Investigations by the U.S. Office of Inspector General have yielded almost $26 billion in savings and expected recoveries of taxpayer dollars in fiscal year 2010, according to a year-end report issued this week.
The savings and recoveries come from a wide array of actions taken against large companies, such as pharmaceutical firms, individuals, and against problems within Medicare's own contractor system and error detection programs.
Among some of the most noteworthy investigation findings were these:
• After a Medicare Fraud Strike Force investigation, Jose Castro-Ramirez and Suresh Chand, who were sentenced to prison terms of 14 and six years respectively, were convicted of paying Medicare beneficiaries cash kickbacks in exchange for their Medicare numbers and false statements they received services.
• AstraZeneca Pharmaceuticals agreed to pay $520 million plus interest and enter a corporate integrity agreement in connection with inappropriate promotion of its antipsychotic drug, Seroquel over five year period. The company "was alleged to have violated the federal anti-kickback statute by offering and paying illegal remuneration to doctors in connection with services rendered by doctors related to the unapproved uses of Seroquel," the report said.
Several companies agreed to pay $7.3 million to settle accusations they violated provisions of the Stark law. For example, physician-owned United Shockwave Services Ltd, United Urology Centers and United Prostate Centers entered into a corporate integrity agreement dealing with accusations that United solicited money from hospitals in exchange for patient referrals.
"It was alleged that United threatened hospitals that it would refer patients to competing hospitals if they did not agree to a contract with United, or promised additional referrals to hospitals that did contract with United Public Health," the report said.
• Nine healthcare employees of MultiEthnic Behavioral Health Services Inc. of Philadelphia were sentenced to prison terms ranging from 15 months to 17.5 years as a result of fraud accusations and the death of an at-risk child said to be under MEBH's care.