A New York hospital has agreed to pay $801,000 to settle allegations that two related radiology practices violated the False Claims Act by improperly billing for imaging services.
Radiation Therapist Associates and Leading Edge Radiation Oncology Services previously provided care across several Brooklyn communities. Their work included image-guided radiation therapy using PET, MRI and CT, the Department of Justice said Jan. 26.
Between 2012 and 2018, the two practices allegedly billed Medicare, Medicaid and Tricare for images that physicians either never reviewed or failed to assess in a timely fashion. Radiation Therapist Associates also submitted claims for initial consultation sessions, in some instances, at a “higher coding level than appropriate.”
“The defendants provided substandard care to cancer patients by not properly or timely reviewing medical imaging and then billed taxpayer-funded healthcare programs for these shoddy services,” U.S. Attorney Breon Peace said in a statement. “My office is committed to holding healthcare providers accountable for such conduct.”
New York-Presbyterian Hospital has agreed to pay the settlement, with $695,000 going to the feds and New York state collecting $106,000. Both physician practices are no longer in business, according to the DOJ. Radiation Therapist Associates was previously located in Brooklyn Methodist Hospital and operated under a contract with a New York-Presbyterian predecessor. Leading Edge Radiation Oncology Services, meanwhile, was piloted by an overlapping group of RTA physicians and run as a joint venture with the hospital.
“We are pleased to put this issue behind us,” a NYP spokesperson said by email. “Note, this occurred prior to New York-Presbyterian becoming the active parent of—and later merging with—Brooklyn Methodist Hospital.”
A whistleblower brought forth the accusations and stands to collect a portion of the proceeds. U.S. attorneys emphasized that these are only allegations, with no determination of liability.
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.