Exclusion Screening

Recent Enforcement Actions from the Office of Inspector General, U.S. Dept. of Health & Human Services



Jeff Aleixo

On the enforcement front here’s a selection of some recent actions taken by the Office of Inspector General. The full descriptions can be found on the OIG’ s official website.

– An unlicensed New Jersey dentist agreed to a $1.1 million dollar fine and a 50-year exclusion from Federal health care program participation for assuming the identity of a licensed (later deceased) dentist and presenting Medicaid claims for services using that dentist’s identity. The allegation included that the unlicensed dentist perpetrated the fraud from late 2005 to late 2012.

– Two cases in February of this year were resolved by way of self-disclosure. In Rhode Island, Orchard View Manor agreed to pay over $61,000 dollars for allegedly employing an individual that it knew or should’ve known was excluded from Federal health care program participation. And in Ohio, OhioHealth Corp. agree to a CMP of over $231,000 dollars for allegedly employing three excluded individuals.

– And in April this year Pafford Medical Services Inc. in Arkansas agreed to a CMP fine of over $390,000 dollars for employing an excluded individual.

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