Sixteen cardiology practices across 12 states have agreed to pay a combined total of $17,761,564. This resolves allegations that they violated the False Claims Act by overbilling Medicare for diagnostic radiopharmaceuticals. These substances are used in diagnosing and treating certain cancers and diseases. In jurisdictions where Medicare Part B reimburses providers based on acquisition costs, it was alleged that these practices reported inflated costs.
"The financial stability of federal healthcare programs depends upon providers complying with applicable billing rules," stated Principal Deputy Assistant Attorney General Brian M. Boynton from the Justice Department’s Civil Division. He emphasized the commitment to ensuring appropriate expenditure of Medicare funds.
The settlements include payments from various medical practices and associated physicians: Western Kentucky Heart & Lung Associates PSC and Mohammed Kazimuddin ($6,750,000), Heart Clinic of Paris P.A. and Arjumand Hashmi ($2,600,000), Scranton Cardiovascular Physician Services LLC ($2,369,111), among others.
"Practices and providers who overcharge the government and fail to return overpayments compromise our healthcare programs," remarked U.S. Attorney Matthew M. Graves for the District of Columbia. He commended whistleblowers for their role in this case.
U.S. Attorney Michael A. Bennett for the Western District of Kentucky added that "these practitioners overbilled the Medicare program by grossly exaggerating the acquisition costs of drugs used in diagnostic imaging of the heart."
Special Agent Maureen Dixon from HHS-OIG stressed that "Medicare providers are required to be honest and accurate in the costs they report for reimbursement." The investigation highlights ongoing efforts to maintain integrity within federal health care programs.
The resolution includes claims brought under qui tam provisions by relators Jasjit Walia and Preet Randhawa in two districts; they will receive more than $2.7 million from these settlements.
This effort was coordinated between several branches including the Justice Department’s Civil Division Fraud Section, U.S Attorneys’ Offices for relevant districts, with support from HHS Office of Counsel to Inspector General.
Trial Attorney James Nealon along with Assistant U.S Attorneys Ben Schecter, Matt Weyand (Western District of Kentucky), John Truong, Stephen DeGenaro (District Of Columbia) handled this matter which remains as allegations without determination on liability yet concluded through settlement agreements viewable via respective links provided above.