The U.S. Attorney’s Office has announced a settlement involving 16 cardiology practices and associated physicians across 12 states, who have agreed to pay over $17.7 million to resolve allegations of False Claims Act violations. The charges pertain to the overbilling of Medicare for diagnostic radiopharmaceuticals.
These settlements were coordinated by the U.S. Attorney’s Office for the District of Columbia and the Western District of Kentucky, alongside the Department of Justice. The District of Columbia's office managed 14 settlements amounting to $10,601,970.97, while the remaining funds were recovered by the Kentucky office.
Diagnostic radiopharmaceuticals are used in diagnosing certain diseases and cancers by targeting specific organs or tissues within the body. In several states including Washington D.C., Medicare Part B reimburses healthcare providers based on their acquisition costs for these substances. It was alleged that some cardiology practices inflated these costs when billing Medicare.
“Practices and providers who overcharge the government and fail to return overpayments compromise our healthcare programs,” stated U.S. Attorney Graves. He praised whistleblowers for reporting such conduct, which enabled authorities to address these issues effectively.
Brian M. Boynton from the Justice Department emphasized compliance with billing rules as crucial for maintaining federal healthcare program integrity: “We are committed to ensuring that Medicare funds are expended appropriately.”
The medical practices involved include Heart Clinic of Paris, P.A., Scranton Cardiovascular Physician Services, LLC, Shannon Clinic, among others listed with their respective settlement amounts.
“These practitioners overbilled the Medicare program by grossly exaggerating acquisition costs,” commented Michael A. Bennett from Kentucky's U.S. Attorney’s Office, reaffirming their commitment to protecting federal health care programs.
Maureen Dixon from HHS-OIG assured continued collaboration with law enforcement partners to investigate any alleged violations under false claims acts.
This civil settlement also resolves claims filed under qui tam provisions by relators Jasjit Walia and Preet Randhawa in both D.C. and Kentucky districts; they will receive approximately $2.2 million from these settlements.
A coordinated effort between various departments within the Justice Department facilitated this resolution, highlighting ongoing efforts against healthcare fraud through mechanisms like the False Claims Act.
The investigation was managed by Trial Attorney James Nealon along with Assistant U.S Attorneys Ben Schecter and Matt Weyand from Kentucky's district as well as Stephen DeGenaro and John C Truong from D.C.'s district office.
It's important to note that while allegations have been settled financially there has been no determination regarding liability in this matter.
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