Briefs

U.S. Departments of Justice, HHS, Labor, Office of Personnel Management and TriCenturion Receive NHCAA Fraud 'Investigation of the Year' Honorable Mention

PHOENIX, Nov 18, 2008 /PRNewswire-USNewswire via COMTEX/ -- D.C. Anesthesiologist Guilty of Fraudulent Billings; Providing Paroled Former Federal Employee Prescription Narcotics for Illegal Distribution

Doctor Forced to Forfeit Porsche, Pay $5,000,000 in Criminal Restitution

The National Health Care Anti-Fraud Association (NHCAA) today presented the 2008 Fraud "Investigation of the Year" Honorable Mention to the U.S Departments of Justice, Health and Human Services and Labor, along with the Office of Personnel Management and TriCenturion for their work in uncovering a Washington D.C. area physician's role in illegally billing public and private payers for services never rendered and prescribing narcotics to a paroled former federal employee who sold them on the street. The award is being presented Tuesday, November 18, 2008, at NHCAA's Annual Training Conference in Phoenix, Arizona, the association's premiere annual event, recognized industry-wide as the nation's leading health care anti-fraud forum.

Flags were first raised when data mining by TriCenturion, a contractor for the Centers for Medicare and Medicaid Services (CMS), showed that Marin McLaren, M.D., was billing private insurance companies, the Federal Employees Health Benefits Plan and the Department of Labor, Office of Workers' Compensation excessively for injections. Because of the volume of information, investigators sought the assistance of the National Drug Intelligence Center for data analysis, asking them to pay particular attention to claims for TEI injections which required special equipment including fluoroscopic image guidance and 3.5 inch needles. Ultimately it was determined that McLaren was filing fraudulent claims and did not own the equipment necessary to do these injections.

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