HHS-OIG highlight $7B in savings in new report 

WASHINGTON – The Fall 2024 Semiannual Report to Congress (SAR) highlights more than $7 billion in expected recoveries and receivables resulting from HHS-OIG investigations and audits conducted during fiscal year 2024. HHS-OIG reported 1,548 criminal and civil enforcement actions in FY 2024 against individuals and entities suspected of engaging in crimes targeting HHS programs and the people they serve, including settlements resulting from using OIG's civil monetary penalty authorities and criminal convictions. HHS-OIG also excluded 3,234 individuals and entities from participation in federal health care programs. Among the DME-related activity highlighted in the report: 

• Charles Burruss and Ardalaan “Armani” Adams were charged with defrauding Medicare through the submission of claims for medically unnecessary durable medical equipment, mostly braces. Burruss and Adams paid millions in kickbacks and bribes to acquire the DME claims, which were generated using aggressive telemarketing strategies in concert with fraudulent telemedicine involving bribed doctors who rarely spoke to the beneficiaries for whom the DME was ordered. Burruss, Adams and their co-conspirators submitted the illegal DME claims to Medicare and other programs through a conglomerate of fraudulently established DME companies. The defendants pled guilty before the U.S. District Court and the Southern District of California to one count of conspiracy to commit wire fraud, conspiracy to commit healthcare fraud, and conspiracy to violate the anti-kickback statute. 
• OIG excluded Elizabeth Hernandez, an advanced registered nurse practitioner, for 97 years based on her conviction for her role in a scheme to defraud Medicare by submitting more than $192 million in claims for orthotic braces and other items patients did not need and telemedicine visits that did not occur. Hernandez was ordered to pay approximately $111 million in restitution and was sentenced to 20 years in prison.