Hospital to pay False Claims Act penalty for allegedly letting unsupervised residents interpret X-rays
An academic medical center has agreed to pay $16,444 and subject its physicians to training to settle allegations it submitted false claims for radiology residents’ unsupervised interpretation of diagnostic X-rays.
The U.S. Attorney’s Office first filed suit against University of Iowa Health Care in 2019, accusing the institution of perpetuating a “batch signing scheme.” Through it, the Iowa City hospital would allegedly bill for radiology services rendered by residents during 12- to 15-hour on-call shifts.
However, the physician supervision and approval required by Medicare never occurred, the office alleged in its complaint.
“Nevertheless, defendant UIHC fraudulently obtains payments from the government for attending/teaching physicians’ services merely by falsifying records and, at the same time, capturing the cost-saving benefits and Medicare funding respectively associated with hosting a resident program,” attorneys contended.
Rather than complete the necessary review, the office alleged, physicians instead would engage in “rapid-fire signing of dozens of reports within a matter of a minute or so, solely in order to falsely bill the government for ‘interpretations’ that never took place,” the complaint alleged.
In an announcement, the U.S. Attorney’s Office said the claims in question were submitted between July 2018 to May 2020. Under the agreement, the University of Iowa will implement mandatory physician training on Medicare’s requirements when requesting payment for diagnostic radiology services in a teaching setting.
“UI cooperated fully during the investigation and did not admit to any liability as part of the settlement agreement,” the U.S. Attorney’s Office for the Northern District of Iowa said March 21.
A whistleblower first surfaced the allegations and stands to share in the feds’ financial recovery, the announcement noted.
“University of Iowa Health Care is pleased that it was found of no wrongdoing and that this settlement resolves the issue,” the institution said in a statement. “We will continue to focus on the research, education, and clinical care for Iowa and Iowans that is important to all the settling parties.”
Marty Stempniak has covered healthcare since 2012, with his byline appearing in the American Hospital Association's member magazine, Modern Healthcare and McKnight's. Prior to that, he wrote about village government and local business for his hometown newspaper in Oak Park, Illinois. He won a Peter Lisagor and Gold EXCEL awards in 2017 for his coverage of the opioid epidemic.