AUGUST REPORT - OIG

Описание: Office of Investigations This office investigates potential crimes and civil violations of law involving VA programs and operations concerning VA employees, contractors, beneficiaries, and other individuals. These investigations focus on a wide range of matters, including healthcare, procurement, benefits, construction, and other fraud; cybercrime and identity theft; bribery and embezzlement; drug offenses; and violent crimes. The following investigations had significant developments this month. Healthcare Investigations Multiple Companies and Individuals Charged in Connection with Foreign Medical Program Fraud Scheme An investigation by the VA Office of Inspector General (OIG) and the US Department of State’s Diplomatic Security Service resulted in charges alleging that 12 individuals and 24 companies participated in a long-term scheme that targeted veterans overseas. Allegedly, the defendants created a network of medical and pharmaceutical service providers that submitted thousands of false claims to VA’s Foreign Medical Program for services that were double billed, grossly overpriced, unnecessary, or not rendered. They then deposited and transferred proceeds received from VA and their private business entities among several banking institutions to disguise their illicit activities. The total loss to VA is approximately $67 million. The Panamanian judicial system is prosecuting this case as a result of a filing by the Department of Justice in coordination with the US Embassy in Panama. Former VA Pharmacist Sentenced in Connection with Fraud Scheme Between May 2017 and June 2018, a former benefits adviser with the Office of Community Care referred more than 40 spina bifida beneficiaries to unlicensed home health agencies owned by the adviser’s friends and family. Among the referrals, the benefits adviser sent patients requiring home health care to a pharmacist who ran such an agency and later obtained employment with the Rocky Mountain Regional VA Medical Center in Aurora, Colorado. These referrals led to payments totaling approximately $19 million from VA to the unlicensed home health agencies engaged in the fraud. The pharmacist was sentenced in the District of Colorado to four years’ supervised release and ordered to pay restitution to VA of $613,000 and a fine of $5,000. As part of the plea agreement, the pharmacist resigned from VA and agreed not to seek or hold federal employment for the term of the sentence imposed by the court. The investigation was conducted by the VA OIG, FBI, and Internal Revenue Service Criminal Investigation. Civil Complaint Filed against Two Debt Collection Agencies and Three Individuals A multiagency investigation led to the filing of a civil complaint in the Northern District of Oklahoma alleging two debt collection companies and three individuals engaged in a healthcare, wire, and mail PAGE 2 AUGUST 2023 HIGHLIGHTS VA Office of Inspector General fraud scheme by collecting fictitious debts from CHAMPVA, TRICARE, Medicare, and other insurance beneficiaries. The defendants allegedly collected over $1.4 million as part of the scheme. This investigation was conducted by the VA OIG, Defense Criminal Investigative Service, Department of Health and Human Services OIG, US Postal Service OIG, Department of Labor OIG, and FBI. Business Executive Sentenced in Connection with COVID-19 Fraud Scheme The owner of a pharmaceutical secondary wholesaler conspired with others to buy and then hoard designated “scarce” materials—including personal protective equipment—at the height of the COVID-19 pandemic. The defendant used deceitful means to sell the equipment to VA, defrauding at least a dozen VA medical centers by selling the equipment at excessive prices. In total, the VA paid $330,000 for this equipment. The defendant was sentenced in the Southern District of Mississippi to 60 months’ imprisonment and 36 months’ supervised release and ordered to pay restitution of $281,086 and a fine of $50,000. This investigation was conducted by the VA OIG, Food and Drug Administration Office of Criminal Investigations, and FBI. VA Psychiatrist Sentenced for Scheme to Sell Opioids to Patients A psychiatrist at the Marion VA Medical Center in Illinois used her position to intentionally sell prescription opioids to her patients for financial gain. She was sentenced in the Southern District of Illinois to five years’ probation, to include one year of home confinement, after previously pleading guilty to conspiracy to distribute controlled substances. The VA OIG and FBI investigated the case. Benefits Investigations Business Owners Pleaded Guilty to Defrauding VA of More than $4 Million The owners of a business that claimed to provide home health services to veterans submitted fraudulent applications on behalf of unwitting VA beneficiaries for VA pension with aid and attendance benefits.