Download SMP Fraud Alert - March 21, 2014

FRAUD ALERT
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:
1. “Ramsey Man Sentenced
on Health Care Fraud
Charge” (DOJ):
http://www.justice.gov/usa
o/ils/News/2014/Mar/0307
2014_Sidener%20Press%
20Release.html
2. “Federal Jury Finds
Missouri Woman Guilty Of
Dear SMP readers,
This week’s Fraud Alert contains a news story about a pharmaceutical
company’s $27.6 million dollar settlement with 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?
Illinois Shares $27.6 Million Pharmaceutical Settlement
Pharmaceutical manufacturer Teva Pharmaceuticals USA Inc. and its
subsidiary IVAX LLC have 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:
http://www.justice.gov/opa/pr/2014/March/14-civ-251.html
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: http://oig.hhs.gov/newsroom/spotlight/2014/teststrips.asp
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.
Health Care Fraud” (DOJ):
http://www.justice.gov/usa
o/ils/News/2014/Mar/0320
2014_Vaughn%20Press%
20Release.html
Consumer Fraud:
3. “FTC Obtains $2.2 Million
Judgment against
Supplement Marketer that
Made Phony Claims for
Treating and Preventing
Diabetes” (FTC):
http://www.ftc.gov/newsevents/pressreleases/2014/03/ftcobtains-22-millionjudgment-againstsupplement-marketermade
4. “A Lotto Malarkey” (FTC):
http://www.consumer.ftc.g
ov/blog/lotto-malarkey
5. “Fake Feds Get People to
Pay”(FTC):
http://www.consumer.ftc.g
ov/blog/fake-feds-getpeople-pay
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, IL 60301
phone (708)383-0258 fax (708)524-0870
[email protected]
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 Alerts contain 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 [email protected].