September 22, 2021

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Former NFL Players Plead Guilty to Nationwide Health Care Fraud Scheme

12 min read
<div>Three former National Football League (NFL) players have pleaded guilty for their roles in a nationwide scheme to defraud a health care benefit program for retired NFL players. A total of 15 defendants have pleaded guilty in connection with this scheme.</div>
Three former National Football League (NFL) players have pleaded guilty for their roles in a nationwide scheme to defraud a health care benefit program for retired NFL players. A total of 15 defendants have pleaded guilty in connection with this scheme.

More from: September 7, 2021

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  • Commercial Shipping: Information on How Intermodal Chassis Are Made Available and the Federal Government’s Oversight Role
    In U.S GAO News
    What GAO Found Containerized shipping—performed by oceangoing vessels using standardized shipping containers—accounted for approximately 60 percent of all world seaborne trade, which was valued at approximately $12 trillion in 2017. At a port, shipping containers are placed on "intermodal chassis" (chassis), standardized trailers that carry shipping containers and attach to tractors for land transport. Multiple entities are involved in the movement of shipping containers, including intermodal equipment providers (IEP) (which own and provide chassis for a fee); ocean carriers (which transport cargo over water); and motor carriers (which transport shipping containers over land via chassis). Four distinct models are used in the U.S. to make chassis available to motor carriers (see table), each with benefits and drawbacks according to the entities GAO interviewed. While chassis are generally provided to motor carriers using one of these four models, more than one model may be available at a port. Chassis Provisioning Models Model 1: Single chassis provider An individual intermodal equipment provider (IEP) owns chassis that are directly provided to shippers or motor carriers. Model 2: Motor carrier-controlled A motor carrier owns or is responsible for a chassis that it has procured under a long-term lease. Model 3: Gray pool A single manager, often a third party, oversees the operations of a pool that is made up of chassis contributed by multiple IEPs. Model 4: Pool-of-pools Each IEP manages its respective chassis fleet, but each allow motor carriers to use any chassis among the fleets and to pick up and drop off chassis at any of the IEPs’ multiple locations. Source: GAO.  |  GAO-21-315R Entities GAO interviewed identified multiple benefits and drawbacks to each of the chassis provisioning models. Regarding benefits, for example, both the single chassis provider model and the motor carrier-controlled model allow IEPs and motor carriers to have direct control over the maintenance and repair of their chassis, something these entities potentially lose under other chassis provisioning models. Further, the gray pool and the pool-of-pools models can resolve many of the logistical concerns regarding the availability of chassis, leading to operational efficiencies for port operators and the ability of motor carriers to choose whatever chassis they wish. Regarding drawbacks, cost considerations were identified in some cases. For example, under the single chassis provider model, two IEPs told us that while an expected part of the business, repositioning chassis to ensure there is a sufficient supply of chassis where they are needed can be costly to the IEPs. The federal government provides oversight of chassis safety but has a limited economic oversight role regarding chassis. The Federal Motor Carrier Safety Administration (FMCSA) employs several inspection methods to help oversee chassis safety and compliance with regulations. For example, inspectors perform roadside inspections on commercial vehicles, including chassis, in operation. FMCSA also performs investigations of individual IEPs to oversee chassis safety. While one stakeholder GAO spoke with stated that FMCSA should consider maintaining safety ratings for IEPs—as is currently done for motor carriers—FMCSA officials told us that the current processes provide sufficient information to select IEPs for investigation. The Federal Maritime Commission (FMC) oversees ocean carriers that provide service to and from the U.S. and works to ensure a competitive and reliable ocean transportation supply system. Entities may file complaints with FMC to allege violations of the Shipping Act of 1984, as amended. One such complaint was filed in August 2020, in which the complainants allege, among other things, that although ocean carriers do not own chassis, they still control the operation of chassis pools at ports. An initial decision on this complaint is expected in August 2021. None of the entities GAO spoke with identified additional actions they would like for FMC to take regarding chassis. Why GAO Did This Study Senate Report 116-109—incorporated by reference into the explanatory statement accompanying the Further Consolidated Appropriations Act, 2020—contained a provision for GAO to study intermodal chassis. Within the U.S., some entities have expressed concerns about chassis, including limited availability of chassis in some circumstances, as well as the age and safety of chassis. This report describes selected stakeholders' views on: (1) the ways in which chassis are made available for the movement of shipping containers and the benefits and drawbacks of those models, and (2) the federal government's role in the chassis market. To address these objectives, GAO reviewed relevant reports on chassis provisioning and federal oversight. GAO interviewed representatives from FMC, FMCSA, five industry associations, and the three largest intermodal equipment providers. GAO also interviewed three ocean carriers, five port operators, and a motor carrier selected, in part, for their large number of container movements. The information obtained from these interviews provides a broad perspective of relevant issues but is not generalizable to all entities. For more information, contact Andrew Von Ah at (202) 512-2834 or vonaha@gao.gov.
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    A Winston-Salem, North Carolina, tax preparer pleaded guilty today to aiding and assisting in the preparation of a false tax return and to filing a false personal income tax return. 
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    The Department of Justice announced today that New Jersey Higher Education Student Assistance Authority (HESAA) has agreed to enter into a settlement and pay $50,000 to resolve allegations that it violated the Servicemembers Civil Relief Act (SCRA) by obtaining unlawful court judgments against two military servicemembers who co-signed student loans.
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  • Contractor Oversight: Information on the National Nuclear Security Administration’s Report on Burdensome Regulatory Requirements
    In U.S GAO News
    What GAO Found In 2019, the Department of Energy's (DOE)'s National Nuclear Security Administration (NNSA) provided a report to Congress on its findings from its survey of the seven contractors that manage and operate its nuclear security enterprise sites to identify requirements the contractors viewed as burdensome. This survey was congressionally mandated after reports by external groups found that the environment in which NNSA carried out its oversight of such management and operating (M&O) contractors was strained. GAO reviewed information on the following three areas related to NNSA's report: Comparison of NNSA's findings with related reports. GAO found that during the past 10 years, three external groups carried out studies and assessments of the nuclear security enterprise and issued reports citing ways NNSA's oversight has contributed to burden for M&O contractors. These groups were all directed by Congress to complete their studies, which were published between 2014 and 2020. Their reports also cite ways in which NNSA's oversight may have contributed to increased costs or reduced mission capabilities. NNSA's Burdensome Regulatory Requirements report explicitly identifies 91 requirements that M&O contractors found burdensome; these include requirements found in sources such as DOE and NNSA directives, federal regulations, and statutes. NNSA's approach to collecting and reporting information on requirements that M&O contractors identified as burdensome. NNSA first collected information on the requirements the contractors viewed as burdensome, and second, asked the contractors to rate these requirements based on the likelihood that the requirement could be changed and the effects such a change would have on cost savings, morale, recruitment and retention, and mission capability. While NNSA did not provide a definition to its contractors of what constituted a "burdensome" requirement, some contractors created their own definitions, while others told us the definition was understood based on the previously published related reports. GAO interviewed M&O contractor representatives and found that their definitions of what constituted a "burdensome requirement" varied. Also, the seven M&O contractors used different approaches to identify and rate requirements they considered burdensome. However, multiple M&O contractors identified the same requirements, or sources of those requirements, as burdensome. For example, one contractor identified the entire DOE Order for Program and Project Management of the Acquisition of Capital Assets (DOE Order 413.3B) as burdensome, while another contractor identified specific requirements within the same order as burdensome. NNSA actions to address matters that M&O contractors identified as burdensome. In its report, NNSA included a list of 16 matters that it committed to reviewing based on the rating data it collected from M&O contractors and input from members of the Operations and Efficiencies Board, an internal body established to improve coordination and collaboration across NNSA's sites. According to NNSA officials, 10 matters are under revision or have been changed; two matters were reviewed, but no changes were made; and four matters were reviewed, and M&O contractor input will be considered should the regulation undergo a revision in the future. NNSA's list of matters included DOE directives, federal requirements, and an M&O contract change. According to agency officials, NNSA chose to prioritize its review of certain matters because the agency did not have the resources to review all 91 requirements that M&O contractors identified as burdensome. NNSA provided technical comments on a draft of this report, which were incorporated as appropriate. Why GAO Did This Study NNSA is responsible for maintaining a safe, secure, and reliable nuclear stockpile and relies on and oversees contractors who manage and operate its laboratory and production sites. NNSA's M&O contracts include requirements for contractors to adhere to laws, regulations, and DOE and NNSA directives. NNSA also has processes to hold contractors accountable for meeting these requirements. Senate Report 115-262, accompanying the John S. McCain National Defense Authorization Act for Fiscal Year 2019, directed NNSA to collect information from its M&O contractors on specific requirements they deemed particularly burdensome and to publish this information in a report. Senate Report 115-262 also included a provision for GAO to review NNSA's report. GAO's report provides information on (1) a comparison of NNSA's findings with findings reported by external groups, (2) NNSA's approach to collecting and reporting information on requirements the M&O contractors identified as burdensome, and (3) NNSA's actions to address the requirements that the M&O contractors identified. GAO reviewed NNSA's 2019 report and supplemental documents and interviewed NNSA officials and M&O contractor representatives. For more information, contact Allison Bawden at (202) 512-3841 or bawdena@gao.gov.
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    A Bulgarian national who was convicted by a federal jury for his role in a transnational and multimillion-dollar scheme to defraud American victims was sentenced today to 121 months in prison.
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  • Fiscal Year 2013 Budget Request: U.S. Government Accountability Office
    In U.S GAO News
    This testimony discusses the U.S. Government Accountability Office’s (GAO) budget request for fiscal year (FY) 2013. We very much appreciate the confidence Congress has shown in our efforts to help support the Congress in carrying out its constitutional responsibilities and to help improve government performance and accountability for the benefit of the American people.GAO is requesting an appropriation of $526.2 million for FY 2013 to support a staffing level of 3,100. This funding level represents a modest increase of 2.9 percent over FY 2012, and is 5.4 percent below our FY 2010 level. The majority of the requested increase represents the first step in rebuilding our staff capacity to a level that will enable us to optimize the benefits we yield for the Congress and the nation.GAO’s work directly contributes to improvements in a broad array of federal programs affecting Americans everywhere and remains one of the best investments across the federal government. With this committee’s support, in FY 2011 GAO provided assistance to every standing congressional committee and about 70 percent of their subcommittees. GAO issues hundreds of products annually in response to congressional requests and mandates. Actions taken related to our findings and recommendations yielded significant results across the government, including financial benefits of $45.7 billion to reduce government expenditures, reallocate funds to more productive areas, or increase revenues. These benefits produced a return on investment of $81 for every dollar invested in GAO.GAO senior officials testified 174 times before the Congress on an array of complex issues including military and veterans disability systems, U.S. Postal Service fiscal sustainability, defense/weapons systems, and Medicare and Medicaid fraud, waste, and abuse. Fifty-seven of these hearings were related to high-risk areas and programs highlighted in GAO’s biennial high-risk report. As the Congress and the administration debate ways to improve the federal government’s long-term fiscal outlook, our mission becomes ever more critical to help identify billions of dollars in cost-saving opportunities to tighten federal budgets and identify revenue-enhancement opportunities. GAO seeks both to help position the government to better manage risks that could compromise the nation’s security, health, and solvency, and to identify opportunities for managing government resources wisely for a more sustainable future. GAO will continue to provide high-quality, high-value, and independent support to the Congress in ways that generate material benefits to the nation. GAO’s High-risk Program calls attention to opportunities for cost savings and improvements in federal agency and program management that offer the potential to save billions of dollars, dramatically improve service to the public, and strengthen confidence and trust in the performance and accountability of the U.S. government. In FY 2011, our work also included several products mandated under the Dodd-Frank Wall Street Reform Act on mortgages, securities markets, financial institutions, the Federal Reserve, and consumer protection. Additionally, our work included many other products related to health-care related reforms.As the Congress and the administration debate ways to improve the federal government’s long-term fiscal outlook, our mission becomes ever more critical to help identify billions of dollars in cost-saving opportunities to tighten federal budgets and identify revenue-enhancement opportunities. GAO seeks both to help position the government to better manage risks that could compromise the nation’s security, health, and solvency, and to identify opportunities for managing government resources wisely for a more sustainable future. GAO will continue to provide high-quality, high-value, and independent support to the Congress in ways that generate material benefits to the nation.GAO’s strategic plan for serving the Congress and the nation, 2010-2015, highlights the broad scope of our efforts to help the institution of the Congress respond to domestic and international challenges, such asaddressing current and emerging challenges to the well-being and financial security of the American people;responding to changing security threats and the challenges of global interdependence;helping transform the federal government to address national challenges; andmaximizing the value of GAO by enabling quality, timely service to the Congress and being a leading practices federal agency.
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  • Former Owners of Telemarketing Company Agree to Pay At Least $4 Million to Resolve False Claims Act Allegations
    In Crime News
    Two Florida men have agreed collectively to pay at least $4 million to resolve allegations that they violated the False Claims Act by engaging in schemes to generate prescriptions for compounded drugs and refer those prescriptions to pharmacies in exchange for illegal kickbacks. Many of those prescriptions were billed to TRICARE, the federal health care program providing insurance for active duty military personnel, military retirees, and military dependents.
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  • Puerto Rico Legislator and Two Capitol Employees Indicted for Theft and Bribery
    In Crime News
    On Wednesday, a federal grand jury in the District of Puerto Rico returned an eight-count indictment against legislator Nelson Del Valle Colon (Del Valle), a member of the Puerto Rico House of Representatives, as well as two of his employees, Nickolle Santos-Estrada (Santos) and her mother Mildred Estrada-Rojas (Estrada), for their alleged participation in a multi-year theft, bribery, and kickback conspiracy.
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  • Justice Department Settles Claim Against Texas IT Company for Using Job Advertisements that Discriminated Against and Deterred U.S. Workers in Favor of Temporary Visa Holders
    In Crime News
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  • Department of Defense: Use of Neurocognitive Assessment Tools in Post-Deployment Identification of Mild Traumatic Brain Injury
    In U.S GAO News
    Traumatic brain injury (TBI) has emerged as a serious concern among U.S. forces serving in military operations in Afghanistan and Iraq. The widespread use of improvised explosive devices in these conflicts increases the likelihood that servicemembers will sustain a TBI, which the Department of Defense (DOD) defines as a traumatically induced structural injury and/or physiological disruption of brain function as a result of an external force. TBI cases within DOD are generally classified as mild, moderate, severe, or penetrating. From 2000 to March 2011 there were a total of 212,742 TBI cases reported by the Defense and Veterans Brain Injury Center within DOD. A majority of these cases, 163,181, were classified as mild traumatic brain injuries (mTBI)--commonly referred to as concussions. Early detection of injury is critical in TBI patient management. Diagnosis of moderate and severe TBI usually occurs in a timely manner due to the obvious and visible nature of the head injury. Identification of mTBI presents a challenge due to its less obvious nature. With mTBI, there may be no observable head injury. In addition, in the combat theater, an mTBI may not be identified if it occurs at the same time as other combat injuries that are more visible or life-threatening, such as orthopedic injuries or open wounds. Furthermore, some of the symptoms of mTBI--such as irritability and insomnia--are similar to those associated with other conditions, such as post-traumatic stress disorder. Although the majority of patients with mTBI recover quickly with minimal intervention, a subset of patients develops lingering symptoms that interfere with social and occupational functioning. Accurate and timely identification of mTBI is important as treatment can mitigate the physical, emotional, and cognitive effects of the injury. Neurocognitive deficits associated with mTBI can be identified by neurocognitive assessment tools. These tools generally consist of a series of tests that measure cognitive performance areas that may be impaired by an mTBI such as attention, judgment, and memory. Identification of mTBI in servicemembers who served in Afghanistan and Iraq has been the subject of recent media attention, with particular attention focused on the proper use of neurocognitive assessment tools to screen all servicemembers postdeployment for deficits or symptoms related to mTBI. In this context and in response to congressional request, this report describes (1) DOD's post-deployment policy on the use of neurocognitive assessment tools as a stand-alone initial screen to identify servicemembers who may have sustained an mTBI during deployment; (2) what informed DOD's decisions to establish this post-deployment policy; and (3) mTBI experts' views on the science related to DOD's policy decision.DOD does not require that all servicemembers be screened post-deployment using a neurocognitive assessment tool but does require that all servicemembers be screened using a set of TBI screening questions. According to DOD officials, this policy was informed by findings and recommendations from several task forces and expert panel reports, and scientific studies. Additionally, mTBI experts told us that the scientific evidence supports DOD's policy. For example, these experts told us that neurocognitive assessment tools cannot determine whether low cognitive function is caused by an mTBI. These experts told us, however, that neurocognitive assessment tools can be useful as part of a full clinical evaluation for a person who has already screened positive for a possible mTBI.
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  • Medicare: Additional Reporting on Key Staffing Information and Stronger Payment Incentives Needed for Skilled Nursing Facilities [Reissued with revisions on Aug. 10, 2021.]
    In U.S GAO News
    What GAO Found Medicare covers short-term care for residents in about 15,500 skilled nursing facilities (SNF) after a hospital stay. GAO's analysis of 2019 staffing data found that almost all SNFs frequently met a federal requirement for a registered nurse (RN) on site for 8 hours per day. Fewer SNFs frequently met two other staffing measures that specify different numbers of nursing hours per resident per day. For example, about half of SNFs frequently met Centers for Medicare & Medicaid Services (CMS) case-mix measures—hours worked per resident that vary based on the medical needs of each SNF's residents—that CMS uses to set SNF staffing ratings. Further, about one-quarter of SNFs frequently met staffing thresholds for minimum RN and total nurse staffing that a CMS staffing study identified as needed to avoid quality problems. SNFs are not subject to these quality thresholds for ratings or as requirements, but many stakeholders have recommended that they be used as SNF staffing thresholds. Percent of Skilled Nursing Facilities (SNFs) That Met Registered (RN) Nurse Staffing Requirement or Measures, 2019 CMS reports certain key staffing information—such as RN overall staffing hours—on its Care Compare website, but does not report other important information. For example, GAO found that average RN staffing hours decreased about 40 percent on weekends, but CMS does not directly report this information. This limits the ability of beneficiaries to make informed choices among SNFs when choosing a facility. GAO estimated that in 2018 Medicare spent over $5 billion on critical incidents that CMS defines as potentially preventable—which are mostly about 377,000 hospital readmissions occurring within 30 days of the SNF admission. Current law directs CMS to make reductions of up to 2 percent to certain SNFs' payments to incentivize them to improve care, but does not address additional reductions. Experts have noted that payment incentives under current law may not be sufficient to motivate SNFs to improve their staffing, which in turn could lead to reductions in critical incidents. Without stronger payment incentives, Medicare is unlikely to reduce the billions in spending on potentially preventable critical incidents or the patient harm that can occur from them. Why GAO Did This Study In 2019, Medicare spent nearly $28 billion on care provided to 1.5 million beneficiaries in SNFs—a type of nursing facilty that provides residents short-term rehabilitation care after a hospital stay rather than long-term nursing home care that Medicare does not cover. SNFs must meet federal standards to participate in Medicare. CMS rates SNFs on factors such as staffing and quality of care and publishes its ratings on the Care Compare website. GAO was asked to examine SNF staffing and rates of critical incidents. This report examines (among other objectives): SNF performance on staffing measures, CMS reporting of staffing information on Care Compare, and Medicare payments for critical incidents. GAO analyzed CMS staffing and critical incidents data, information on Care Compare, and Medicare claims data for 2018 and 2019. GAO also interviewed CMS officials and other stakeholders such as key researchers and beneficiary groups.
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    In Crime News
    The Department of Justice today announced that United Microelectronics Corporation, Inc. (UMC), a Taiwan semiconductor foundry, pleaded guilty to criminal trade secret theft and was sentenced to pay a $60 million fine, in exchange for its agreement to cooperate with the government in the investigation and prosecution of its co-defendant, a Chinese state-owned-enterprise.
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    In Crime News
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