oversight

Office of Personnel Management (OPM) Inspector General (OIG) investigations closed CY 2015 - CY 2016

Published by the Office of Personnel Management, Office of Inspector General on 2017-03-06.

Below is a raw (and likely hideous) rendition of the original report. (PDF)

Description of document:                 Office of Personnel Management (OPM) Inspector General
                                         (OIG) investigations closed CY 2015 - CY 2016

Requested date:                          25-December-2016

Released date:                           12-January-2017

Posted date:                             06-March-2017

Source of document:                      Attention: FOIA Request
                                         U.S. Office of Personnel Management
                                         FOIA Requester Service Center
                                         1900 E Street, NW
                                         Room 5415
                                         Washington, D.C. 20415-7900
                                         Fax:    202-606-1719
                                         Email: foia@opm.gov




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                           UNITED STATES OFFICE OF PERSONNEL MANAGEMENT
                                                  Washington, OC 20415



  Office of the
Inspector General




                                                 January 12, 2017

                                                                              FOIA Request# 2017-02326




         This is in response to your Freedom oflnformation Act (FOIA) request of December 25, 2016,
         in which you asked for a copy of a list of Office of Personnel Management (OPM) Office of the
         Inspector General (OIG) investigations closed during calendar years 2015 and 2016. The OPM
         OIG received your request on December 27, 2016.

         The attached document is responsive to your request. Please note that certain information has
         been redacted to avoid the unwarranted invasion of personal privacy, pursuant to 5 U.S.C. §§
         552(b )(6) and (b )(7)(C).

         For any further assistance or to discuss any aspect of your request, you may contact the
         undersigned at 202-606-2030, as well as the OPM FOIA Public Liaison at 202-606-1153.
         Additionally, you may contact the Office of Government Information Services (OGIS) to inquire
         about the FOIA mediation services they offer. The contact information for OGIS is as follows:
                        Office of Government Information Services
                        National Archives and Records Administration
                        8601 Adelphi Road-OGIS
                        College Park, Maryland 20740
                        Email:        ogis@nara.gov
                        Telephone: 202-741-5770
                        Toll-free:    1-877-684-6448
                        Facsimile: 202-741-5769

         If you are not satisfied with the response to this request, you may administratively appeal by
         writing to:
                         Robin M. Richardson
                         FOIA Appeals Officer
                         Office of the Inspector General
                         1900 E Street, NW
                         Room 6400
                         Washington, DC 20415


         www.opm.gov                                                                           www.usajobs.gov
Please include a copy of your initial request, a copy of this letter, and a statement explaining why
you disagree with our decision. You should write "Freedom of Information Act Appeal" on the
front of the envelope and on the first page of the appeal letter. Your appeal must be postmarked
within 90 days of the date of this response.


                                                      Regards,



                                                      Kevin T. Miller
                                                      Attorney-Advisor

Enclosure
                                                                          OPM-OIG Office of Investigations

                                                                     Closed Investigation Disposition Summary
                                                                    Start Date: 01/01/2015 End Date: 12/31/2016
                                                          Total Count of Cases: 137 Total OPM Recovery Net: 26,082,910.15
                                                                   This report generated on 01/03/2017 08:04:22 AM
                                                                          Date
Count   Case Number                          Case Title             Investigation     Closed Status             OPM Organization                    Program                                 Allegation                      Allegation Subtype          Disposition Summary                               Notes                      OPM Recovery Net             Staff
                                                                        Closed
 1      I 2010 00078   Bennie Alcoy                                 01/02/2015      Complete            Retirement Services            CSRS (Civil Service Retirement    Deceased Annuitant                                                         Criminal Action                    This case was primarly completed in                   44,067.49 (b) (6), (b) (7)(C)
                                                                                                                                       System)                                                                                                                                         Magnum.
 2      I-14-00201     Selena Murphy                                01/08/2015    Complete            Retirement Services              CSRS (Civil Service Retirement    Deceased Annuitant                                                         Criminal Action                    Closing case. CFO memo was                           124,950.66
                                                                                                                                       System)                                                                                                                                         emailed. Case file sent to ASAC
                                                                                                                                                                                                                                                                                      (b) (6), (b) (7)(
                                                                                                                                                                                                                                                                                                        via UPS tracking number 1Z
                                                                                                                                                                                                                                                                                      (b) (6), (b) (7)(C)
 3      I-14-00564     (b) (6), (b) (7)(C)                          01/15/2015    Complete            Healthcare and Insurance         FEHBP (Federal Employees Health   Doctor Shopper                                  Pharmacy                   Prosecution Declined              Case was presented in the MDGA and                           0.00
                                                                                                                                       Benefits Program)                                                                                                                              was declined for criminal prosecution
                                                                                                                                                                                                                                                                                      based on the age of the subject (74)
                                                                                                                                                                                                                                                                                      and low financial impact to the
                                                                                                                                                                                                                                                                                      Government. This matter is now
                                                                                                                                                                                                                                                                                      closed.
 4      I-13-00640     Qualitest Pharmaceuticals, Inc.              01/21/2015    Lack of Resources   Healthcare and Insurance         FEHBP (Federal Employees Health   Off-Label Marketing, Services Not Rendered      Drug Manufacturer                                            Closing due to lack of resources.                            0.00
                                                                                                                                       Benefits Program)
 5      I-14-01116     (b) (6), (b) (7)(C)                          01/23/2015    Lack of Resources   Healthcare and Insurance         FEHBP (Federal Employees Health   Billing Dispute                                                                                              Declined LOR-NOA                                             0.00
                                                                                                                                       Benefits Program)
 6      I-12-00185     Todd Mitnick                                 01/28/2015    Complete            Federal Investigative Services   Background Investigations         Fabrication (Recovery), Fabrication (Targeted   OPM Contractor             Administrative Action, Criminal Criminal Conviction/Debarment (Admin)                    86,181.86
                                                                                                                                                                         Review), False Statement                                                   Action
 7      I-14-01183     (b) (6), (b) (7)(C)                          01/29/2015    Complete            Retirement Services              Other                             PII Breach                                      OPM Employee               Management Advisory Issued updated as requested                                                0.00

 8      I-12-00037     Tuan Vu                                      01/30/2015    Complete            Healthcare and Insurance         FEHBP & FEDVIP                    Services Not Rendered                           Dentist                    Civil Action, Criminal Action     Aspects of case were documented in                    195,452.82
                                                                                                                                                                                                                                                                                      MAGNUM.
 9      I 2010 00028   Sakina Parks                                 02/03/2015    Complete            Retirement Services              CSRS (Civil Service Retirement    Deceased Annuitant, Representative Payee                                   Criminal Action                                                                           7,936.80
                                                                                                                                       System)
 10     I 2011 00065   (b) (6), (b) (7)(C)                          02/03/2015    Lack of Resources   Healthcare and Insurance         FEHBP (Federal Employees Health   Services Not Rendered                                                                                        The reporting agent recommends that                          0.00
                                                                                                                                       Benefits Program)                                                                                                                              this complaint be closed pending the
                                                                                                                                                                                                                                                                                      receipt of substantive information that
                                                                                                                                                                                                                                                                                      demonstrates that the FEHBP has
                                                                                                                                                                                                                                                                                      been significantly affected by the
                                                                                                                                                                                                                                                                                      allegations set forth in the complaint.

 11     I-14-00699     Louicot Alexandre                            03/02/2015    Complete            Healthcare and Insurance         FEHBP (Federal Employees Health   Forgery                                         Pharmacy                   Criminal Action                                                                                0.00
                                                                                                                                       Benefits Program)
 12     I 2007 00104   Dr. Arnold Nerenberg                         03/12/2015    Complete            Healthcare and Insurance         FEHBP (Federal Employees Health   Services Not Rendered                                                      Administrative Action, Criminal                                                                0.00
                                                                                                                                       Benefits Program)                                                                                            Action
 13     I 2011 00359   DFW Rehab and Diagnostics                    03/12/2015    Complete            Healthcare and Insurance         FEHBP (Federal Employees Health   Services Not Rendered                                                      Criminal Action                                                                          39,328.94
                                                                                                                                       Benefits Program)
 14     I-12-00378     Dr. William Arkell                           03/12/2015    Complete            Healthcare and Insurance         FEHBP (Federal Employees Health   Phantom Provider                                Home Health                Criminal Action                   Case is recommended for closing after                  18,411.38
                                                                                                                                       Benefits Program)                                                                                                                              defendant pleaded guilty to an
                                                                                                                                                                                                                                                                                      information and was sentenced to 32
                                                                                                                                                                                                                                                                                      months imprisonment.
 15     I-14-00308     University of Iowa                           03/12/2015    Lack of Resources   Healthcare and Insurance         FEHBP (Federal Employees Health   Billing Dispute, Miscoding/Upcoding             Hospital                                                     This case is recommended for closure                         0.00
                                                                                                                                       Benefits Program)                                                                                                                              due to lack of OPM resources to
                                                                                                                                                                                                                                                                                      investigate based on the departure of
                                                                                                                                                                                                                                                                                      SA (b) (6), (b) (7)(C)
 16     I 2010 00461   Genzyme Corporation                          03/13/2015    Complete            Healthcare and Insurance         FEHBP (Federal Employees Health   False Claim, Off-Label Marketing                Drug Manufacturer          Civil Action                                                                          1,578,606.74
                                                                                                                                       Benefits Program)
 17     I 2010 00871   Astrazeneca Pharmaceuticals LP               03/18/2015    No Action Required Healthcare and Insurance          FEHBP (Federal Employees Health   Off-Label Marketing                             Drug Manufacturer                                            Case file sent to HQ via UPS tracking                        0.00
                                                                                                                                       Benefits Program)                                                                                                                              number 1(b) (6), (b) (7)(C)

 18     I-14-01227     Elouise Lee                                  03/31/2015    Complete            Retirement Services              CSRS (Civil Service Retirement    Deceased Annuitant                                                         Administrative Action             OPM Voluntary Repayment                                43,265.57
                                                                                                                                       System)                                                                                                                                        Agreement.
 19     I 2011 00036   Shire Specialty Pharmaceuticals              04/03/2015    Complete            Healthcare and Insurance         FEHBP (Federal Employees Health   Off-Label Marketing                             PBM                        Civil Action                      This case is being closed as a civil                1,178,121.61
                                                                                                                                       Benefits Program)                                                                                                                              resolution has been reached.
 20     I 2011 00028   Ishtaiq Mal k                                05/15/2015    Complete            Healthcare and Insurance         FEHBP (Federal Employees Health   Miscoding/Upcoding                                                         Civil Action                                                                          3,482,203.00
                                                                                                                                       Benefits Program)
 21     I 2011 00051   DeRamus Hearing Aid Center                   05/15/2015    Complete            Healthcare and Insurance         FEHBP (Federal Employees Health   Services Not Rendered                                                      Criminal Action                                                                         325,000.00
                                                                                                                                       Benefits Program)
 22     I-14-00299     Luis Miguel Buzzi                            05/15/2015    Complete            Healthcare and Insurance         FEHBP (Federal Employees Health   Kickback, Services Not Rendered                                            Criminal Action                                                                                0.00
                                                                                                                                       Benefits Program)
 23     I-13-00018     Dr. Marco Ayulo                              05/18/2015    Complete            Healthcare and Insurance         FEHBP (Federal Employees Health   Off-Label Marketing, Services Not Rendered      Physician Group Practice   Civil Action                      On February, 2, 2015, Dr. Ayulo                         5,034.59
                                                                                                                                       Benefits Program)                                                                                                                              entered into a Final Settlement
                                                                                                                                                                                                                                                                                      Agreement with the United States to
                                                                                                                                                                                                                                                                                      resolve the Civil issues identified. The
                                                                                                                                                                                                                                                                                      total settlement amount is $92,503.00
                                                                                                                                                                                                                                                                                      of which the FEHBP share is
                                                                                                                                                                                                                                                                                      $5,190.30 for losses incurred by the
                                                                                                                                                                                                                                                                                      FEHBP Program minus the 3%
                                                                                                                                                                                                                                                                                      Department of Justice fee 3%
                                                                                                                                                                                                                                                                                      ($155.71) for a total recovery of
                                                                                                                                                                                                                                                                                      $5,034.59. The funds should come to
                                                                                                                                                                                                                                                                                      OPM as an IPAC distr bution.




                                                                                                                                                                                                                                                                                                                                                                       1
24   I-13-00286     Ali Ben-Jacob / Cache Valley Cancer   05/18/2015   Complete            Healthcare and Insurance         FEHBP (Federal Employees Health   Services Not Rendered                          Physician Group Practice   Civil Action                    On 12/22/14, Dr. Ali Ben-Jacob, MD            101,174.90 (b) (6), (b) (7)(C)
                    Treatment                                                                                               Benefits Program)                                                                                                                           agreed to pay $2,317,867.16 to resolve
                                                                                                                                                                                                                                                                        its civil liability arising from the
                                                                                                                                                                                                                                                                        company's submission of false claims
                                                                                                                                                                                                                                                                        to the Medicare, TRICARE, and the
                                                                                                                                                                                                                                                                        FEHBP Programs. The total
                                                                                                                                                                                                                                                                        settlement amount is $2,317,867.16 of
                                                                                                                                                                                                                                                                        which $104,304.02 will be paid to OPM
                                                                                                                                                                                                                                                                        for losses incurred by the FEHBP
                                                                                                                                                                                                                                                                        Program. A criminal and forfeiture
                                                                                                                                                                                                                                                                        action of an estimated $1,556,557.00
                                                                                                                                                                                                                                                                        are still outstanding by the FDA.

25   I-13-00560     Utah Pain and Rehab                   05/18/2015   Complete            Healthcare and Insurance         FEHBP (Federal Employees Health   Miscoding/Upcoding                             Physical Therapy           Civil Action                    On March 23, 2015, after mediation by           9,425.61
                                                                                                                            Benefits Program)                                                                                                                           the District Judge Wells (District of UT),
                                                                                                                                                                                                                                                                        Utah Pain and Rehabilitation entered
                                                                                                                                                                                                                                                                        into a Final Settlement Agreement with
                                                                                                                                                                                                                                                                        the United States to resolve the Civil
                                                                                                                                                                                                                                                                        issues identified. The total settlement
                                                                                                                                                                                                                                                                        amount is $28,800.00 of which the
                                                                                                                                                                                                                                                                        FEHBP prorated share should be
                                                                                                                                                                                                                                                                        33.74% of the settlement total or
                                                                                                                                                                                                                                                                        $9,717.12 for losses incurred by the
                                                                                                                                                                                                                                                                        FEHBP Program minus the 3%
                                                                                                                                                                                                                                                                        Department of Justice fee 3%
                                                                                                                                                                                                                                                                        ($291.51) for a total recovery of
                                                                                                                                                                                                                                                                        $9,425.61. Payments will be made in
                                                                                                                                                                                                                                                                        installments beginning April 1, 2015 at
                                                                                                                                                                                                                                                                        $600 per month for 48 months. The
                                                                                                                                                                                                                                                                        funds should come to OPM as an IPAC
                                                                                                                                                                                                                                                                        distr bution. This matter is now closed
                                                                                                                                                                                                                                                                        by OIG.
26   I 2009 00859   (b) (6), (b) (7)(C)                   05/19/2015   Complete            Federal Investigative Services   Background Investigations         Fabrication (Recovery)                         OPM Contractor             Administrative Action           offset; debarment sanctions                   136,531.40
27   I 2010 00228                                         05/19/2015   Complete            Federal Investigative Services   Background Investigations         Fabrication (Targeted Review)                  OPM Contractor             Administrative Action           offset; debarment sanctions                   170,131.64
28   I 2011 00002                                         05/19/2015   Complete            Federal Investigative Services   Background Investigations         Fabrication (Recovery)                         OPM Contractor             Administrative Action           contract offset; debarment sanctions           89,320.76
29   I-12-00314     Jonathan Hargett                      05/26/2015   Complete            Healthcare and Insurance         FEHBP (Federal Employees Health   Forgery, Miscoding/Upcoding, Services Not      Enrollee/Member            Criminal Action                                                               943,519.46
                                                                                                                            Benefits Program)                 Rendered
30   I 2007 00109   Najerausa International DBA           05/28/2015   Complete            Healthcare and Insurance         FEHBP (Federal Employees Health   Services Not Rendered                                                     Criminal Action                                                               158,564.93
                    Continental Pharmacy                                                                                    Benefits Program)
31   I 2011 00027   Vascular Solutions Inc                05/28/2015   Complete            Healthcare and Insurance         FEHBP (Federal Employees Health   Off-Label Marketing                                                       Civil Action                    Civil action has returned approximately        11,456.27
                                                                                                                            Benefits Program)                                                                                                                           $13,000 to the FEHBP.

32   I-14-00786     John Stephen Davis                    05/28/2015   Complete            Retirement Services              CSRS (Civil Service Retirement    Deceased Annuitant                                                        Criminal Action                                                               218,820.06
                                                                                                                            System)
33   I 2011 00423   Northampton Hospital Company LLC 05/29/2015        Complete            Healthcare and Insurance         FEHBP (Federal Employees Health   Not Medically Necessary                        Hospital                   Civil Action                    Civil Settlement Agreement was                  9,700.00
                    dba Easton Hospital                                                                                     Benefits Program)                                                                                                                           reached.
34   I-13-00203     (b) (6), (b) (7)(C)              05/29/2015        Complete            Federal Investigative Services   Background Investigations         Fabrication (Targeted Review)                  OPM Employee               Administrative Action,          summary updated -
                                   0.00
                                                                                                                                                                                                                                        Prosecution Declined            admin sanctions
                                                                                                                                                                                                                                                                        (termination/debarment)
35   I-12-00415     Cardionet, Inc.                       06/12/2015   Complete            Healthcare and Insurance         FEHBP (Federal Employees Health   False Diagnosis                                                           Civil Action                                                                  137,123.83 Lori
                                                                                                                            Benefits Program)
36   I-13-00252     Mohamad Ghraowi                       06/12/2015   Complete            Healthcare and Insurance         FEHBP (Federal Employees Health   Miscoding/Upcoding, Not Medically Necessary,                              Criminal Action                 The facility, South Texas                            0.00
                                                                                                                            Benefits Program)                 Off-Label Marketing, Services Not Rendered                                                                Comprehensive Cancer Center, LLC.,
                                                                                                                                                                                                                                                                        was criminally convicted, placed on 5
                                                                                                                                                                                                                                                                        years probation and forfeited
                                                                                                                                                                                                                                                                        $900,000.00.
37   I-13-00403     Sean Orr                              06/18/2015   Complete            Healthcare and Insurance         FEHBP (Federal Employees Health   Miscoding/Upcoding                             Physician                  Civil Action                    To correct the recovery amount of             107,400.12
                                                                                                                            Benefits Program)                                                                                                                           $42,020.77 to $39,599.99.

38   I-13-00589     Lee Concetta Vaccaro                  06/22/2015   Complete            Retirement Services              CSRS (Civil Service Retirement    Deceased Annuitant                                                        Civil Action, Criminal Action   The defendant paid restitution in full to      50,945.00
                                                                                                                            System)                                                                                                                                     the Distrct Attorney's office one day
                                                                                                                                                                                                                                                                        before his sentencing. As a result of
                                                                                                                                                                                                                                                                        that there is no court document
                                                                                                                                                                                                                                                                        regarding restitution. However, he was
                                                                                                                                                                                                                                                                        sentenced to Petty Larceny and
                                                                                                                                                                                                                                                                        unconditional discharge
39   I-13-00006     Safeway Inc.                          10/19/2015   Complete            Healthcare and Insurance         FEHBP (Federal Employees Health   Billing Dispute                                Pharmacy                   Prosecution Declined                                                                 0.00
                                                                                                                            Benefits Program)
40   I-13-00319     Flore Simpson                         10/29/2015   Complete            Retirement Services              CSRS (Civil Service Retirement    Deceased Annuitant                                                        Civil Action                    UPS tracking number for case file - (b) (6)   110,328.00
                                                                                                                            System)
41   I-15-00193     (b) (6), (b) (7)(C)                   10/30/2015   Lack of Resources   Healthcare and Insurance         FEHBP (Federal Employees Health   Billing Dispute                                                                                           Low FEHB exposure and lack of                        0.00
                                                                                                                            Benefits Program)                                                                                                                           resources to warrant further
                                                                                                                                                                                                                                                                        investigation.
42   I-13-00960     James Conrad                          11/02/2015   Complete            Retirement Services              CSRS & FERS                       Deceased Annuitant                                                        Criminal Action                 Case complete barring any appeals.            141,135.12
43   I-13-00961     (b) (6), (b) (7)(C)                   11/02/2015   Complete            Healthcare and Insurance         FEHBP (Federal Employees Health   Enrollment Eligibility                                                    Prosecution Declined                                                                0.00
                                                                                                                            Benefits Program)
44   I 2011 00194   OtisMed Corporation                   11/04/2015   Complete            Healthcare and Insurance         FEHBP (Federal Employees Health   Not Medically Necessary                                                   Civil Action, Criminal Action                                                 257,807.11
                                                                                                                            Benefits Program)
45   I 2011 00354   Garden State Cardiovascular           11/04/2015   No Action Required Healthcare and Insurance          FEHBP (Federal Employees Health   Miscoding/Upcoding                             Physician                                                  Case settled, no money allotted to the               0.00
                    Specialists PC                                                                                          Benefits Program)                                                                                                                           FEHBP.
46   I-15-00546     Leonard Jackson                       11/23/2015   Complete            Retirement Services              CSRS (Civil Service Retirement    Deceased Annuitant                                                        Criminal Action                                                               197,012.23
                                                                                                                            System)
47   I-15-00225     Lillie Norman                         11/27/2015   Complete            Retirement Services              CSRS (Civil Service Retirement    Deceased Annuitant                                                        Criminal Action                 No handwritten notes associated to             26,467.36
                                                                                                                            System)                                                                                                                                     case file.
48   I-13-00147     Nuvasive                              11/30/2015   Complete            Healthcare and Insurance         FEHBP (Federal Employees Health   Off-Label Marketing                                                       Civil Action                    case file sent to HQ via ups tracking         467,482.58
                                                                                                                            Benefits Program)                                                                                                                           number (b) (6), (b) (7)(C)
49   I-13-00386     Maryland Orthopedics                  11/30/2015   No Action Required Healthcare and Insurance          FEHBP (Federal Employees Health   Billing Dispute, Miscoding/Upcoding, Not       Physician                                                  Case file sent to HQ via UPS tracking                0.00
                                                                                                                            Benefits Program)                 Medically Necessary, Services Not Rendered                                                                number (b) (6), (b) (7)(C)

50   I-13-00596     (b) (6), (b) (7)(C)                   12/03/2015   Complete            Healthcare and Insurance         FEHBP (Federal Employees Health   Miscoding/Upcoding                                                        Criminal Action                                                               137,893.00
                                                                                                                            Benefits Program)




                                                                                                                                                                                                                                                                                                                                               2
51   I 2003 00016   United Medical Lab                  12/09/2015   Complete            Healthcare and Insurance         FEHBP (Federal Employees Health   Services Not Rendered                          Physician Group Practice   Prosecution Declined     Criminal and Civil prosecution declined.         0.00 (b) (6), (b) (7)(C)
                                                                                                                          Benefits Program)
52   I-15-00196     Eleni Solos-Kountouris              01/14/2016   Complete            Healthcare and Insurance         FEHBP (Federal Employees Health   False Claim                                    Provider                   Civil Action                                                          1,640.11
                                                                                                                          Benefits Program)
53   I-14-00547     Samer Kuzbari                       01/20/2016   Complete            Healthcare and Insurance         FEHBP (Federal Employees Health   Miscoding/Upcoding                                                        Civil Action             Case closed as Kuzbari signed a             79,659.31
                                                                                                                          Benefits Program)                                                                                                                    settlement agreement.
54   I-14-00816     Homer A. Johnson                    01/20/2016   Complete            Retirement Services              CSRS (Civil Service Retirement    Deceased Annuitant                                                        Criminal Action          This case is being closed as Johnson        83,279.39
                                                                                                                          System)                                                                                                                              has received sentencing.
55   I-15-01451     (b) (6), (b) (7)(C)                 01/21/2016   No Action Required Healthcare and Insurance          FEHBP (Federal Employees Health   False Claim                                                                                                                                         0.00
                                                                                                                          Benefits Program)
56   I 2011 00148   Kentwood Pharmacy                   02/02/2016   Complete            Healthcare and Insurance         FEHBP (Federal Employees Health   Services Not Rendered                                                     Criminal Action                                                      40,160.80
                                                                                                                          Benefits Program)
57   I-15-01544     Kroger                              02/04/2016   Complete            Healthcare and Insurance         FEHBP (Federal Employees Health   Contract Fraud, False Claim                    Pharmacy                   Civil Action                                                        943,064.99
                                                                                                                          Benefits Program)
58   I-13-00980     Farid Fata                          02/11/2016   Complete            Healthcare and Insurance         FEHBP (Federal Employees Health   Miscoding/Upcoding, Services Not Rendered                                 Criminal Action                                                           0.00
                                                                                                                          Benefits Program)
59   I-13-01011     DermaTran Health Solution, LLC      02/22/2016   Lack of Resources   Healthcare and Insurance         FEHBP (Federal Employees Health   Not Medically Necessary                        Pharmacy                                            Closing case due to a lack of F/U and            0.00
                                                                                                                          Benefits Program)                                                                                                                    development from referring carrier and
                                                                                                                                                                                                                                                               OIG LOR to develop case.

60   I 2011 00782   Orbit Medical Inc                   02/23/2016   Complete            Healthcare and Insurance         FEHBP (Federal Employees Health   Services Not Rendered                                                     Civil Action             Our Civil Investigation of Orbit medical    55,290.00
                                                                                                                          Benefits Program)                                                                                                                    Inc. has resulted in a settlement. The
                                                                                                                                                                                                                                                               total settlement amount is
                                                                                                                                                                                                                                                               $7,500,000.00 of which the FEHBP
                                                                                                                                                                                                                                                               share should be $57,000.00 for losses
                                                                                                                                                                                                                                                               incurred by the FEHB Program minus
                                                                                                                                                                                                                                                               the 3% Department of Justice fee 3%
                                                                                                                                                                                                                                                               ($1,710.00) for a total recovery of
                                                                                                                                                                                                                                                               $55,290.00. The funds should come to
                                                                                                                                                                                                                                                               OPM as an IPAC distr bution.
                                                                                                                                                                                                                                                               Investigation is now complete. 
                                                                                                                                                                                                                                                               
                                                                                                                                                                                                                                                               Delayed closing due to CLEAR being
                                                                                                                                                                                                                                                               offline.
61   I-12-00548     MedEquip One Inc.                   02/23/2016   Complete            Healthcare and Insurance         FEHBP (Federal Employees Health   Miscoding/Upcoding                             DME Supplier               Civil Action             On August 24, 2015, MedEquip One            44,054.20
                                                                                                                          Benefits Program)                                                                                                                    LLC entered into a settlement
                                                                                                                                                                                                                                                               agreement with the United States
                                                                                                                                                                                                                                                               Department of Justice regarding
                                                                                                                                                                                                                                                               MedEquip's submission of claims to the
                                                                                                                                                                                                                                                               covered Government Health Programs
                                                                                                                                                                                                                                                               listed for payment for DME from
                                                                                                                                                                                                                                                               January 1, 2009 through June 30,
                                                                                                                                                                                                                                                               2012, for which MedEquip did not have
                                                                                                                                                                                                                                                               sufficient medical record
                                                                                                                                                                                                                                                               documentation to establish health care
                                                                                                                                                                                                                                                               program coverage. The total settlement
                                                                                                                                                                                                                                                               amount is $1,250,000.00 of which the
                                                                                                                                                                                                                                                               FEHBP share should be $45,416.70
                                                                                                                                                                                                                                                               for losses incurred by the FEHB
                                                                                                                                                                                                                                                               Program minus the 3% Department of
                                                                                                                                                                                                                                                               Justice fee 3% ($1,362.50) for a total
                                                                                                                                                                                                                                                               recovery of $44,054.20. The funds
                                                                                                                                                                                                                                                               should come to OPM as an IPAC
                                                                                                                                                                                                                                                               distr bution. 
                                                                                                                                                                                                                                                               
                                                                                                                                                                                                                                                               Investigation is now complete. Case to
                                                                                                                                                                                                                                                               be closed at this time.
                                                                                                                                                                                                                                                               
                                                                                                                                                                                                                                                               Delayed closure due to CLEAR being
                                                                                                                                                                                                                                                               offline.
62   I-12-00751     Franklin Pharmacy                   02/23/2016   Complete            Healthcare and Insurance         FEHBP (Federal Employees Health   Services Not Rendered                          Pharmacy                   Prosecution Declined                                                      0.00
                                                                                                                          Benefits Program)
63   I-13-00827     CATVIDEO                            03/03/2016   Complete            Human Resources Solutions        Other                             Contract Fraud                                                            Allegation(s) Not                                                         0.00
                                                                                                                                                                                                                                      Substantiated
64   I-14-00825     (b) (6), (b) (7)(C)                 03/03/2016   Complete            OIG                              Other                             Employee Misconduct                            OPM Employee               Administrative Action,                                                    0.00
                                                                                                                                                                                                                                      Dismissed
65   I-14-01071                                         03/03/2016   Complete            Federal Investigative Services   Other                             False Statement, Supervisor/Manager            OPM Employee               Allegation(s) Not                                                         0.00
                                                                                                                                                            Misconduct                                                                Substantiated
66   I-14-01182     Government iPhone                   03/03/2016   Complete            OIG                              Other                             Employee Misconduct, Other                     OPM Employee               Dismissed                                                                 0.00
67   I-15-00579     (b) (6), (b) (7)(C)                 03/03/2016   Complete            Federal Investigative Services   Background Investigations         Other, PII Breach                              OPM Contractor             Prosecution Declined                                                      0.00
68   I-15-01184     Winvale/CSID                        03/03/2016   Complete            Employee Services                Agency & Veterans Support         Contract Fraud, Contractor Misconduct,         OPM Employee               Allegation(s) Not                                                         0.00
                                                                                                                                                            Employee Misconduct                                                       Substantiated
69   I 2011 00755   (b) (6), (b) (7)(C)                 03/07/2016   Complete            Federal Investigative Services   Background Investigations         Fabrication (Recovery)                                                    Administrative Action                                               234,607.36
70   I 2011 00238                                       03/08/2016   Complete            Retirement Services              Disability                        False Statement                                                           Criminal Action          Case file sent to HQ via UPS tracking       30,057.47
                                                                                                                                                                                                                                                               number (b) (6), (b) (7)(C)

71   I-13-00860     Chiropractic and Rehab Associates   03/08/2016   No Action Required Healthcare and Insurance          FEHBP (Federal Employees Health   Services Not Rendered                                                                              After preliminary inquiry, the case was          0.00
                                                                                                                          Benefits Program)                                                                                                                    closed due to lack of resources and
                                                                                                                                                                                                                                                               FBI closing their case.
72   I-14-00521     Frank Johannissohn                  03/09/2016   Complete            Retirement Services              CSRS (Civil Service Retirement    Eligibility Issue, Identity Theft                                         Criminal Action                                                           0.00
                                                                                                                          System)
73   I 2011 00165   Inspire Pharmaceuticals Inc         03/10/2016   Complete            Healthcare and Insurance         FEHBP (Federal Employees Health   Off-Label Marketing                            Drug Manufacturer          Civil Action                                                        584,531.21
                                                                                                                          Benefits Program)
74   I-12-00445     Desai                               03/10/2016   Complete            Healthcare and Insurance         FEHBP (Federal Employees Health   Miscoding/Upcoding                             Family Care                Civil Action                                                         19,593.38
                                                                                                                          Benefits Program)
75   I-14-00840     Alpha Direct Compounding            03/14/2016   Complete            Healthcare and Insurance         FEHBP (Federal Employees Health   Miscoding/Upcoding, Not Medically Necessary,   Pharmacy                   Civil Action                                                         14,964.77
                                                                                                                          Benefits Program)                 Services Not Rendered
76   I-12-00243     (b) (6), (b) (7)(C)                 03/31/2016   Complete            Federal Investigative Services   Background Investigations         Fabrication (Recovery)                         OPM Contractor             Administrative Action    A final NPD was issued. No further         108,520.71
                                                                                                                                                                                                                                                               action is required.




                                                                                                                                                                                                                                                                                                                                     3
77    I-15-01248     Donald Waiberman                    04/18/2016   Complete            Federal Investigative Services   Background Investigations         Lost/Stolen Property, Missing Credentials,   OPM Contractor             Criminal Action                                                                             0.00 (b)   (6), (b) (7)(C)
                                                                                                                                                             Misuse/Abuse of Credentials
78    I-14-00829     Gina Adams                          04/19/2016   Complete            Federal Investigative Services   Background Investigations         Fabrication (Recovery), False Statement      OPM Employee               Administrative Action, Criminal Case File Inspection completed                        10,000.00
                                                                                                                                                                                                                                     Action
79    I-12-00291     Millennium Laboratories             05/11/2016   Complete            Healthcare and Insurance         FEHBP (Federal Employees Health   Kickback                                     Outpatient Facility        Civil Action                    Hard copy file sent to ASAC (b) (6), (b) (7)( via   4,807,992.13
                                                                                                                           Benefits Program)                                                                                                                         UPS tracking number (b) (6), (b) (7)(C)

80    I-13-00071     Ajrawat Washington Pain Medical     05/11/2016   Complete            Healthcare and Insurance         FEHBP (Federal Employees Health   False Diagnosis, Services Not Rendered       Physician                  Criminal Action                                                                      862,167.46
                     Cntr                                                                                                  Benefits Program)
81    I-15-02264     Apex Compounding Pharmacy           05/11/2016   Lack of Resources   Healthcare and Insurance         FEHBP (Federal Employees Health   Miscoding/Upcoding                                                                                                                                                  0.00
                                                                                                                           Benefits Program)
82    I 2011 00250   Center for Hearing                  05/12/2016   No Action Required Healthcare and Insurance          FEHBP (Federal Employees Health   Not Medically Necessary                                                                                                                                             0.00
                                                                                                                           Benefits Program)
83    I-12-00086     Century Ambulance Service           05/12/2016   Complete            Healthcare and Insurance         FEHBP (Federal Employees Health   Services Not Rendered                        Ambulance                  Civil Action                        case file sent to HQ via UPS tracking            214,550.99
                                                                                                                           Benefits Program)                                                                                                                             number (b) (6), (b) (7)(C)
84    I-15-01546     MedMatch                            05/12/2016   Complete            Healthcare and Insurance         FEHBP (Federal Employees Health   False Claim, Kickback                        Pharmacy                   Civil Action                                                                          39,233.34
                                                                                                                           Benefits Program)
85    I-15-00194     (b) (6), (b) (7)(C)                 05/19/2016   No Action Required Healthcare and Insurance          FEHBP (Federal Employees Health   Identity Theft                               Physician                                                      The USAO has determined that there is                   0.00
                                                                                                                           Benefits Program)                                                                                                                             no monetary loss to the government in
                                                                                                                                                                                                                                                                         this matter, and that health care fraud
                                                                                                                                                                                                                                                                         will not be charged in this case. The
                                                                                                                                                                                                                                                                         USAO will be pursuing social security
                                                                                                                                                                                                                                                                         fraud and aggravated identity theft
                                                                                                                                                                                                                                                                         charges. Since there is no loss to the
                                                                                                                                                                                                                                                                         FEHBP and no health care fraud
                                                                                                                                                                                                                                                                         charges being applied, the reporting
                                                                                                                                                                                                                                                                         agent suggests that this complaint be
                                                                                                                                                                                                                                                                         closed. The USAO will keep the
                                                                                                                                                                                                                                                                         reporting agent abreast if issues arise
                                                                                                                                                                                                                                                                         that may affect the FEHBP.

86    I-15-00785     (b) (6), (b) (7)(C)                 05/19/2016   Complete            Federal Investigative Services   Background Investigations         False Statement, Other, Travel or Purchase Card OPM Employee            Administrative Action                                                                       0.00
                                                                                                                                                             Misuse
87    I-14-00837     Norma McNeil                        05/26/2016   Complete            Retirement Services              CSRS & FERS                       Eligibility Issue                                                       Criminal Action                                                                      132,527.06
88    I-14-00298     Miguel Espinosa (b) (6), (b) (7)(   05/31/2016   Complete            Healthcare and Insurance         FEHBP (Federal Employees Health   Kickback                                                                Criminal Action                                                                      246,499.43
                                                                                                                           Benefits Program)
89    I-12-00240     Electronic Funds Transfer (EFT)     06/06/2016   Complete            Retirement Services              CSRS & FERS                       Identity Theft                                                          Criminal Action, Dismissed,                                                                 0.00
                     Fraud Scheme                                                                                                                                                                                                    Prosecution Declined
90    I-13-00167     Lillian R. Jenkins                  06/10/2016   Complete            Retirement Services              CSRS (Civil Service Retirement    Deceased Annuitant                                                      Prosecution Declined                                                                        0.00
                                                                                                                           System)
91    I-14-01341     Paradigm Spine LLC                  06/21/2016   Complete            Healthcare and Insurance         FEHBP (Federal Employees Health   Kickback, Off-Label Marketing                DME Supplier               Civil Action                                                                          38,450.93
                                                                                                                           Benefits Program)
92    I-12-00005     (b) (6), (b) (7)(C)                 06/23/2016   Complete            Federal Investigative Services   Background Investigations         Fabrication (Recovery)                       OPM Contractor             Administrative Action,                                                                40,595.48
                                                                                                                                                                                                                                     Prosecution Declined
93    I-12-00464                                         06/23/2016   Complete            Employee Services                USA Jobs                          Contract Fraud, Supervisor/Manager Misconduct OPM Employee              Management Advisory Issued          supervisor/mgr misconduct -                             0.00
                                                                                                                                                                                                                                                                         contracting issue
94    I-12-00296     St. Michael's Medical Center        06/27/2016   No Action Required Healthcare and Insurance          FEHBP (Federal Employees Health   False Diagnosis                              Outpatient Facility                                            FEHBP not included in settlement                        0.00
                                                                                                                           Benefits Program)
95    I-15-00793     (b) (6), (b) (7)(C)                 06/27/2016   No Action Required Healthcare and Insurance          FEHBP (Federal Employees Health   Doctor Shopper                               Enrollee/Member                                                Criminal Action and drug rehab by the                   0.00
                                                                                                                           Benefits Program)                                                                                                                             State, FEHBP not included in
                                                                                                                                                                                                                                                                         prosecution.
96    I-15-00281     Eric A. Wiegandt                    07/05/2016   Complete            Healthcare and Insurance         FEHBP (Federal Employees Health   Services Not Rendered                                                   Criminal Action                                                                       93,595.95
                                                                                                                           Benefits Program)
97    I-15-01933     (b) (6), (b) (7)(C)                 07/08/2016   No Action Required Healthcare and Insurance          FEGLI                             False Statement, Theft                                                                                      The case is being closed due to lack of                 0.00
                                                                                                                                                                                                                                                                         prosecution by Federal and State
                                                                                                                                                                                                                                                                         courts, due to the victim being
                                                                                                                                                                                                                                                                         deceased.
98    I-15-00125     Spencer Pastick                     08/16/2016   Complete            Healthcare and Insurance         FEHBP (Federal Employees Health   Doctor Shopper                               Enrollee/Member            Criminal Action                                                                         1,885.36
                                                                                                                           Benefits Program)
99    I-15-01549     Durbin Pharmacy                     08/19/2016   Complete            Healthcare and Insurance         FEHBP (Federal Employees Health   False Claim, Kickback                        Pharmacy                   Civil Action                                                                            7,081.51
                                                                                                                           Benefits Program)
100   I-15-01551     Well Health                         08/19/2016   Complete            Healthcare and Insurance         FEHBP (Federal Employees Health   False Claim, Kickback                        Pharmacy                   Civil Action                                                                         195,452.26
                                                                                                                           Benefits Program)
101   I-15-01552     North Beaches Pharmacy              08/19/2016   Complete            Healthcare and Insurance         FEHBP (Federal Employees Health   False Claim, Kickback                        Pharmacy                   Civil Action                                                                             125.01
                                                                                                                           Benefits Program)
102   I-16-00109     Topical Specialists Pharmacy        08/19/2016   Complete            Healthcare and Insurance         FEHBP (Federal Employees Health   False Claim, Kickback                        Pharmacy                   Civil Action                        Case file sent to HQ via UPS tracking            115,957.01
                                                                                                                           Benefits Program)                                                                                                                             number (b) (6), (b) (7)(C)

103   I-15-01060     Irene Murphy                        09/06/2016   Complete            Retirement Services              CSRS (Civil Service Retirement    Deceased Annuitant                                                      Criminal Action                                                                      216,811.05
                                                                                                                           System)
104   I-15-01548     Qmed RX/New England Home            09/07/2016   Complete            Healthcare and Insurance         FEHBP (Federal Employees Health   False Claim, Kickback                        Pharmacy                   Civil Action                                                                          63,332.06
                     Infusion                                                                                              Benefits Program)
105   I-13-00684     Drayer Physical Therapy Institute   10/03/2016   Complete            Healthcare and Insurance         FEHBP (Federal Employees Health   Miscoding/Upcoding                           Physician Group Practice   Civil Action                                                                         189,134.96
                                                                                                                           Benefits Program)
106   I-15-00031     Axiom Mobile Imaging                10/03/2016   Complete            Healthcare and Insurance         FEHBP (Federal Employees Health   False Claim                                                             Criminal Action                                                                             0.00
                                                                                                                           Benefits Program)
107   I-12-00546     Westfield Hospital                  10/11/2016   Complete            Healthcare and Insurance         FEHBP (Federal Employees Health   False Diagnosis, Phantom Provider            Physician                  Administrative Action, Civil                                                          67,532.48
                                                                                                                           Benefits Program)                                                                                         Action
108   I-14-00458     Juanita Norwood                     10/11/2016   Complete            Retirement Services              CSRS & FERS                       Deceased Annuitant, Representative Payee                                Criminal Action                     Case file sent to HQ via UPS tracking            115,440.65
                                                                                                                                                                                                                                                                         number (b) (6), (b) (7)(C)

109   I 2010 00083   Anna Sharwarko                      10/14/2016   Lack of Resources   Retirement Services              CSRS (Civil Service Retirement    Deceased Annuitant                                                                                          Subject cannot be located/cannot be                     0.00
                                                                                                                           System)                                                                                                                                       arrested
110   I 2011 00066   (b) (6), (b) (7)(C)                 10/14/2016   Lack of Resources   Healthcare and Insurance         FEHBP (Federal Employees Health   Miscoding/Upcoding                                                                                                                                                  0.00
                                                                                                                           Benefits Program)
111   I-14-01223     Clarice Hilderbrand                 10/14/2016   Complete            Retirement Services              CSRS (Civil Service Retirement    Deceased Annuitant                                                      Prosecution Declined                                                                        0.00
                                                                                                                           System)
112   I-15-00161     OREX MEDICAL CENTER                 10/14/2016   No Action Required Healthcare and Insurance          FEHBP (Federal Employees Health   False Claim                                  Provider                                                                                                               0.00
                     CORPORATION                                                                                           Benefits Program)




                                                                                                                                                                                                                                                                                                                                                     4
113   I-15-00214     Kathryn Miller                    10/14/2016   Complete            Retirement Services                CSRS (Civil Service Retirement    Deceased Annuitant                                                 Criminal Action                 On 12/10/2015, ROBERT MILLER was           176,703.86 (b) (6), (b) (7)(C)
                                                                                                                           System)                                                                                                                              indicted on 2 counts of 18 U.S.C. 641 -
                                                                                                                                                                                                                                                                Theft of Public Money/Fraudulent
                                                                                                                                                                                                                                                                Conversion of Funds in the Western
                                                                                                                                                                                                                                                                District of Tennessee. On 01/06/16
                                                                                                                                                                                                                                                                Miller was arrested in Shelby County
                                                                                                                                                                                                                                                                TN and transferred to the US Marshalls
                                                                                                                                                                                                                                                                on 01/07/16. Miller had an arraignment
                                                                                                                                                                                                                                                                on 01/13/16 in US Federal court. 
                                                                                                                                                                                                                                                                
                                                                                                                                                                                                                                                                Defendant Robert Miller was sentenced
                                                                                                                                                                                                                                                                on 7/26/16 in WDTN US District Court.
                                                                                                                                                                                                                                                                Miller plead guilty to counts one and
                                                                                                                                                                                                                                                                two of the indictment for Theft of
                                                                                                                                                                                                                                                                Government Money. Miller was
                                                                                                                                                                                                                                                                sentenced to time served, 12 months
                                                                                                                                                                                                                                                                home detention, and 3 years of
                                                                                                                                                                                                                                                                supervised release. Miller was ordered
                                                                                                                                                                                                                                                                to pay restitution in the amount of
                                                                                                                                                                                                                                                                $176,703.86 to OPM and $58,267 to
                                                                                                                                                                                                                                                                the Social Security Administration. The
                                                                                                                                                                                                                                                                schedule of payments are regular
                                                                                                                                                                                                                                                                monthly installments of not less than
                                                                                                                                                                                                                                                                10% of gross monthly income. Miller is
                                                                                                                                                                                                                                                                to pay a $200 court assessment as
                                                                                                                                                                                                                                                                well. 
                                                                                                                                                                                                                                                                
                                                                                                                                                                                                                                                                This matter is now closed by OIG and a
                                                                                                                                                                                                                                                                final tracking memo was sent to the
                                                                                                                                                                                                                                                                OPM Retirement Section outlining
                                                                                                                                                                                                                                                                Investigation results.

114   I-16-00337     (b) (6), (b) (7)(C)               10/28/2016   Complete            Merit Systems Audit & Compliance   Combined Federal Campaign         Embezzlement                                                       Dismissed                       The case is being submitted for                   0.00
                                                                                                                                                                                                                                                                closure, as there is low exposure, lack
                                                                                                                                                                                                                                                                of resources, and lack of any current
                                                                                                                                                                                                                                                                OPM/Federal nexus.
115   I-14-00293                                       11/01/2016   Complete            Healthcare and Insurance           FEHBP (Federal Employees Health   OIG Courtesy Copy                                                  Dismissed, Prosecution                                                            0.00
                                                                                                                           Benefits Program)                                                                                    Declined, Subject Fled the
                                                                                                                                                                                                                                United States
116   I-14-00344     Michael Wheatley                  11/01/2016   Complete            Healthcare and Insurance           FEHBP (Federal Employees Health   Not Medically Necessary                                            Criminal Action                                                             17,431.11
                                                                                                                           Benefits Program)
117   I-14-00369     Frank McQueen Jr                  11/01/2016   Complete            Retirement Services                CSRS (Civil Service Retirement    Deceased Annuitant                                                 Criminal Action                                                             88,904.00
                                                                                                                           System)
118   I-14-00589     (b) (6), (b) (7)(C)               11/01/2016   Lack of Resources   Healthcare and Insurance           FEHBP (Federal Employees Health   Services Not Rendered                                                                                                                                0.00
                                                                                                                           Benefits Program)
119   I-15-00482     Haroutyoun Margossian             11/01/2016   Complete            Healthcare and Insurance           FEHBP (Federal Employees Health   Not Medically Necessary, Services Not Rendered Physician           Civil Action, Criminal Action                                               63,669.21
                                                                                                                           Benefits Program)
120   I-13-00449     Adventist Health System           11/03/2016   No Action Required Healthcare and Insurance            FEHBP (Federal Employees Health   Miscoding/Upcoding                             Hospital                                            Added FBI Notification Letter               42,415.96
                                                                                                                           Benefits Program)
121   I-14-00473     (b) (6), (b) (7)(C)               11/04/2016   No Action Required Healthcare and Insurance            FEHBP (Federal Employees Health   False Diagnosis, Not Medically Necessary       Enrollee/Member                                     Case closed with no action required.              0.00
                                                                                                                           Benefits Program)                                                                                                                    FEHBP not affected. Hard copy case
                                                                                                                                                                                                                                                                file contains signed copy of ROI only.


122   I 2010 00458                                     11/14/2016   Complete            Federal Investigative Services     Background Investigations         Fabrication (Recovery), False Statement        OPM Contractor      Administrative Action,          Contract Offset/Debarment Action            92,638.31
                                                                                                                                                                                                                                Prosecution Declined
123   I 2010 00824                                     11/15/2016   Complete            Federal Investigative Services     Background Investigations         Fabrication (Recovery)                         OPM Contractor      Administrative Action,                                                     184,986.64
                                                                                                                                                                                                                                Prosecution Declined
124   I-15-00960                                       11/21/2016   Complete            Employee Services                  Other                             Employee Misconduct                            OPM Employee        Administrative Action,                                                            0.00
                                                                                                                                                                                                                                Prosecution Declined
125   I-16-00479     Marie Zemo                        12/07/2016   Complete           Retirement Services                 CSRS & FERS                       Deceased Annuitant                                                 Criminal Action                                                               2,899.00
126   I 2009 00030   PAR Pharmaceutical Companies Inc. 12/12/2016   No Action Required Healthcare and Insurance            FEHBP (Federal Employees Health   Off-Label Marketing                            Drug Manufacturer                                                                                     0.00
                                                                                                                           Benefits Program)
127   I 2011 00004   (b) (6), (b) (7)(C)               12/12/2016   Complete            Federal Investigative Services     Background Investigations         Fabrication (Recovery)                         OPM Contractor      Administrative Action,         Please close pending reviewing the          107,123.65
                                                                                                                                                                                                                                Prosecution Declined           hard copy case file.
128   I-15-00651     TriCore Reference Labs            12/12/2016   Complete            Healthcare and Insurance           FEHBP (Federal Employees Health   Services Not Rendered                                              Dismissed, Prosecution                                                            0.00
                                                                                                                           Benefits Program)                                                                                    Declined
129   I-15-00653     (b) (6), (b) (7)(C)               12/12/2016   Complete            Healthcare and Insurance           FEHBP (Federal Employees Health   False Claim, False Statement, Not Medically    Provider            Allegation(s) Not                                                                 0.00
                                                                                                                           Benefits Program)                 Necessary, Services Not Rendered                                   Substantiated
130   I-15-01242                                       12/12/2016   Complete            Healthcare and Insurance           FEHBP (Federal Employees Health   Services Not Rendered                                              Subject Fled the United States                                                    0.00
                                                                                                                           Benefits Program)
131   I 2011 00723   Ricky Reaves                      12/14/2016   Complete            Federal Investigative Services     Background Investigations         Fabrication (Recovery)                         OPM Contractor      Administrative Action, Criminal close pending hard copy file review.        91,124.20
                                                                                                                                                                                                                                Action
132   I-12-00313     (b) (6), (b) (7)(C)               12/15/2016   No Action Required Healthcare and Insurance            FEHBP (Federal Employees Health   Miscoding/Upcoding                             Physician                                                                                             0.00
                                                                                                                           Benefits Program)
133   I-14-00678     BioReference Laboratories Inc.    12/15/2016   No Action Required Healthcare and Insurance            FEHBP (Federal Employees Health   Not Medically Necessary                        Laboratory                                          case file sent to UPS via tracking                0.00
                                                                                                                           Benefits Program)                                                                                                                    number (b) (6), (b) (7)(C)
134   I-15-00961     Vidascript Pharmacy               12/15/2016   No Action Required Healthcare and Insurance            FEHBP (Federal Employees Health   Not Medically Necessary                                                                                                                              0.00
                                                                                                                           Benefits Program)
135   I-14-00421     (b) (6), (b) (7)(C)               12/19/2016   No Action Required Retirement Services                 CSRS (Civil Service Retirement    Eligibility Issue                                                                                  This case was declined prosecution by             0.00
                                                                                                                           System)                                                                                                                              the Eastern District New York. This
                                                                                                                                                                                                                                                                case will be referred back to the
                                                                                                                                                                                                                                                                retirement services so they can take
                                                                                                                                                                                                                                                                other action if need be.
136   I-16-00407     Bostwick Laboratories             12/22/2016   No Action Required Healthcare and Insurance            FEHBP (Federal Employees Health   False Claim                                    Provider                                                                                              0.00
                                                                                                                           Benefits Program)
137   I 2008 00096   US et. al. and McCoyd v Abbott    12/24/2016   Complete            Healthcare and Insurance           FEHBP (Federal Employees Health   Off-Label Marketing                            Drug Manufacturer   Civil Action                    received second IPAC                      4,906,424.55
                     Laboratories                                                                                          Benefits Program)




                                                                                                                                                                                                                                                                                                                                    5