A Florida imaging center has agreed to pay $3 million to settle charges that it filed false Medicare claims that violated Stark law prohibitions on physician self-referral, according to the U.S. Department of Justice (DOJ).
In a settlement announced on June 8, the DOJ said that Midtown Imaging and its former owners Midtown Imaging P.A. and PBC Medical Imaging had agreed to the settlement. As part of the deal, two radiologists who blew the whistle on the alleged fraud will receive $600,000 in whistleblower payments.
The DOJ charged that the imaging center submitted false claims to Medicare between 2000 and 2008 by inking leasing and professional services agreements with referring physicians and physician groups that violated the federal Medicare antikickback statute and the Stark law, according to a statement from the agency.
Dr. Teresa Cortinas and Dr. Walter Wojcicki, former Midtown Imaging radiologists, named the clinic in a suit they brought in 2009 under provisions of the False Claims Act, which permits private citizens with knowledge of fraud against the government to bring a lawsuit on behalf of the U.S. and to share in the settlement. The lawsuit alleged that Midtown Imaging entered into prohibited financial relationships with physicians and physician groups.
The DOJ said the case is an example of the Health Care Fraud Prevention and Enforcement Action Team (HEAT) initiative -- announced in May 2009 by Attorney General Eric Holder and Health and Human Services Secretary Kathleen Sebelius -- which seeks to reduce and prevent Medicare and Medicaid financial fraud through cooperation between the Attorney General and U.S. Department of Health and Human Services.
One of the most powerful tools in the effort is the False Claims Act, which the DOJ has used to recover more than $5.7 billion since January 2009 in cases involving fraud against federal healthcare programs. The department's total recoveries in False Claims Act cases since January 2009 are more than $7.3 billion, the DOJ said.
Specific to radiology, two suits were settled in 2010 by the DOJ. One was with a large multispecialty physician group in Florida that agreed to pay $12 million to settle allegations that it submitted false reimbursement claims for radiation oncology treatments to federal healthcare agencies. The other was with a California imaging provider, Oaks Diagnostics, that paid the U.S. government $647,000 to settle charges that it filed false claims with Medicare for unnecessary imaging tests.
