Friday, March 21, 2014
Please share this Fraud Alert with colleagues, consumers, or other professionals in your area. If you have any questions about the Illinois SMP program, or to receive these Fraud Alerts directly, please contact Jason Echols, Healthcare Consumer Protection Coordinator at AgeOptions.
This document was supported in part by a grant (No. 90MP0163 & 90SP0061) from the Administration on Aging (AoA), Administration for Community Living (ACL), U.S. Department of Health and Human Services (DHHS). Grantees carrying out projects under government sponsorship are encouraged to express freely their findings and conclusions. Therefore, points of view or opinions do not necessarily represent official AoA, ACL, or DHHS policy.
Fraud In The News
The following are current news articles about health care and fraud issues.
Health Care Fraud:
- “Ramsey Man Sentenced on Health Care Fraud Charge” (DOJ):
- “Federal Jury Finds Missouri Woman Guilty Of Health Care Fraud” (DOJ):
- “FTC Obtains $2.2 Million Judgment against Supplement Marketer that Made Phony Claims for Treating and Preventing Diabetes” (FTC):
- “A Lotto Malarkey” (FTC):
- “Fake Feds Get People to Pay”(FTC):
Dear SMP readers,
This week’s Fraud Alert containsanews story about a pharmaceutical company’s $27.6 million dollar settlementwith the federal government and Illinois and a special fraud spotlight on diabetic testing supplies.
Have a great weekend and happy spring!
What you will find in this week’s Fraud Alert
- Illinois Shares $27.6 Million Pharmaceutical Settlement
- Diabetic Test Strips – Gateway to Fraud?
Pharmaceutical manufacturer Teva Pharmaceuticals USA Inc. and its subsidiary IVAX LLChave reached a settlement with the federal government and the state of Illinois to resolve allegations that the company paid kickbacks to an Illinois physician. In this case, kickbacks in the form of money and trips to Florida were allegedly given so that the physician would prescribe the company’s anti-psychotic drug, even though the drug is typically given as a last resort. The government alleges that these kickbacks led to false claims being submitted to Medicare and Medicaid. The pharmaceutical company has agreed to pay $27.6 million to the federal government and Illinois.
The government has filed civil action against the physician and that case is still pending in court. Read more about this $27.6 million settlement in this U.S. Department of Justice (DOJ) press release:
Diabetic Test Strips – Gateway to Fraud?
The U.S. Department of Health and Human Services Office of Inspector General (HHS OIG) recently released an article spotlighting how the agency investigates fraudulent billing for diabetic test strips. Read the spotlight article here:
As this article illustrates, potential fraud involving diabetic test strips or supplies often begins with an unsolicited call from a medical supplier offering something for free, such as test strips or a diabetic cookbook. The caller will say all they need from you is your Medicare number.
Never give your Medicare number in exchange for something that is “free.”If it is truly free, why would they need it?Suppliers of durable medical equipment, including diabetic supplies, violate Medicare’s marketing rules when they call you unsolicited. Any supplies you need and want billed to Medicare must be ordered by your doctor.
Report these types of calls to the Illinois SMP at (800)699-9043.
Jason B. Echols, MSW, Health Care Consumer Protection Coordinator
AgeOptions
1048 Lake Street, Suite 300
Oak Park, IL60301
phone (708)383-0258 fax (708)524-0870
ageoptions.org
AgeOptions, the Area Agency on Aging of Suburban Cook County, is committed to improving the quality of life and maintaining the dignity of older adults and those who care about them – through leadership and support, community partnerships, comprehensive services, accurate information and powerful advocacy.
Fraud Alertscontain information about current scams taking place in Illinois, announcements and updates about programs or services related to health care and/or fraud protection, and links to news articles about health care and fraud topics. Please forward any recommendations or announcements that you would like to be included in a future Fraud Alert to .