OIG Compliance Simplified

After it disclosed conduct to the OIG pursuant to its CIA, Quest Diagnostics, Incorporated (Quest), New Jersey, agreed to pay $152,560.51 for allegedly violating the Civil Monetary Penalties Law. OIG alleged that Quest employed four individuals that it knew or should have known were excluded from participation in Federal health care programs.\r\n\r\n \r\n\r\nAfter it disclosed conduct to the OIG pursuant to its CIA, Amerigroup Corporation (Amerigroup), Virginia, agreed to pay $30,754.93 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that Amerigroup contracted with three individuals that it knew or should have known were excluded from participation in Federal health care programs and paid...

On November 5, 2015, OIG excluded C.F. Health Management, Inc. d/b/a/ Gainesville Pain Management (Gainesville), for a period of five years, based on a material breach of its Corporate Integrity Agreement (CIA). During the first reporting period of its CIA, Gainesville\'s Independent Review Organization (IRO) identified an error rate of 28% in its Discovery Sample and an error rate of 37.98% in its Full Sample, resulting in an extrapolated overpayment of $239,961.80. On July 16, 2015, OIG issued a letter demanding stipulated penalties in the amount of $34,000 based on Gainesville\'s failure to repay the overpayment identified by its IRO. After Gainesville failed to respond to OIG\'s demand letter, OIG issued a not...

On November 15, 2015, OIG excluded Todd Roberts and Roberts Physical and Aquatic Therapy, LLC a/k/a Roberts Physical Therapy and Wellness Center, LLC (collectively, Roberts), for a period of six years based on a material breach of its Corporate Integrity Agreement (CIA). During the first reporting period of its CIA, Roberts\' Independent Review Organization (IRO) identified an overpayment of $32,295, which Roberts has not paid. Roberts also failed to timely submit its Implementation Report, First Annual Report, and Second Annual Report. On June 16, 2014, OIG issued a letter demanding stipulated penalties in the amount of $24,000. OIG issued a notice of material breach and intent to exclude on September 1, 2015 f...

On July 14, 2016, Pinnacle Hospice Care (PHC), Colorado, entered into a $50,000 settlement agreement with OIG. The settlement agreement resolves allegations that PHC employed an individual who was excluded from participating in any Federal health care program. OIG\'s investigation revealed that the excluded individual provided items or services to PHC patients that were billed to Federal health care programs. Senior Counsel Ellen Slavin represented OIG with the assistance of Paralegal Specialist Eula Taylor....

After it self-disclosed conduct to OIG, Moses H. Cone Memorial Hospital Operating Corporation d/b/a Cone Health System (CHS), North Carolina, agreed to pay $475,220.66 for allegedly violating the Civil Monetary Penalties Law. OIG alleged that CHS employed an individual that it knew or should have known was excluded from participation in Federal health care programs....

After it self-disclosed conduct to OIG, Fort Duncan Medical Center, L.P. d/b/a Fort Duncan Regional Medical Center (FDRMC), Texas, agreed to pay $545,995.62 for allegedly violating the Civil Monetary Penalties Law. OIG alleged that FDRMC employed an individual that it knew or should have known was excluded from participation in Federal health care programs.\r\n\r\n ...

After it self-disclosed conduct to OIG, UHS of Westwood Pembroke, Inc. d/b/a Pembroke Hospital (Pembroke Hospital), Massachusetts, agreed to pay $807,856.65 for allegedly violating the Civil Monetary Penalties Law. OIG alleged that Pembroke Hospital employed two individuals that it knew or should have known were excluded from participation in Federal health care programs.\r\n\r\n ...

On June 24, 2016, Simpson Chiropractic (Simpson), Oklahoma, entered into a $31,000 settlement agreement with OIG. The settlement agreement resolves allegations that Simpson employed an individual who was excluded from participating in any Federal health care program. OIG\'s investigation revealed that the excluded individual, a chiropractic assistant, provided items or services to Simpson patients that were billed to Federal health care programs....

On June 8, 2016, KASKA, Inc. d/b/a St. Otto\'s Care Center (SOCC), Minnesota, entered into a $65,000 settlement agreement with OIG. The settlement agreement resolves allegations that SOCC employed an individual who was excluded from participating in any Federal health care program. OIG\'s investigation revealed that the excluded individual, a certified nursing assistant, provided items or services to SOCC patients that were billed to Federal health care programs....

On May 5, 2016, CCRC PropCo-Cypress Village, LLC (Cypress Village), and BLC Atrium-Jacksonville, LLC (Atrium), Florida, entered into a $17,881.65 settlement agreement with OIG. The settlement agreement resolves allegations that Cypress Village and Atrium employed an individual who was excluded from participating in any Federal health care program. OIG\'s investigation revealed that the excluded individual, a speech-language pathologist, provided items or services to Cypress Village and Atrium patients that were billed to Federal health care programs. Senior Counsel Nicole Caucci represented OIG....