Compliance News Roundup: Inside the OIG’s Latest Report on Medicaid

1. Oahu Physical Therapist Pleads Guilty To HealthCare Fraud – “Garrett Okubo, of Honolulu, Hawaii, pled guilty today in federal court to four counts of health care fraud in violation of Title 18, United States Code, Section 1347. According to court documents and information presented in court, Okubo was the owner and operator of a physical therapy business in Honolulu. From January 2011 through October 2017, Okubo submitted false claims for payment for physical therapy services to TRICARE, Medicare, Medicaid, and HMSA. Okubo submitted claims to these health care benefit programs using his unique provider number, thereby falsely stating that Okubo himself had personally provided the physical therapy services to his patients, when in reality the services were provided by Okubo’s unlicensed staff members, including at times when Okubo was travelling on the U.S. mainland or in a foreign country. The government alleges that Okubo billed approximately $5.5 million of false claims for services provided by his unlicensed staff members, of which approximately $3.7 million was actually paid. Okubo reserved the right to challenge the loss amount in his plea agreement.” Get the full scoop >>

2. London Cardiologist Convicted of Health Care Fraud for Medically Unnecessary Pacemakers – “On April 11, 2018, a federal jury convicted London physician Dr. Anis Chalhoub of health care fraud. The jury returned its guilty verdict after twelve days of trial, during which it heard evidence that Dr. Chalhoub defrauded Medicare, Medicaid, and other insurers by implanting medically unnecessary pacemakers in his patients and causing the unnecessary procedures and follow-up care to be billed to health insurance programs.” Get the full scoop >>

3. Deeper Than the Headlines: Inside the OIG’s Latest Report on Medicaid – Everyone has to report to someone, even the OIG, and one way they report is via testimony before Congress. The latest of such testimony was given on April 12, 2018, by Megan H. Tinker, Senior Advisor for Legal Review. She testified before the United States House of Representatives, Committee on Oversight and Government Reform: Subcommittee on Government Operations Subcommittee on Intergovernmental Affairs. Get the full scoop >>