Question

In November 2015, Ebong Aloysius Tilong was indicted on charges of conspiracy to commit healthcare fraud, healthcare fraud, conspiracy to pay kickbacks, payment of kickbacks, and conspiracy to commit money laundering. Investigators believe that Tilong and his wife Marie Neba fraudulently billed Medicare millions for home health services that were either medically unnecessary or were not provided. Tilong and Neba operated Fiango Home healthcare, Inc., a home health agency doing business in Houston, Texas. Trial evidence showed that Tilong paid illegal kickbacks to patient recruiters for referring Medicare beneficiaries to Fiango for purported home health services. Tilong also paid illegal kickbacks to Medicare beneficiaries and falsified medical records in order to bill Medicare for home health services that were, in actuality, not medically necessary or not provided. Tilong also attempted to destroy evidence, blackmail a witness, and suborning perjury from witnesses. From February 2006 to June 2015, Fiango was paid over $13 million in fraudulent Medicare reimbursements. In June 2017, Tilong pleaded guilty to filing fraudulent tax returns related to Fiango. In August 2017, Neba was sentenced to 75 years in prison. Tilong was scheduled for sentencing in October 2017, but failed to appear. In December 2017, Tilong was sentenced in absentia to 80 years in prison. Investigators believe that Tilong fled the United States and is believed to be residing in Cameroon.

1. What was significant about the fraud and abuse issue(s) you learned about?
2. What attempts were made, or could be made, to stop the fraud or abuse?
3. What was the role of the Office of the Inspector General in addressing fraud or abuse in the case(s) you watched?

Answer 1

home health Service supervision should be more careful both off site and on site.

communication interprofession was not adequate

Regulatory bodies should give sudden visit