Investigative Reports

The VA Office of Inspector General (OIG) received wide-ranging allegations of misconduct in the operations of the Veterans Health Administration’s Consolidated Patient Account Center (CPAC) field offices, which function within the Office of Community Care and conduct medical billing functions for VA medical centers in designated regions. The OIG substantiated the following allegations: 1. CPAC management improperly used government funds to purchase food for CPAC employees in fiscal years 2015 and 2016 in connection with events held as part of VA’s Diversity and Inclusion initiative; 2. One CPAC violated VA policy for disposing of excess equipment when computer monitors were given to a local school without following established procedures; and 3. Some CPAC field offices violated VA policy requiring that destruction of temporary paper records be performed pursuant to a written contract. The OIG made two recommendations, with which VA concurred and took prompt corrective action. The OIG considers these recommendations closed. Allegations relating to improper travel, the misuse of funds for the purchase of daily planners and a wheelchair, and the improper use of purchase cards for armored car services were not substantiated.

A Mechanical Inspector based in Beech Grove, Indiana, violated Amtrak policies by posting images and material characterized as disturbing, offensive, and inappropriate on a publicly available social media site. The former employee admitted to posting images which promoted Nazi ideologies on a social media website which identified him as a company employee. We also found that he was arrested in November 2016 for Driving Under the Influence and did not report his arrest to the company as required by company policy. The employee resigned on September 9, 2020, in lieu of a disciplinary hearing and is not eligible for rehire.

The OIG investigated allegations that a Bureau of Land Management (BLM) State Director used their Government position for the financial gain of two personal friends. We found no evidence that the State Director misused their Government position or violated any ethics regulations.

This investigation was initiated after OIG auditors identified irregular transactions paid for with a TVA Purchasing Card. More specifically, the auditors discovered the Purchasing Card was used by a cardholder to make payments to an apartment complex. The subsequent investigation substantiated that the employee used the card to make several monthly rental payments to the apartment complex where she lived. To address this situation and prevent similar improper usage of the Purchasing Card in the future, the OIG made several recommendations. The OIG recommended TVA do the following: (1) Take action to recover from the employee the outstanding balance of the unauthorized transactions, (2) consider disciplinary action against the employee, (3) ensure that all cardholders and approvers in Transmission and Power Supply are current on annual Purchase Card training, and (4) take measures to ensure approving officials are notified when Purchasing Card statements are not reconciled monthly and to suspend cards when there is repeated noncompliance with this requirement.

A Boilermaker/Welder, based in Beech Grove, Indiana, violated Amtrak policies by engaging in outside employment to work for his own companies while on sick leave. We also confirmed that he was conducting and engaging in work for his own companies on days that he requested leave for “union business.” Finally, our investigation found that he did not seek or request written approval from Amtrak to engage in outside employment which, according to the website for his personal business, advertises services for the railroad industry and, as a result, violated the company’s Conflict of Interest Policy. The employee was terminated from his employment on September 15, 2020.

OIG Investigations Newsletter Volume XXIX: June 1 - July 31, 2020

The OIG investigated an allegation that a former Bureau of Land Management (BLM) employee accessed child pornography with a U.S. Government computer.We found no evidence that the employee accessed child pornography. We evaluated the employee’s network traffic, which showed their computer accessed sites hosting suspected child pornography; however, we were not able to determine if the employee accessed the areas of the websites that hosted the suspected child pornography. The employee took certain actions with respect to the hard drive, so we were unable to recover any images or other evidence from the computer. The employee admitted to viewing adult pornography on their Government computer while on duty but denied viewing child pornography.The employee resigned during our investigation after receiving a notice of proposed removal. The U.S. Attorney declined prosecution of this matter.

Babar Iqbal, a doctor from Los Angeles, California, and owner of Riverside Regional Surgery Center, pleaded guilty on June 10, 2020, in Superior Court of California, Riverside to several charges related to health care insurance fraud. As part of the scheme, Iqbal targeted patients whose insurance paid higher reimbursement amounts to providers who were considered out of network and performed services that were medically unnecessary. Iqbal also conspired with marketers to obtain fraudulent insurance policies for individuals who did not have health insurance. The marketers then referred these individuals to Iqbal at the Riverside Regional Surgery Center. In return, the marketers received a commission based on the reimbursement amount the insurance companies paid Iqbal. The Amtrak health insurance plan was fraudulently billed approximately $1,653,210 as a result of the scheme. Iqbal will be sentenced at a future date.

Joseph Kieffer, a marketer from Los Angeles, California, pleaded guilty on July 20, 2020, in U.S. District Court, Central District of California, to conspiracy to pay illegal renumerations related to a health care fraud scheme. Kieffer paid kickbacks to patients and to marketers for patient referrals for medically unnecessary compounded drugs. As part of the scheme, Fusion RX Compounding Pharmacy then billed health care providers for the compounded drugs at rates much higher than average medications. The owner of Fusion Rx Compounding Pharmacy was also charged for his role in the scheme. The Amtrak health insurance plan was fraudulently billed approximately $17,000 as a result of the scheme. Criminal judicial proceedings are pending.

Tuesday, September 1, 2020We investigated allegations that a building management employee working in the Office of the Assistant Secretary – Indian Affairs misused their official position and engaged in unethical or illegal behavior.We found that the building management employee misused their Government charge card, participated in bid rigging, took a Government laptop for personal use, and failed to properly follow the DOI parking pass process policy, in violation of U.S. Department of the Interior policy and Federal regulations.The U.S. Department of Justice declined prosecution. The building management employee was removed from Federal service. We provided this final report to the Assistant Secretary for Indian Affairs.

Babar Iqbal, a California-based doctor and owner of Riverside Regional Surgery Center, was sentenced in the Superior Court of California, County of Riverside, on August 31, 2020, to 27 months in prison and was ordered to pay restitution of $2,799,550 for health care insurance fraud. Iqbal targeted patients whose insurance paid higher reimbursement amounts to providers who were considered out of network, and he performed services that were medically unnecessary. Iqbal also conspired with marketers to obtain fraudulent insurance policies for individuals who did not have health insurance. The marketers then referred these individuals to Iqbal at the Riverside Regional Surgery Center. In return, the marketers received a commission based on the reimbursement amount the insurance companies paid Iqbal. Amtrak’s health insurance plan was fraudulently billed approximately $1,653,210 as a result of the scheme. Iqbal previously pleaded guilty to several charges related to health care insurance fraud in June 2020.