Why is the OIG so worried about Owners?


Because they are seeing a trend of excluded owners hiding behind the corporate veil of a company that is billing CMS for federal healthcare dollars. Let’s see a few examples:

January 2015:

The OIG published an enforcement action they took against an excluded pharmacist that billed CMS for items while he was excluded AND was the owner of a Minnesota pharmacy. The OIG settled with the pharmacist, Joseph C. Moon for $96,259.57 for items allegedly billed by him from March 10, 2006 to July 17, 2013. 

January 2015:  

The OIG published an enforcement action against Onsite OHS, INC and Kyle Johnson, a clinical laboratory and its former owner. Johnson was the sole shareholder of the laboratory holding company that owned Onsite at the time the survey was done, which was the triggering event for the fine.

May 2014:  

The OIG excluded a Missouri Medical Clinic for 10 years from all federally funded health care programs based on the company’s conviction for healthcare fraud. The Medical Clinic employed the husband, wife and daughter as Physicians and the son as a Manager. The Company pleaded guilty to a felony count of healthcare fraud and ordered to pay $832,717 in restitution to Medicare and Missouri Medicaid.  

These are just a few examples of why the Office of Inspector General is looking behind the Corporate Veil to see who owns and/or manages a healthcare vendor that is billing CMS or for federal healthcare dollars.  

You May Also Like:
How to get off the Exclusion List
OIG Data Analysis Finds Excluded Provider
The Importance of Exclusion Screening
Vendor Compliance 101: Vendor Risk Management

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