OIG State Enforcement Actions for August - DoctorsManagement OIG State Enforcement Actions for August - DoctorsManagement

OIG State Enforcement Actions for August 2020

September 1, 2020

by Sean Weiss, Partner & VP of Compliance

The OIG posted State Enforcement Actions for August. As always, I’m baffled by the indecency and willingness to harm others! State Enforcement Actions

The Department of Justice has also issued 2 new enforcement actions.  The first is a manager of Medical Clinics in Brooklyn and Queens who was sentenced to 13 years in prison for a Multimillion-Dollar money laundering and health care kickback scheme and was also ordered by the Court to pay restitution in the amount of $23 million to Medicare, $16 million to Medicaid, $433,297 to the Internal Revenue Service and forfeit $2,614,233.79: https://go.usa.gov/xGgV7  This case is truly disturbing and demonstrates the depths a person will stoop to fuel their greed and desire for more and more!

The second is an opioid manufacturer’s former Global Medical Director who plead guilty in connection with drug safety claims. Timothy Baxter admitted that an Indivior employee he supervised sent inaccurate drug-safety information to the Massachusetts Medicaid agency, MassHealth, in 2012. More specifically, the director was familiar with the issue of unintended pediatric exposure – meaning children taking drugs by accident – and worked on it over several years. In 2012, Indivior had a contractor collect data on unintended pediatric exposure to buprenorphine drugs, with the director approving the project: https://go.usa.gov/xGgpP   Truly appalling!

What to do next…

  1. If you need help with an audit appeal or regulatory compliance concern, contact us at (800) 635-4040 or via email at info@drsmgmt.com.
  2. Read more about our: Total Compliance Solution

Why do thousands of providers trust DoctorsManagement to help improve their compliance programs and the health of their business?

Experienced compliance professionals. Our compliance services are structured by a chief compliance officer and supported by a team that includes physicians, attorneys and a team of experienced auditors. The team has many decades of combined experience helping protect the interests of physicians and the organizations they serve.

Quality of coders and auditors. Our US-based auditors receive ongoing training and support from our education division, NAMAS (National Alliance of Medical Auditing Specialists). All team members possess over 15 years of experience and hold both the Certified Professional Coder (CPC®) as well as the Certified Professional Medical Auditor (CPMA®) credentials.

Proprietary risk-assessment technology – our auditing team uses ComplianceRiskAnalyzer(CRA)®, a sophisticated analytics solution that assesses critical risk areas. It enables our auditors to precisely select encounters that pose the greatest risk of triggering an audit so that they can be reviewed and the risk can be mitigated.

Synergy – DoctorsManagement is a full-service healthcare consultancy firm. The many departments within our firm work together to help clients rise above the complexities faced by today’s healthcare professionals. As a result, you receive quality solutions from a team of individuals who are current on every aspect of the business of medicine.