Friday, September 16, 2011

OIG CAPTURED Fugitive: Rolando Cueto

Rolando Cueto was captured on June 30, 2011 at Miami International Airport. Prior to his arrest, he was residing in Costa Rica using a fraudulent identity.
In September 2008, an indictment was filed charging Rolando Cueto and Juan Carlos Garcia with one count of Conspiracy to Commit Health Care Fraud and six counts of Health Care Fraud.
Cueto was the true owner and operator of E.O. Medical Enterprises, a durable medical equipment company operating in Hialeah, Florida. E.O. Medical submitted over $1.8 million in false claims to Medicare for medical equipment that was neither ordered by a physician nor provided to the beneficiary as claimed.
Cueto attempted to use a nominee owner to hide his involvement in the scheme. Cueto also recruited individuals to cash checks drawn on E.O. Medical's bank account, who then returned the cash to Cueto.
Garcia pleaded guilty to one count of Conspiracy to Commit Health Care Fraud and is currently serving his 2.5-year jail sentence. Garcia was also ordered to pay over $500,000 in restitution.

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What is Single Payer?

Single-payer is a term used to describe a type of financing system. It refers to one entity acting as administrator, or “payer.” In the case of health care, a single-payer system would be setup such that one entity—a government run organization—would collect all health care fees, and pay out all health care costs. In the current US system, there are literally tens of thousands of different health care organizations—HMOs, billing agencies, etc. By having so many different payers of health care fees, there is an enormous amount of administrative waste generated in the system. (Just imagine how complex billing must be in a doctor’s office, when each insurance company requires a different form to be completed, has a different billing system, different billing contacts and phone numbers—it’s very confusing.) In a single-payer system, all hospitals, doctors, and other health care providers would bill one entity for their services. This alone reduces administrative waste greatly, and saves money, which can be used to provide care and insurance to those who currently don’t have it.

What is Single Audit?

Each year, the Federal Government provides over $400 billion in grants to State, local and tribal governments, colleges, universities and other non-profit organizations (non-Federal entities). The Single Audit Act of 1984 (with amendment in 1996) and OMB Circular A-133 ("Audits of State, Local Governments, and Non-Profit Organizations") provide audit requirements for ensuring that these funds are expended properly. All non-Federal entities that expend $500,000 or more of Federal awards in a year ($300,000 for fiscal year ending on or before December 30, 2003) are required to obtain an annual audit in accordance with the Single Audit Act Amendments of 1996 (pdf), OMB Circular A-133, the OMB Circular Compliance Supplement and Government Auditing Standards. A single audit is intended to provide a cost-effective audit for non-Federal entities in that one audit is conducted in lieu of multiple audits of individual programs. The Single Audit provides the Federal government with assurance that these recipients comply with such directives by having anindependent external source (the CPA) report on such compliance.

OMB Circular A-133 Compliance Supplement 2009

Health Care Fraud Enforcement

Friday, September 16, 2011

OIG CAPTURED Fugitive: Rolando Cueto

OIG CAPTURED Fugitive: Rolando Cueto

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