FOR IMMEDIATE RELEASE|
WEDNESDAY, JUNE 23, 2004
TDD (202) 514-1888
SOUTHWEST FLORIDA RADIOLOGISTS TO PAY U.S. $2.5 MILLION
FOR ALLEGEDLY OVERCHARGING MEDICARE
WASHINGTON, D.C. - Radiology Regional Center (RRC), a group of radiologists in Southwest Florida, has agreed to pay the United States more than $2.53 million to settle allegations that it submitted false claims to the Medicare Program, the Justice Department announced today. The United States alleged that Radiology Regional Center knowingly submitted claims to Medicare for which it was not entitled to payment.
According to the civil settlement agreement, the United States alleged that during part of the 1990s and early 2000s, RRC billed Medicare for ultrasound procedures, reconstruction procedures and magnetic resonance imagings (MRIs) which were not ordered by the patients' treating physicians. Additionally, the government alleges that RRC billed for two venous or arterial studies for the same patient on the same date although only one of the procedures was properly billable; and for certain mammograms that did not qualify as diagnostic procedures and, instead, should have been billed as screening mammograms.
"This settlement again demonstrates the United States' commitment to protecting federal funds from fraud," said Peter D. Keisler, Assistant Attorney General in charge of the Civil Division. "The federal health care system operates on the good faith and honesty of its providers, and we will actively pursue those who misuse the system for financial gain."
The civil settlement arises from a qui tam or whistleblower suit brought by Suzan Walker, a former RRC employee. As a result of the settlement, Walker will receive $443,378. Under the False Claims Act, private individuals who bring suits against companies can receive between 15 and 25 percent of the recovery in a case in which the government intervenes.
The Medicare Program is administered by the Centers for Medicare and Medicaid Services of the U.S. Department of Health and Human Services. The case was handled jointly by the Justice Department's Civil Division and the United States Attorney's Office for the Middle District of Florida, with investigative assistance provided by TriCenturion, LLC, a Medicare Program Safety Contractor.
The case is entitled U.S. ex rel. United States ex rel. Suzan Walker v. Radiology Regional Center, Case No. 2:00-CV-558-FTM-29DNF (M.D. Florida).