OIG Compliance Simplified

On August 24, 2018, St. Mary’s Health System (St. Mary’s), Lewiston, Maine, entered into a $68,497.32 settlement agreement with OIG. The settlement agreement resolves allegations that St. Mary’s employed an individual who was excluded from participating in any Federal health care program. OIG’s investigation revealed that the excluded individual, a call center patient scheduler, provided items and services to St. Mary’s patients that were billed to Federal health care programs.

On August 2, 2018, Ireland Health Care Center, Inc. d/b/a Singleton Health Care Center (SHCC), Cleveland, Ohio, entered into a $45,735.42 settlement agreement with OIG. The settlement agreement resolves allegations that SHCC employed an individual who was excluded from participating in any Federal health care program. OIG’s investigation revealed that the excluded individual, a licensed practical nurse, provided items or services to SHCC’s patients that were billed to Federal health care programs.

On August 2, 2018, Gerrish Chiropractic Center (GCC), Bar Harbor, Maine, entered into a $7,019.10 settlement agreement with OIG. The settlement agreement resolves allegations that GCC employed an individual who was excluded from participating in any Federal health care program. OIG’s investigation revealed that the excluded individual, an office manager and chiropractic assistant, provided items or services to GCC’s patients that were billed to Federal health care programs.

On July 2, 2018, William H. Newman, M.D., and Allergy & Asthma Specialists of Northern Vermont, P.C. (collectively, “Dr. Newman”), entered into a $61,142.96 settlement agreement with OIG. The settlement agreement resolves allegations that Dr. Newman employed an individual who was excluded from participating in any Federal health care program. OIG’s investigation revealed that the excluded individual, a registered nurse, provided items or services to Dr. Newman’s patients that were billed to Federal health care programs.

On May 17, 2018, Immediate Home Care (IHC) in Bensalem, Pennsylvania, entered into a $189,445.68 settlement agreement with OIG. The settlement agreement resolves allegations that IHC employed an individual who was excluded from participating in any Federal health care program. OIG’s investigation revealed that the excluded individual, a home health nurse, provided items or services to IHC’s patients that were billed to Federal health care programs.

On May 4, 2018, Alameda Health System (AHS), California, entered into a $257,874 settlement agreement with OIG. The settlement agreement resolves allegations that AHS employed an individual who was excluded from participating in any Federal health care program. OIG’s investigation revealed that the excluded individual, an eligibility clerk, provided items or services to AHS’s patients that were paid for by Federal health care programs.

On March 27, 2018, ASAP Home Nurses, Inc. (ASAP), located in Wadsworth, Ohio, entered into a $11,406.26 settlement agreement with OIG. The settlement agreement resolves allegations that ASAP employed an individual who was excluded from participating in any Federal health care program. OIG’s investigation revealed that the excluded individual, a state tested nurse aide, provided items or services to ASAP’s patients that were billed to Federal health care programs.

On March 26, 2018, Community Care, Inc. (CCI), located in Brookfield, Wisconsin, entered into a $208,585.20 settlement agreement with OIG. The settlement agreement resolves allegations that CCI, a care management organization, contracted with an individual who was excluded from participating in any Federal health care programs. OIG’s investigation revealed that the excluded individual provided for residential items or services to CCI’s patients that were billed to Federal health care programs.

On March 21, 2018, Pharmex Pharmacy, LLC, and Israel Weber (collectively, “Pharmex”), Lakewood, New Jersey, entered into a $314,205.76 settlement agreement with OIG. The settlement agreement resolves allegations that Pharmex employed an individual who was excluded from participating in any Federal health care programs. OIG’s investigation revealed that the excluded pharmacist provided items or services to Pharmex patients that were billed to Federal health care programs.

On February 13, 2018, Southwest Trinity Management, LLC (STM), entered into a $141,986.36 settlement agreement with OIG. The settlement agreement resolves allegations that STM, through a skilled nursing facility it owns and manages in Oklahoma City, Oklahoma, employed an individual who was excluded from participating in any Federal health care program. OIG’s investigation revealed that the excluded individual, a licensed practical nurse, provided items or services that were billed to Federal health care programs.

On December 29, 2017, Turtle Creek Recovery Center (Turtle Creek), Dallas, Texas, entered into a $24,428.58 settlement agreement with OIG. The settlement agreement resolves allegations that Turtle Creek employed an individual who was excluded from participating in any Federal health care program. OIG’s investigation revealed that the excluded individual, a counselor, provided items or services to Turtle Creek’s patients that were billed to Federal health care programs.

On November 6, 2017, Diamonds & Pearls Health Services, LLC (DPHS), Cleveland, Ohio, entered into a $75,471.92 settlement agreement with OIG. The settlement agreement resolves allegations that DPHS employed an individual who was excluded from participation in any Federal health care programs. OIG’s investigation revealed that the excluded individual, a scheduling/staffing coordinator, provided items or services to DPHS patients that were billed to Federal health care programs.

On November 6, 2017, Center for Ear, Nose Throat & Allergy, P.C. (CENTA), Carmel, Indiana, entered into a $51,564.14 settlement agreement with OIG. The settlement agreement resolves allegations that CENTA employed an individual who was excluded from participating in any Federal health care program. OIG’s investigation revealed that the excluded individual, a medical records file clerk, provided items or services to CENTA’s patients that were billed to Federal health care programs.

On October 11, 2017, Shawnee Health Services (Shawnee), Carterville, Illinois, entered into a $107,761.08 settlement agreement with OIG. The settlement agreement resolves allegations that Shawnee employed an individual who was excluded from participation in any Federal health care programs. OIG’s investigation revealed that the excluded individual, a case manager, provided items or services to Shawnee clients that were receiving services under a Medicaid waiver program.

On October 10, 2017, The Arkansas Department of Health (ADH) entered into a $39,343.61 settlement agreement with OIG. The settlement agreement resolves allegations that ADH employed an individual who was excluded from participation in any Federal health care programs. OIG’s investigation revealed that the excluded individual, a hospice social worker, provided items or services to patients of a community based hospice operated by ADH that were billed to Federal health care programs.