Medicare Fraud Leads to OIG Exclusion List

In order to cover up her embezzlement, she purportedly submitted false claims to a Minnesota Medicaid and multiple other insurance carriers in order to create a pattern of double billing that allowed her to replace the monies she had embezzled from the corporate checking account.  The overbilling she conducted raised more than $600,000 in proceeds from 2006 through 2012. 

According to the OIG and HHS, being convicted of health care fraud results in an automatic federal exclusion.  Should Ms. Mueller be convicted, she will be placed on the OIG exclusion list and will be prohibited from working for any health care organization that bills Medicare or Medicaid. 

If convicted, Ms. Mueller will face a prison sentence on the charges of health care fraud of 10 years in prison.  This case is being investigated by the Minnesota Attorney General’s Office which, has a task force with the Medicaid Fraud Control Unit focusing on home health care fraud investigations.

Often our clients ask why they need to check the federal and state exclusion lists for employees who are not licensed of involved in direct patient care.  Ms. Mueller’s case is a good example of an employee of a health care organization who can end up as an excluded party but have no involvement in direct patient care and is not a licensed caregiver.  Health care organizations billing Medicare and/or Medicaid must be careful not to hire any employees currently listed on the OIG exclusion list or on any state Medicaid exclusion list regardless of their credentials or level of patient interaction.

You May Also Like:
How to Get of the OIG Exclusion List
Differences in the OIG Exclusion List, LEIE and GSA 

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