Compliance News Roundup: OIG Hospital Review Case Studies

1. California Clinic Owner Sentenced to 63 Months in Prison for Role in Occupational Therapy Fraud Scheme - A rehabilitation clinic operator in Los Angeles County was sentenced to 63 months in prison today for his role in a $3.4 million Medicare fraud scheme that involved billing for occupational therapy services that were not medically necessary and not provided. Acting Assistant Attorney General Kenneth A. Blanco of the Justice Department’s Criminal Division, U.S. Attorney Eillen M. Decker of the Central District of California and Special Agent in Charge Christian J. Schrank of the U.S. Department of Health and Human Services’ Office of Inspector General’s (HHS-OIG) Los Angeles Regional Office made the announcement. Read more here: https://www.justice.gov/opa/pr/california-clinic-owner-sentenced-63-months-prison-role-occupational-therapy-fraud-scheme

2. Health fraud conviction of Dr. Paulus is dismissed - ASHLAND - A health fraud conviction against a former King's Daughters Medical Center cardiologist has been dismissed in federal court.Dr. Richard E. Paulus was convicted in U.S. District Court by a jury last fall following a seven-week trial on one count of health care fraud and 10 counts of making false statements. Paulus, a retired cardiologist, had been released on bond pending final sentencing on April 25. He faced 25 years or more in prison. Read more here: http://www.herald-dispatch.com/news/health-fraud-conviction-of-dr-paulus-is-dismissed/article_fbafb52d-6cab-537a-afa7-fb2da99132ca.html

3. Deeper Than The Headlines: OIG Hospital Review Case Studies - Most of us improve in our  careers by watching and learning from others. In compliance, it couldn’t be more true. Last week, the OIG posted a report of their Medicare Compliance Review of the University of Florida Health Jacksonville Hospital. This is the most recent of many such reports. OIG has been performing these hospital compliance reviews for many years now. Reviewing them in greater depth can give your compliance program an idea of the types of claims OIG is reviewing. Read more here: Deeper Than the Headlines: OIG Hospital Review Case Studies