October 18, 2021

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Orlando Cardiologist Pays $6.75 Million to Resolve Allegations of Performing Unnecessary Medical Procedures

9 min read
<div>Dr. Ashish Pal, a cardiologist based in Orlando, Florida, has paid $6.75 million to resolve allegations that he violated the False Claims Act by performing medically unnecessary ablations and vein stent procedures.</div>
Dr. Ashish Pal, a cardiologist based in Orlando, Florida, has paid $6.75 million to resolve allegations that he violated the False Claims Act by performing medically unnecessary ablations and vein stent procedures.

More from: September 15, 2021

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  • U.S.-Based Promoter of Foreign Cryptocurrency Companies Charged in over $11 Million Securities Fraud Scheme
    In Crime News
    A California man was charged in a complaint unsealed today for his alleged participation in a coordinated cryptocurrency and securities fraud scheme that used purported digital currency platforms and foreign-based financial accounts.
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  • COVID-19: Efforts to Increase Vaccine Availability and Perspectives on Initial Implementation
    In U.S GAO News
    What GAO Found The federal government has taken several actions to increase the availability of COVID-19 vaccine doses and indicated it expects to have enough doses available for all adults in the United States by the end of May. As of April 1, 2021, the government had purchased 1.2 billion doses of one- and two-dose regimen vaccines. Also, vaccine companies reported making additional manufacturing sites operational, among other actions to expand capacity and mitigate challenges. Federal officials said projecting future availability of vaccine doses can be difficult, in part because of uncertainty surrounding complex manufacturing processes. Given this uncertainty, coupled with the significant manufacturing and distribution increases needed to have enough vaccine doses available for all adults, managing public expectations is critical. GAO's prior work has found that timely, clear, and consistent communication about vaccine availability is essential to ensure public confidence and trust, especially as initial vaccine implementation did not match expectations. COVID-19 Vaccination Site Stakeholders GAO interviewed identified challenges with initial COVID-19 vaccine implementation. For example, some stakeholders said states often did not have information critical to distribution at the local level, such as how many doses they would receive and when. The federal government has begun initiatives—outlined in a national response strategy—to improve implementation, such as creating new vaccination sites. In its March 2021 distribution strategy, CDC provided a high-level description of its activities and noted that more details would be included in future reports to Congress. To meet the expectations set by recent announcements, such as the planned expansion of vaccine eligibility to all adults and the introduction of tools to help individuals find vaccines, it will be imperative that the federal government effectively coordinate and communicate its plans, as GAO recommended in September 2020. Why GAO Did This Study Providing the public with safe and effective vaccines to prevent COVID-19 is crucial to mitigating the public health and economic impacts of the disease. The U.S. had almost 30 million reported cases and over 545,000 reported deaths as of March 27, 2021. The federal government took a critical step in December 2020 in authorizing the first two COVID-19 vaccines and beginning distribution of doses across the nation. The government had distributed about 180.6 million vaccine doses, and about 147.8 million doses had been administered, as of March 27, 2021, according to Centers for Disease Control and Prevention (CDC) data. The CARES Act includes a provision for GAO to report on its ongoing monitoring and oversight efforts related to the COVID-19 pandemic. This report examines, among other issues, actions the federal government has taken to increase the availability of COVID-19 vaccine doses, and challenges with initial vaccine implementation—that is, prioritizing, allocating, distributing, and administering vaccine doses—identified by stakeholders and steps the federal government has taken to improve vaccine implementation. GAO reviewed documents from the Departments of Defense and Health and Human Services, transcripts of public briefings, data from CDC, and interviewed or received written responses from federal officials, vaccine company representatives, and select public health stakeholders. GAO incorporated technical comments from the Department of Defense, the Department of Health and Human Services, and the Federal Emergency Management Agency as appropriate. For more information, contact Alyssa M. Hundrup at (202) 512-7114 or hundrupa@gao.gov.
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  • Secretary Blinken’s Call with EU High Representative for Foreign Affairs and Security Policy Borrell
    In Crime Control and Security News
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  • Commercial Vehicle Security: Risk-Based Approach Needed to Secure the Commercial Vehicle Sector
    In U.S GAO News
    Numerous incidents around the world have highlighted the vulnerability of commercial vehicles to terrorist acts. Commercial vehicles include over 1 million highly diverse truck and intercity bus firms. Within the Department of Homeland Security (DHS), the Transportation Security Administration (TSA) has primary federal responsibility for ensuring the security of the commercial vehicle sector, while vehicle operators are responsible for implementing security measures for their firms. GAO was asked to examine: (1) the extent to which TSA has assessed security risks for commercial vehicles; (2) actions taken by key stakeholders to mitigate identified risks; and (3) TSA efforts to coordinate its security strategy with other federal, state, and private sector stakeholders. GAO reviewed TSA plans, assessments, and other documents; visited a nonrandom sample of 26 commercial truck and bus companies of varying sizes, locations, and types of operations; and interviewed TSA and other federal and state officials and industry representatives.TSA has taken actions to evaluate the security risks associated with the commercial vehicle sector, including assessing threats and initiating vulnerability assessments, but more work remains to fully gauge security risks. Risk assessment uses a combined analysis of threat, vulnerability, and consequence to estimate the likelihood of terrorist attacks and the severity of their impact. TSA conducted threat assessments of the commercial vehicle sector and has also cosponsored a vulnerability assessment pilot program in Missouri. However, TSA's threat assessments generally have not identified the likelihood of specific threats, as required by DHS policy. TSA has also not determined the scope, method, and time frame for completing vulnerability assessments of the commercial vehicle sector. In addition, TSA has not conducted consequence assessments, or leveraged the consequence assessments of other sectors. As a result of limitations with its threat, vulnerability, and consequence assessments, TSA cannot be sure that its approach for securing the commercial vehicle sector addresses the highest priority security needs. Moreover, TSA has not developed a plan or time frame to complete a risk assessment of the sector. Nor has TSA completed a report on commercial trucking security as required by the Implementing Recommendations of the 9/11 Commission Act (9/11 Commission Act). Key government and industry stakeholders have taken actions to strengthen the security of commercial vehicles, but TSA has not assessed the effectiveness of federal programs. TSA and the Department of Transportation (DOT) have implemented programs to strengthen security, particularly those emphasizing the protection of hazardous materials. States have also worked collaboratively to strengthen commercial vehicle security through their transportation and law enforcement officials' associations, and the establishment of fusion centers. TSA also has begun developing and using performance measures to monitor the progress of its program activities to secure the commercial vehicle sector, but has not developed measures to assess the effectiveness of these actions in mitigating security risks. Without such information, TSA will be limited in its ability to measure its success in enhancing commercial vehicle security. While TSA has also taken actions to improve coordination with federal, state, and industry stakeholders, more can be done to ensure that these coordination efforts enhance security for the sector. TSA signed joint agreements with DOT and supported the establishment of intergovernmental and industry councils to strengthen collaboration. TSA and DOT completed an agreement to avoid duplication of effort as required by the 9/11 Commission Act. However, some state and industry officials GAO interviewed reported that TSA had not clearly defined stakeholder roles and responsibilities consistent with leading practices for collaborating agencies. TSA has not developed a means to monitor and assess the effectiveness of its coordination efforts. Without enhanced coordination with the states, TSA will have difficulty expanding its vulnerability assessments.
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  • Secretary Blinken’s Call with French Foreign Minister Le Drian
    In Crime Control and Security News
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  • Laboratory Owner Pleads Guilty to $73 Million Medicare Kickback Scheme
    In Crime News
    A Florida man pleaded guilty yesterday in the Southern District of Florida for his role in a $73 million conspiracy to defraud Medicare by paying kickbacks to a telemedicine company to arrange for doctors to authorize medically unnecessary genetic testing. The scheme exploited temporary amendments to telehealth restrictions enacted during the COVID-19 pandemic that were intended to ensure access to care for Medicare beneficiaries.
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  • University of Arkansas Professor Indicted for Wire Fraud and Passport Fraud
    In Crime News
    The Department of Justice announced today that Simon Saw-Teong Ang, 63, of Fayetteville, Arkansas, was indicted by a federal grand jury in the Western District of Arkansas on 42 counts of wire fraud and two counts of passport fraud.
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  • Under Secretary for Civilian Security, Democracy, and Human Rights Uzra Zeya, Special Envoy for the Northern Triangle Ricardo Zuniga, Bureau of Population, Refugees, and Migration Deputy Assistant Secretary Marta Youth, and Senior Advisor to the USAID Administrator and Executive Director of the USAID Northern Triangle Task Force Michael Camilleri On the Collaborative Migration Management Strategy and Root Causes Strategy Toward Migration
    In Crime Control and Security News
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  • Future Years Defense Program: Actions Needed to Improve Transparency of DOD’s Projected Resource Needs
    In U.S GAO News
    Congress needs the best available data about DOD's resource tradeoffs between the dual priorities of transformation and fighting the global war on terrorism. To help shape its priorities, in 2001 DOD developed a capabilities-based approach focused on how future adversaries might fight, and a risk management framework to ensure that current defense needs are balanced against future requirements. Because the Future Years Defense Program (FYDP) is DOD's centralized report providing DOD and Congress data on current and planned resource allocations, GAO assessed the extent to which the FYDP provides Congress visibility over (1) projected defense spending and (2) implementation of DOD's capabilities-based defense strategy and risk management framework.The FYDP provides Congress with mixed visibility over DOD's projected spending for the current budget year and at least four succeeding years. On the one hand, it provides visibility over many programs that can be aggregated so decision makers can see DOD's broad funding priorities by showing shifts in appropriation categories. On the other hand, in some areas DOD likely understates the future costs of programs in the FYDP because it has historically employed overly optimistic planning assumptions in its budget formulations. As such, DOD has too many programs for the available dollars, which often leads to program instability, costly program stretchouts, and delayed program termination decisions. Also, the FYDP does not reflect costs of ongoing operations funded through supplemental appropriations. Since September 2001, DOD has received $158 billion in supplemental appropriations to support the global war on terrorism, and DOD expects to request another supplemental in January 2005 to cover operations in Iraq and Afghanistan. While DOD officials stated they are uncertain of the amount of the request, some requirements they intend to fund with the supplemental appropriation have already been identified, such as temporarily increasing the Army's force structure. Defining costs during ongoing operations is challenging and supplemental appropriations are sometimes necessary; however, not considering the known or likely costs of ongoing operations expected to continue into the new fiscal year as part of larger budget deliberations will preclude DOD and congressional decision makers from fully examining the budget implications of the global war on terrorism. The FYDP provides Congress limited visibility over important DOD initiatives. While DOD is considering how to link resources to defense capabilities and the risk management framework, it does not have specific plans to make these linkages in the FYDP, in part because the initiatives have not been fully defined or implemented. Because the FYDP lacks these linkages, decision makers cannot use it to determine how a proposed increase in capability would affect the risk management framework, which balances dimensions of risk, such as near term operational risk versus risks associated with mid- to long-term military challenges.
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  • Cybersecurity: HHS Defined Roles and Responsibilities, but Can Further Improve Collaboration
    In U.S GAO News
    What GAO Found The Department of Health and Human Services' (HHS) Office of Information Security is responsible for managing department-wide cybersecurity. HHS clearly defined responsibilities for the divisions within that office to, among other things, document and implement a cybersecurity program, as required by the Federal Information Security Modernization Act of 2014. For healthcare and public health critical infrastructure sector cybersecurity, HHS also defined responsibilities for five HHS entities. Among these entities are the Health Sector Cybersecurity Coordination Center, which was established to improve cybersecurity information sharing in the sector, and the Healthcare Threat Operations Center, a federal interagency program co-led by HHS and focused on, among other things, providing descriptive and actionable cyber data. Private-sector partners that receive information provided by the Health Sector Cybersecurity Coordination Center informed GAO that they could benefit from receiving more actionable threat information. However, this center does not routinely receive such information from the Healthcare Threat Operations Center, and therefore is not positioned to provide it to sector partners. This lack of sharing is due, in part, to HHS not describing coordination between the two entities in procedures defining their responsibilities for cybersecurity information sharing. Until HHS formalizes coordination for the two entities, they will continue to miss an opportunity to strengthen information sharing with sector partners. Further, HHS entities led, or participated in, seven collaborative groups that focused on cybersecurity in the department and healthcare and public health sector. These entities regularly collaborated on cyber response efforts and provided cybersecurity information, guidance, and resources through these groups and other means during COVID-19 between March 2020 and December 2020. In addition, the HHS entities coordinated with the Department of Homeland Security's Cybersecurity and Infrastructure Security Agency (CISA) to address cyber threats associated with COVID-19. Further, the HHS entities fully demonstrated consistency with four of the seven leading collaboration practices that GAO identified, and partially addressed the remaining three (see table). Until HHS takes action to fully demonstrate the remaining three leading practices, it cannot ensure that it is improving cybersecurity within the department and the healthcare and public health sector. Extent to Which the Department of Health and Human Services (HHS) Demonstrated Leading Practices for Collaborating Leading practice Extent to which the HHS working groups demonstrated the leading practice Define and track outcomes and accountability ◑ - five groups met this practice Bridge organizational cultures ● – all seven groups met this practice Identify leadership ● – all seven groups met this practice Clarify roles and responsibilities ◑ - six groups met this practice Include relevant participants in the group ● – all seven groups met this practice Identify resources ● – all seven groups met this practice Document and regularly update written guidance and agreements ◑ - six groups met this practice Source: GAO analysis of HHS documentation. | GAO-21-403 Why GAO Did This Study HHS and the healthcare and public health sector rely heavily on information systems to fulfill their missions, including delivering healthcare-related services and responding to national health emergencies, such as COVID-19. Federal laws and guidance have set requirements for HHS to address cybersecurity within the department and the sector. Federal guidance also requires collaboration and coordination to strengthen cybersecurity at HHS and in the sector. GAO was asked to review HHS's organizational approach to address cybersecurity. This report discusses HHS's roles and responsibilities for departmental cybersecurity; HHS's roles and responsibilities for healthcare and public health sector cybersecurity; and HHS's efforts to collaborate to manage its cybersecurity responsibilities. To perform its work, GAO reviewed documentation describing HHS's cybersecurity roles and responsibilities, assessed those responsibilities for fragmentation, duplication, and overlap, and evaluated the department's collaborative efforts against GAO's leading practices for collaboration. GAO also interviewed relevant officials at HHS and CISA, and in the sector.
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  • Former Veterans Affairs Doctor Sentenced to Prison for Sexual Abuse of Veterans
    In Crime News
    A former doctor of osteopathic medicine who previously worked at the Veterans Affairs (VA) Medical Center in Beckley, West Virginia, was sentenced today for depriving veterans of their civil rights under color of law by sexually abusing them.
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  • Justice Department Announces Closing of Investigation into 2014 Officer Involved Shooting in Cleveland, Ohio
    In Crime News
    The Justice Department announced today that the career prosecutors reviewing the independent federal investigation into the fatal shooting of Tamir Rice on Nov. 22, 2014, in Cleveland, Ohio, found insufficient evidence to support federal criminal charges against Cleveland Division of Police (CDP) Officers Timothy Loehmann and Frank Garmback.  Yesterday the department notified counsel for Mr. Rice’s family of the decision and today sent a letter to Mr. Rice’s family explaining the findings of the investigation and reasons for the decision.
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  • Veterans Affairs: Use of Additional Funding for COVID-19 Relief
    In U.S GAO News
    What GAO Found The Department of Veterans Affairs (VA) received $19.6 billion in supplemental funding—additional funding above the annual appropriation—in March 2020 to respond to the COVID-19 pandemic. GAO's analysis of VA data shows that through March 2021, VA had obligated $9.9 billion and expended $8.1 billion of the supplemental funding. Department of Veterans Affairs (VA) Reported Obligations and Expenditures of CARES Act and Families First Coronavirus Response Act Funding through March 2021 Note: An obligation is a definite commitment that creates a legal liability to pay, and an expenditure is the actual spending of money. The majority of the obligated supplemental funding ($8.3 billion) was obligated by VA's Veterans Health Administration (VHA) for care provided to veterans by non-VA providers, the additional costs of salaries (such as for overtime) and related expenses of VHA staff, supplies and materials, and support for homeless veterans, due to COVID-19 response. The remaining obligations included costs of VA's transition to telehealth and telework during the COVID-19 pandemic, primarily through the Office of Information Technology (OIT). According to spend plan documents and department officials, VA plans to obligate its remaining $9.7 billion in funding on activities including COVID-19 testing, purchasing supplies and equipment, and distributing COVID-19 vaccines. VA mainly relies on its standard financial management processes to oversee the use of supplemental funds, including establishing new versions of standard financial codes to account for and report on use of funds through VA's financial system. VA also collected details about the use of supplemental funding, such as descriptions of the activities for which funds were obligated, that were not available in its financial system. In addition, the VA components that received the majority of the supplemental funding—VHA and OIT—set up additional processes and issued guidance specific to the use of supplemental funding, such as establishing councils to review funding requests. Why GAO Did This Study As of April 14, 2021, VA reported 224,538 cumulative veteran cases of COVID-19, and 11,366 deaths. The CARES Act and Families First Coronavirus Response Act included supplemental funding for COVID-19 relief, and the Consolidated Appropriations Act, 2021, permitted VA additional flexibility to transfer these funds across the department. The CARES Act also included a provision for GAO to report on its ongoing monitoring and oversight efforts related to the COVID-19 pandemic. This report examines 1) VA's obligations and expenditures of COVID-19 supplemental funding, as well as its plans to obligate remaining funds, and 2) how VA oversees the use of COVID-19 supplemental funds. GAO reviewed VA data on obligations, expenditures, and spend plans for COVID-19 supplemental funding, as well as contracting documentation and documentation on the processes and guidance VA developed to oversee the use of funds. GAO interviewed VA officials responsible for oversight of the supplemental funding, including officials from five regional networks, selected based on funding levels and geography, to gather information about their roles in overseeing the use of and accounting for supplemental funding. VA reviewed a draft of this report and provided a technical comment, which was incorporated as appropriate. For more information, contact Sharon M. Silas at (202) 512-7114 or silass@gao.gov.
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  • Attorney General William P. Barr Announces Updates on Operation Legend at Roundtable in Albuquerque, New Mexico
    In Crime News
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  • Attorney General William P. Barr Announces Results of Operation Legend
    In Crime News
    Earlier today, Attorney General William P. Barr announced the results of Operation Legend, which was first launched in Kansas City, Missouri, on July 8, 2020, and then expanded to Chicago and Albuquerque, New Mexico, on July 22, 2020; to Cleveland, Ohio, Detroit, Michigan, and Milwaukee, Wisconsin, on July 29, 2020; to St. Louis, Missouri, and Memphis, Tennessee, on August 6, 2020; and to Indianapolis, Indiana, on August 14, 2020.
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    In Travel
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  • Afghanistan Security: Some Improvements Reported in Afghan Forces’ Capabilities, but Actions Needed to Enhance DOD Oversight of U.S.-Purchased Equipment
    In U.S GAO News
    What GAO Found Since the Resolute Support mission began in 2015, the Afghan National Defense and Security Forces (ANDSF) have improved some fundamental capabilities, such as high-level operational planning, but continue to rely on U.S. and coalition support to fill several key capability gaps, according to Department of Defense (DOD) reporting. DOD has initiatives to address some ANDSF capability gaps, such as a country-wide vehicle maintenance and training effort, but DOD reports it does not expect the ANDSF to develop and sustain independent capabilities in some areas, such as logistics, for several years. Examples of U.S.-Purchased Equipment for the Afghan National Defense and Security Forces While DOD has firsthand information on the abilities of the Afghan Air Force and Special Security Forces to operate and maintain U.S.-purchased equipment, it has little reliable information on the equipment proficiency of conventional ANDSF units. U.S. and coalition advisors are embedded at the tactical level for the Air Force and Special Security Forces, enabling DOD to directly assess those forces' abilities. However, the advisors have little direct contact with conventional ANDSF units on the front lines. As a result, DOD relies on those units' self-assessments of tactical abilities, which, according to DOD officials, can be unreliable. GAO's analysis of three critical equipment types illustrated the varying degrees of DOD's information (see figure above). For example, DOD provided detailed information about the Air Force's ability to operate and maintain MD-530 helicopters and the Special Security Forces' ability to operate and maintain Mobile Strike Force Vehicles; however, DOD had limited information about how conventional forces operate and maintain radios and Mobile Strike Force Vehicles. DOD's lack of reliable information on conventional forces' equipment operations and maintenance abilities adds to the uncertainty and risk in assessing the progress of DOD efforts in Afghanistan. Why GAO Did This Study Developing independently capable ANDSF is a key component of U.S. and coalition efforts to create sustainable security and stability in Afghanistan under the North Atlantic Treaty Organization (NATO)-led Resolute Support mission. The United States is the largest contributor of funding and personnel to Resolute Support, providing and maintaining ANDSF equipment, along with training, advising, and assistance to help the ANDSF effectively use and sustain the equipment in the future. House Report 114-537 included a provision for GAO to review the ANDSF's capability and capacity to operate and sustain U.S.-purchased weapon systems and equipment. This report addresses (1) what has been reported about ANDSF capabilities and capability gaps and (2) the extent to which DOD has information about the ANDSF's ability to operate and maintain U.S.-purchased equipment. To conduct this work, GAO analyzed DOD and NATO reports and documents, examined three critical equipment types, and interviewed DOD officials in the United States and Afghanistan. This is a public version of a sensitive report issued in September 2018. Information that DOD deemed sensitive has been omitted.
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  • Civil Rights Division Opens Investigation into Potential Discrimination in Public Contracting
    In Crime News
    The Department of Justice Civil Rights Division has opened an investigation into whether the public contracting and procurement practices of Kansas City, Missouri comply with the U.S. Constitution and the Civil Rights Act of 1964.
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  • Justice Department Issues Proposed Rule and Model Legislation to Reduce Gun Violence
    In Crime News
    Today, the Department of Justice announced two new steps to help address the continuing epidemic of gun violence affecting communities across the country. First, the department issued a notice of proposed rulemaking that makes clear that when individuals use accessories to convert pistols into short-barreled rifles, they must comply with the heightened regulations on those dangerous and easily concealable weapons. Second, the department published model legislation to help states craft their own “extreme risk protection order” laws, sometimes called “red flag” laws. By sending the proposed rule to the Federal Register and publishing the model legislation today, the department has met the deadlines that the Attorney General announced alongside President Biden in April. 
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