Healthcare Exclusion Screening: It’s Not Just for Hospitals- What About Imaging Companies?

Preferred Imaging, LLC, a provider of diagnostic imaging services, has agreed to pay $3,510,000 for improperly billing Medicare and Medicaid for services performed without proper medical supervision.  Preferred Imaging cooperated with the investigation and, by settling, did not admit any wrongdoing or liability.  The announcement was made July 22, 2016, by U.S. Attorney John Parker.

Preferred Imaging operates independent diagnostic facilities in Texas, Illinois, and Kansas.  Certain procedures performed by IDTFs, such as procedures involving the administration of contrast dye, must be supervised by an on-site physician.  The settlement resolves allegations that Preferred Imaging submitted claims to Medicare, Medicaid, and TRICARE for procedures that were performed between January 2009 and February 2015 without a supervising physician on-site. 

“The requirement that certain services are supervised by a physician is in place to protect Medicare and Medicaid patients,” said U.S. Attorney Parker.  “This settlement clearly reflects our commitment to hold facilities responsible for failing to ensure that those requirements are satisfied.”

The settlement resolves allegations filed by relator Tracy Sifuentes, a former employee of Preferred Imaging, under the qui tam or whistleblower provisions of the FCA and TMFPA, which authorize private parties to sue for fraud on behalf of the United States and State of Texas and share in the recovery.  The relator will receive $596,700.

This investigation was conducted by Health and Human Services Office of Inspector General, Defense Criminal Investigative Services, and the Texas Attorney General’s Civil Medicaid Fraud Division.

Advertisements

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s