– Diabetes patients warned of scam, 557
– Medicaid fraud unit begins FCA education effort, Special Report, 773
– SNF, failure to minimize accident risk, civil fine (7th Cir.), 420
– Whistleblowers encouraged to stop fraud, 708

INFORMATION NETWORKS AND TECHNOLOGY

– E-records

See ELECTRONIC HEALTH RECORDS

– Hardware

See COMPUTERS AND COMPUTER EQUIPMENT

– Internet

See INTERNET

– Software

See SOFTWARE

INSPECTOR GENERAL (IG), HHS

– Accountable care organizations, workshop scheduled, 729
– Administration, FY2011 work plan released, 787
– Adverse events, reporting requirements, compliance, 12
– Anti-kickback laws

– – Ambulance/municipality contract, no sanctions, 830
– – Ambulatory care center allowed, 732
– – Brain tumor patients, assistance program allowed, 731
– – Charitable donations for use of software allowed, 650
– – Children, one free post-tonsillectomy stay allowed, 787
– – Cochlear implant supplier/provider payments may be disallowed, 733
– – Donations to tax-exempt group allowed, 733
– – Drugs, copay help for underinsured patients allowed, 446
– – Grants and DME from nonprofit charity allowed, 788
– – Hospitals discounts, Medigap insurer's proposal not fined, 785
– – Ill. doctor-owned enterprise, settlement, 571
– – Medigap providers, discounted services allowed, 202
– – Municipalities' waiver of Medicare cost-sharing allowed, 544
– – Nonprofit's drug cost assistance program approved, 500
– – Preauthorization for insurance by hospitals allowed, 732
– – Radiology services

– – – Oncology center may offer free dietitian and social worker services, 544
– – – Preauthorization services for referrals not fined, 785

– – Retirement home, gift cards for residents' referrals allowed, 446
– – Safe harbor proposal, 10
– – Sleep testing provider deal with hospital allowed, 732

– Audit and inspection reports, 90; 137; 182; 225; 262; 306; 352; 397; 432; 468; 528; 560; 593; 633; 673; 713; 770; 818; 860
– Drugs

– – Rebates, uncollected by states, loophole, 242
– – Reporting noncompliance, enforcement planned, 789

– Enforcement, first half of FY 2010, $3B expected, 496
– Enrollment in health plans, Levinson urges improvements, 330
– “Excluded persons,” IG authority

See LEGISLATION, FEDERAL, HR 6130

– Independent review groups, certification guidance, 445
– Medicaid

– – Disproportionate share payments, state-owned hospitals, 572
– – Drugs, inflated payments, 67
– – Excluded providers, enrollment analysis, 446
– – Permanent error rate measurements, eight error types specified, 332
– – State fraud control units, IG debuts new web page, 381

– Medical devices, imaging machine approvals to be re-examined, 786
– Medicare

– – Deceased beneficiaries, unrecovered 2006 and 2007 claims, 790
– – DME, Part B claims, contractor's inappropriate payments, 734
– – ESRD drugs, bundled payment rates, 736
– – Feeding tubes, enteral therapy claims, inappropriate claims cost, 546
– – Hospice care, questionable Medicare Part B claims identified, 792
– – Information security for contractors, gaps found, 609
– – MA sales agents, inappropriate financial incentives, 203
– – Medical supplies

– – – Claims processing system, potential vulnerability, 332
– – – DME telemarketing, alert, 63

– – Mental health

– – – Part B payments, inappropriate, 2006 nursing home stays, 569
– – – Psychiatric facilities, inpatient, overpayments, 501

– – Part B drug coverage, late pricing submission reported, 160
– – Part D drug coverage

– – – Adjusted rates, 2009 savings potential, 570
– – – Prescribers, invalid identifiers in 2007, 569
– – – Sponsors, formulary changes, notice, 16

– – Recovery audit contractors, potential fraud referrals, 161
– – Rehabilitation facilities

– – – Inpatient, coding errors, 570
– – – Overpayments, 546

– – Retroactive beneficiary liability, no sanctions for waiving, 548
– – Senior Medicare Patrol, 2009 savings, report, 445
– – Support surface claims, 10
– – Wheelchairs, documentation requirements, compliance, 12

– Recommendations by IG, unimplemented, could have saved $5B, 244
– Website updated, fraud reporting added, 408

INSURANCE

– Car

See AUTOMOBILE INSURANCE

– Health

See HEALTH INSURANCE

INTERNATIONAL DEVELOPMENTS

See specific countries
– FCPA

See FOREIGN CORRUPT PRACTICES ACT (FCPA)

INTERNET

– Controlled substances, online sales

– – Anxiety, insomnia, weight loss drugs, doctor sentenced (D.N.J.), 349
– – Discounted drugs, owner sentenced (N.D. Tex.), 33

– Data management

See ELECTRONIC HEALTH RECORDS

– IG website updated, fraud reporting added, 408
– Medtronic website shows payments to doctors, 519
– State Medicaid fraud units, IG debuts new web page, 381

INTERVENTION

– U.S., in qui tam suits

See generally QUI TAM SUITS

IOWA

– State regulations, HAWK-I program, 305

ITALY

– Medical devices, Sorin Group settles marketing claims, 245