Healthicity Blog

1. Owner of Two New York Medical Clinics Sentenced to 84 Months for Her Role in $55 Million Health Care Fraud Scheme - “The owner of two Brooklyn, New York, medical clinics was sentenced today to 84 months in prison for her role in a $55 million healthcare fraud scheme.

The OIG has updated their work plan in the last year more frequently than in the past and recently added nine more items in September of 2017. Anytime the OIG updates their work plan, I think it’s important to take a deep dive into the new content.

The field of compliance isn’t as simple as hiring honest people who will hopefully “always obey the rules.” In fact, careful hiring doesn’t constitute a compliance plan at all.

If you have a compliance program, you most likely have a full-time compliance officer or an individual who is accountable for your organization’s compliance program, even if it’s only a portion of that person’s overall duties.

An organization that fails to create and maintain an effective compliance program could be forced to return overpayments. And providers may face severe civil, criminal, and financial penalties.

1. Mylan Agrees to Pay $465 Million to Resolve False Claims Act Liability for Underpaying EpiPen Rebates - “Pharmaceutical companies Mylan Inc. and Mylan Specialty L.P. have agreed to pay $465 million to resolve claims

The OIG has frequently reviewed chiropractic services over the last several years. Their most recent report was posted on their website on Aug. 18, 2017 and concluded that a Brooklyn chiropractor had a 100% error rate for claims over a two-year period worth about $672,000.

Auditing and Monitoring: One of the 7 Elements of an Effective Compliance Program

The OIG frequently creates and shares short videos about important compliance topics in their series, “Eye on Oversight.” Their most recent release demonstrates the importance of OIG Audits.