October 21, 2021

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Final Defendant Sentenced in $80 Million Health Care Fraud Conspiracy

16 min read
<div>A Florida man was sentenced today to 210 months in prison for conspiracy to commit health care fraud and wire fraud.</div>
A Florida man was sentenced today to 210 months in prison for conspiracy to commit health care fraud and wire fraud.

More from: May 27, 2021

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  • State Department Terrorist Designations of HASM and Its Leaders and Maintenance of PIJ FTO Designation
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  • Surface Transportation Security: TSA Has Taken Steps to Improve its Surface Inspector Program, but Lacks Performance Targets
    In U.S GAO News
    According to the Transportation Security Administration (TSA) Surface Transportation Security Inspector Operations Plan (TSA's plan), surface transportation security inspectors—known as surface inspectors—are to enter key details for program activities in the Performance and Results Information System (PARIS)—TSA's system of record for all surface inspector activities. In December 2017, GAO reported that TSA was unable to fully account for surface inspector time spent assisting with non-surface transportation modes, including aviation, due to data limitations in PARIS, and recommended TSA address these limitations. Since GAO's report, TSA updated PARIS to better track surface inspector activities in non-surface transportation modes. Transportation Security Administration Surface Inspectors Assess Security of a Bus System TSA's plan outlines steps to align work plan activities with risk assessment findings. However, TSA cannot comprehensively ensure surface inspectors are targeting program resources to high-risk modes and locations because it does not consistently collect information on entity mode or location in PARIS. According to officials, TSA plans to update PARIS and program guidance to require inspectors to include this information in the system by the end of fiscal year 2020. TSA's plan outlines performance measures for the surface inspector program, but does not establish quantifiable performance targets for all activities. Targets indicate how well an agency aspires to perform and could include, for example, entity scores on TSA security assessments, among others. By developing targets, TSA would be better positioned to assess the surface inspector program's progress in achieving its objective of increasing security among surface transportation entities. Surface transportation—freight and passenger rail, mass transit, highway, maritime and pipeline systems—is vulnerable to global terrorism and other threats. TSA is the federal agency primarily responsible for securing surface transportation systems. The FAA Reauthorization Act of 2018 requires TSA to submit a plan to guide its Surface Transportation Security Inspectors Program. The Act includes a provision for GAO to review TSA's plan. This report examines the extent to which TSA's plan and its implementation: (1) address known data limitations related to tracking surface inspector activities among non-surface modes, (2) align surface operations with risk assessments, and how, if at all, TSA ensures inspectors prioritize activities in high-risk modes and locations, and (3) establish performance targets for the surface inspector program. GAO reviewed TSA's June 2019 plan and analyzed data on inspector activities for fiscal years 2017 through 2019. GAO interviewed officials in headquarters and a non-generalizable sample of 7 field offices selected based on geographical location and the presence of high-risk urban areas. GAO recommends that TSA establish quantifiable performance targets for the surface inspector program's activity-level performance measures. DHS concurred with our recommendation. For more information, contact Triana McNeil at (202) 512-8777 or McNeilT@gao.gov.
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    The Justice Department announced Thursday that the White River Regional Housing Authority in Melbourne, Arkansas, has agreed to pay $70,000 to resolve a lawsuit alleging that it and its former employee, Duane Johnson, violated the Fair Housing Act (FHA) when Johnson sexually harassed an applicant who sought a Housing Choice Voucher from the Housing Authority. 
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    Former Tallahassee City Commissioner Scott Maddox and his former business partner Paige Carter-Smith were sentenced today in the Northern District of Florida to five years and two years in prison, respectively, for their roles in a multi-year scheme to use Maddox’s power as a sitting City Commissioner to extract bribes from Tallahassee companies with business in front of the City Commission. Maddox and Carter-Smith were also ordered to pay restitution in the amount of $76,763 and $115,619, respectively, and ordered to pay a forfeiture money judgment in the amount of $70,000.
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  • Veterans Health Care: Agency Efforts to Provide and Study Prosthetics for Small but Growing Female Veteran Population
    In U.S GAO News
    The Department of Veterans Affairs' (VA) Veterans Health Administration (VHA) provides veterans with prosthetic services to assist with their mobility, vision, and hearing needs. The proportion of prosthetics VHA provided to female veterans has been small compared to the share provided to male veterans. However, in fiscal years 2015 to 2019, this proportion grew from 6.8 percent to 7.9 percent and accounted for about $889.1 million of the $15.4 billion total cost of prosthetics. Artificial limbs comprised a relatively small number of the total prosthetics VHA provided to veterans in fiscal years 2015 to 2019; however, veterans who use artificial limbs have complex needs and are significant users of health care services. VHA provided prosthetic services to a small but growing female veteran amputee population (almost 3 percent of veteran amputees in fiscal year 2019), who were generally younger than male veteran amputees. VHA has established an individualized patient care approach in its Amputation System of Care that seeks to address the prosthetic needs of each veteran, including accounting for gender-specific factors. VHA officials said that using a standardized, multidisciplinary approach across VA medical facilities also helps them incorporate the concerns and preferences of female veterans. For example, veterans are provided care by a team that includes a physician, therapist, prosthetist (clinician who helps evaluate prosthetic needs and then designs, fabricates, fits, and adjusts artificial limbs), and other providers as needed. Female veteran amputees GAO spoke with at one VA medical facility said they were satisfied with their VHA care. They also noted a lack of commercially available prosthetic options that VHA providers can use to meet women's needs. Examples of Female Veterans' Artificial Limb Prosthetics Women are generally studied less than their male counterparts in prosthetic and amputee rehabilitation research. VHA designated prosthetics for female veterans a national research priority in 2017, and has funded eight related studies as of May 2020: four pertain to lower limb amputation, three pertain to upper limb amputation, and one pertains to wheelchairs. VHA officials noted the importance of this research priority and the ongoing challenge of recruiting study participants due to the small female veteran population. VHA researchers said they employ various tactics to address this challenge, such as using multi-site studies and recruiting participants from the non-veteran population. Women are the fastest growing veteran subpopulation, with the number of female veterans using VHA health care services increasing 29 percent from 2014 to 2019. Female veterans accounted for an estimated 10 percent of the total veteran population in fiscal year 2019. They are eligible to receive a full range of VHA health care services, including obtaining prosthetics. House Report 115-188 included a provision for GAO to review VHA's prosthetic services for female veterans. This report examines 1) trends in prosthetics provided by VHA to female veterans; 2) characteristics of the female veteran population with limb loss and how VHA provides prosthetic services to these veterans through its Amputation System of Care; and 3) VHA's research efforts and the challenges that exist in studying prosthetics for female veterans with limb loss. GAO analyzed VHA documents, as well as data from fiscal years 2015 to 2019 on prosthetics and veterans with amputations. GAO interviewed agency officials from VHA central office and officials and female veteran amputees at two VA medical facilities selected for expertise in amputation care and prosthetics research activities. In addition, GAO interviewed VHA researchers conducting studies on prosthetics for female veterans. GAO provided a draft of this report to VA. VA provided general and technical comments, which were incorporated as appropriate. For more information, contact Jessica Farb at (202) 512-7114 or farbj@gao.gov.
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  • Defense Reform: DOD Has Made Progress, but Needs to Further Refine and Formalize Its Reform Efforts
    In U.S GAO News
    The Department of Defense (DOD) has made progress in establishing valid and reliable cost baselines for its enterprise business operations and has additional efforts ongoing. DOD's January 2020 report responding to section 921 of the John S. McCain National Defense Authorization Act (NDAA) for Fiscal Year (FY) 2019 addressed most of the key requirements from that section but also had some limitations, which DOD acknowledged. For example, the baselines included only labor and information technology costs because DOD's financial data do not attribute costs to other specific activities required under section 921. However, DOD officials told GAO they have developed and are continuing to refine baselines for all of the department's enterprise business operations, such as financial and human resource management, to enable DOD to better track the resources devoted to these operations and the progress of reform. While still in progress, this effort shows promise in addressing the weaknesses in DOD's section 921 report and in meeting the need for consistent baselines for DOD's reform efforts that GAO has previously identified. GAO found that DOD's reported savings of $37 billion from its reform efforts and a Defense-Wide Review to better align resources are largely reflected in its budget materials; however, the savings were not always well documented or consistent with the department's definitions of reform. Specifically: DOD had limited information on the analysis underlying its savings estimates, including (1) economic assumptions, (2) alternative options, and (3) any costs of taking the actions to realize savings, such as opportunity costs. Therefore, GAO was unable to determine the quality of the analysis that led to DOD's savings decisions. Further, some of the cost savings initiatives were not clearly aligned with DOD's definitions of reform, and thus DOD may have overstated savings that came from its reform efforts rather than other sources of savings, like cost avoidance. For example, one initiative was based on the delay of military construction projects. According to DOD officials, this was done to fund higher priorities. But if a delayed project is still planned, the costs will likely be realized in a future year. Without processes to standardize development and documentation of savings and to consistently identify reform savings based on reform definitions, decision makers may lack reliable information on DOD's estimated reform savings. In coordinating its reform efforts, DOD has generally followed leading practices for collaboration, but there is a risk that this collaboration may not be sustained in light of any organizational changes that Congress or DOD may make. This risk is increased because the Office of the Chief Management Officer (OCMO) and other offices have not formalized and institutionalized these efforts through written policies or agreements. Without written policies or formal agreements that define how organizations should collaborate with regard to DOD's reform and efficiency efforts, current progress may be lost, and future coordination efforts may be hindered. DOD spends billions of dollars each year to maintain key business operations. Section 921 of the NDAA for FY 2019 established requirements for DOD to reform these operations and report on their efforts. DOD has also undertaken additional efforts to reform its operations in recent years. Section 921 called for GAO to assess the accuracy of DOD's reported cost baselines and savings, and section 1753 of the NDAA for FY 2020 called for GAO to report on the OCMO's efficiency initiatives. This report assesses the extent to which DOD has (1) established valid and reliable baseline cost estimates for its business operations; (2) established well-documented cost savings estimates reflecting its reforms; and (3) coordinated its reform efforts. GAO assessed documents supporting costs, savings estimates, and coordination efforts; interviewed DOD officials; observed demonstrations of DOD's reform tracking tools; and assessed DOD's efforts using selected criteria. GAO is making three recommendations—specifically, that DOD establish formal processes to standardize development and documentation of cost savings; ensure that reported savings are consistent with the department's definition of reform; and formalize policies or agreements on its reform efforts. DOD concurred with GAO's recommendations. For more information, contact Elizabeth Field at (202) 512-2775 or fielde1@gao.gov.
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  • Texas Sport Supplement Company Owner Pleads Guilty to Unlawful Distribution of Steroid-Like Drugs
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    A former Texas resident and his sport supplement company pleaded guilty today to a felony charge relating to the introduction of unapproved new drugs into interstate commerce, the Department of Justice announced.
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  • Telecommunications: FCC Has Implemented the Lifeline National Verifier but Should Improve Consumer Awareness and Experience
    In U.S GAO News
    As of June 2020, the Federal Communications Commission (FCC) required consumers nationwide to use the Lifeline National Verifier (Verifier), a centralized process and data system, to check their eligibility for Lifeline. Because consumers who participate in certain federal benefits programs qualify for discounted phone and internet service through Lifeline, the Verifier checks state and federal benefits databases to verify consumers' eligibility. The Verifier also includes a manual review process for consumers to submit documents proving their eligibility if they cannot be found in a database. As of November 2020, the Verifier had connections with databases in 20 states and 2 federal agencies. GAO found that although consumers in states without state database connections had the same likelihood of actually meeting eligibility requirements as consumers in states with such connections, they were less likely to be found eligible for Lifeline through the Verifier (see figure). Average Eligibility Determination for New Lifeline Applicants in States with and without State Database Connections to the Lifeline National Verifier, June 2018 through June 2020 FCC coordinated with state and federal stakeholders to implement the Verifier. However, stakeholders told GAO that many eligible consumers are not aware of the Verifier or Lifeline. Consumers may lack this awareness because FCC's consumer education planning did not always align with key practices, such as developing consistent, clear messages and researching target audiences. As a result, eligible consumers may not apply for Lifeline. Moreover, while FCC originally envisioned tribal governments and organizations assisting residents of tribal lands with the Verifier, it has not provided them with quality information to effectively do so. Although FCC reported that the Verifier is meeting its goal of improving the consumer experience, GAO found that the manual review process, which FCC used to determine the eligibility of more than half of applicants in many states, is challenging for consumers. However, FCC does not collect complete information on consumers' experience with this process, and thus is limited in its ability to identify and address the challenges consumers face. Such challenges likely contributed to eligible consumers giving up on their applications. For example, we found that more than two-thirds of applicants who underwent manual review between June 2018 and June 2020 did not complete their applications. FCC's Lifeline program discounts phone and internet service for eligible low-income consumers. In 2019, FCC authorized $982 million in support for 6.9 million eligible consumers. FCC created the Verifier with the stated goals of reducing fraud and costs and improving the consumer experience. The Verifier includes an online application, connections to state and federal benefits databases, and a standardized manual review process. GAO was asked to review FCC's implementation of the Verifier. This report examines: (1) the status of the Verifier; (2) FCC's coordination with stakeholders and efforts to educate consumers and facilitate tribal stakeholders' involvement; and (3) the extent to which the Verifier is meeting its goals. GAO reviewed FCC orders and documentation; analyzed Verifier performance and Lifeline subscriber data; interviewed FCC and other agency officials, and selected industry, state, tribal, and consumer stakeholders; and surveyed state officials. Stakeholders were selected to obtain a variety of non-generalizable viewpoints. GAO is making six recommendations, including that FCC develop a consumer education plan, provide quality information to tribal organizations, and collect information on consumers' experience with the manual review process. FCC agreed to take steps to address all of GAO's recommendations. For more information, contact Andrew Von Ah at (202)-512-2834 or vonaha@gao.gov.
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  • Army and Marine Corps Training: Metrics Needed to Assess Initiatives on Training Management Skills
    In U.S GAO News
    Over the past decade, Army and Marine Corps forces have deployed repeatedly with limited time between deployments. At their home stations, combat training centers, and other locations, units have focused their limited training time on training for counterinsurgency operations. Prior to deploying, units also conduct a large-scale exercise referred to as a culminating training event. With the drawdown of forces in Iraq, the services have begun to resume training for a fuller range of offensive, defensive, and stability missions. The House report to the National Defense Authorization Act for Fiscal Year 2011 directed GAO to report on the Army's and Marine Corps' abilities to complete training requirements. GAO assessed the extent to which the services' (1) active component forces are completing training prior to the culminating training event and (2) leaders are positioned to plan and manage training as forces resume training for a fuller range of missions. GAO analyzed training requirements and unit training documentation, and interviewed headquarters and unit personnel during site visits between July 2010 and July 2011.Deploying Army and Marine Corps units conduct extensive predeployment training--both individual and collective, to include a large-scale culminating training event--at their home stations, combat training centers, and other locations. However, several factors, such as limited training time between deployments, the large number of training requirements, and the current focus on counterinsurgency operation training have been preventing units from completing all desired training prior to the culminating training event. For example, based on GAO's site visits, 7 of 13 units were not able to complete all of the desired individual and collective training (e.g., company-level live fire training) prior to arriving at the combat training centers. Further, officials from all of the units GAO spoke with stated that they planned to delay certain training until they were at the combat training centers since resources--such as theater-specific equipment like mine resistant ambush protected vehicles--were more readily available there. GAO found that some units had to train to improve proficiency levels at the combat training centers prior to beginning the culminating training events, and therefore were not always able to take full advantage of the training opportunities available to them at the combat training centers to conduct complex, higher-level training. Still, according to trainers at the combat training centers, while units arrive with varying levels of proficiency, all forces leave with at least the platoon level proficiency required to execute the counterinsurgency missions required for ongoing operations in Iraq and Afghanistan. Over the past decade, continuous overseas deployments have reduced training timeframes and resulted in senior leaders assuming training management responsibilities from junior leaders. Specifically, leaders at higher headquarters have taken responsibility for much of the training management function--planning, preparing, and assessing training--while junior leaders have focused primarily on training execution. However, changing conditions, such as increased competition for resources in a constrained fiscal environment, increased time at home station, and a return to training for a fuller range of missions, make it imperative that all leaders possess a strong foundation in training management. The services are developing various initiatives to restore and develop training management skills in their leaders, but neither service has developed results-oriented performance metrics to gauge the effectiveness of their efforts to restore these skills. As GAO has previously reported, establishing metrics can help federal agencies target training investments and assess the contributions that training programs make to improving results. Without a means of measuring the effectiveness of their efforts, the Army and Marine Corps will not have the information they need to assess the extent to which their leaders have the training management skills needed to plan, prepare, and assess required training. GAO recommends that the services develop results-oriented performance metrics that can be used to evaluate the effectiveness of their training management initiatives and support any adjustments that the services may need to make to these initiatives. DOD concurred with this recommendation.
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  • VA Health Care: Community Living Centers Were Commonly Cited for Infection Control Deficiencies Prior to the COVID-19 Pandemic
    In U.S GAO News
    The Department of Veterans Affairs (VA) is responsible for overseeing the quality of nursing home care provided to residents in VA-owned and -operated community living centers (CLC). VA models its oversight process on the methods used by the Centers for Medicare & Medicaid Services, which uses inspections of nursing homes to determine whether the home meets federal quality standards. These standards require, for example, that CLCs establish and maintain an infection prevention and control program. VA uses a contractor to conduct annual inspections of the CLCs, and these contractors cite CLCs with deficiencies if they are not in compliance with quality standards. Infection prevention and control deficiencies cited by the inspectors can include situations where CLC staff did not regularly use proper hand hygiene or failed to correctly use personal protective equipment. Many of these practices can be critical to preventing the spread of infectious diseases, including COVID-19. GAO analysis of VA data shows that infection prevention and control deficiencies were the most common type of deficiency cited in inspected CLCs, with 95 percent (128 of the 135 CLCs inspected) having an infection prevention and control deficiency cited in 1 or more years from fiscal year 2015 through 2019. GAO also found that over the time period of its review, a significant number of inspected CLCs—62 percent—had infection prevention and control deficiencies cited in consecutive fiscal years, which may indicate persistent problems. An additional 19 percent had such deficiencies cited in multiple, nonconsecutive years. Why GAO Did This Study COVID-19 is a new and highly contagious respiratory disease causing severe illness and death, particularly among the elderly. Because of this, the health and safety of the nation’s nursing home residents—including veterans receiving nursing home care in CLCs—has been a particular concern.  GAO was asked to review the quality of care at CLCs. In this report, GAO describes the prevalence of infection prevention and control deficiencies in CLCs prior to the COVID-19 pandemic. Future GAO reports will examine more broadly the quality of care at CLCs and VA’s response to COVID-19 in the nursing home settings for which VA provides or pays for care. For this report, GAO analyzed VA data on deficiencies cited in CLCs from fiscal years 2015 through 2019. Using these data, GAO determined the most common type of deficiency cited among CLCs, the number of CLCs that had infection prevention and control deficiencies cited, and the number of CLCs with repeated infection prevention and control deficiencies over the period from fiscal years 2015 through 2019. GAO also obtained and reviewed inspection reports and corrective action plans to describe examples of the infection prevention and control deficiencies cited at CLCs and the CLCs’ plans to remedy the noncompliance. For more information, contact Sharon M. Silas at (202) 512-7114 or SilasS@gao.gov.
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