Practice agrees to pay $1.4M for allegedly delivering teleradiology services from outside the US
A Jacksonville, Florida, imaging practice has agreed to pay $1.4 million to settle allegations that it fraudulently delivered teleradiology services from outside the United States, authorities announced Friday.
The Department of Justice claims that Mori, Bean and Brooks billed government payment programs for the interpretation work between 2012 and 2019. Medicare stipulates that remote rads must operate within the confines of the U.S. to be eligible for reimbursement.
DOJ officials said that during the seven-year period, MBB also billed for services initially performed overseas, but then reinterpreted by an additional rad in the States. The practice then reportedly billed for the second, domestic rad’s work, as if the other doc performed the original read.
“Medicare only pays for services provided in accordance with Medicare rules. Today’s settlement should serve as a warning that anyone attempting to defraud taxpayer-funded healthcare programs will be vigorously pursued,” Omar Perez Aybar, a special agent with the Office of the Inspector General, said in a statement.
Former MBB radiologist Thomas Heyck first surfaced the allegations, filing a whistleblower lawsuit under the False Claims Act. He stands to collect 19% of the proceeds, or $266,000, for his involvement.
The DOJ alleges that MBB continued to bill for its out-of-the-country reads until the feds informed it of the investigation. At that point, the practice “successfully reduced the amount owed to the government through diligent and effective cooperation.”
Mori, Bean and Brooks operates more than a dozen locations, employs 40-plus radiologists, and became part of imaging giant Radiology Partners in late 2018. In a statement, RP emphasized that the settlement does not involve or implicate the quality of services provided, and there has been no determination of wrongdoing by MBB. All exams were medically necessary and delivered by United States-trained, board-certified radiologists, said Associate Chief Medical Officer Richard Heller, MD, MBA.
“RP remains confident in its robust compliance program and practices—resources that all RP-affiliated practices access upon practice partnership,” he said in a statement.
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.