Showing posts with label LEIE Database. Show all posts
Showing posts with label LEIE Database. Show all posts

Wednesday, February 20, 2013

Systemic breakdown attributes to massive fraud

I’m not sure where the breakdown is, but there is no doubt a breakdown; a big one!  Either agencies are failing to report, or the OIG is failing to add criminals to their list. Which ever the case, the free flow of tax dollars from your pocket to fraudsters bank accounts goes unchecked.

In checking to see if Dr. Robin Lockwood is at least excluded from defrauding taxpayers from any more money for her employer, Ocean Dental, I find she still has access to our tax dollars; she’s not on the governments List of Excluded Individuals and Entities (LEIE). 

According to the OIG, if a criminal conviction is related to – Fraud, Obstruction of an investigation or misdemeanor conviction relating to controlled substances and should be reported as soon as the defendant is sentenced - even if appealed - there is supposed to be a “Mandatory Exclusion”. Maybe mandatory means something difference in government-speak.

Mandatory exclusions: OIG is required by law to exclude from participation in all Federal health care programs individuals and entities convicted of the following types of criminal offenses: Medicare or Medicaid fraud, as well as any other offenses related to the delivery of items or services under Medicare, Medicaid, SCHIP, or other State health care programs; patient abuse or neglect; felony convictions for other health care-related fraud, theft, or other financial misconduct; and felony convictions relating to unlawful manufacture, distribution, prescription, or dispensing of controlled substances.

The sources who are supposed to report to the OIG are the USAO’s, MFCU’s (Medicaid Fraud Control Units), Local Prosecutors, State Medicaid Agencies and Licensing boards and should include the judgment, plea agreement, final actions, indictment information, investigative report or narrative, aggravating factors, mitigating factors, and a cover letter with a brief summary.

There are numerous acts under which the government should stop the massive fraud, one being under the Social Security Act 1128(b)(4), where Michael DeRose, DDS and William Mueller, DDS the founders of Small Smiles Dental Centers are listed.