Rose Radiology to pay almost $9 million to settle false billing allegations

According to the Tampa Bay Times, Rose Radiology Centers Inc. a Tampa Bay based diagnostic center, will pay the government $8.71 million to settle allegations that it violated the federal False Claims Act by billing federal health care programs for unnecessary radiology procedures.

Rose Radiology Centers Inc. operated approximately a dozen offices in the Tampa Bay area and is the official radiology practice for the Tampa Bay Rays and Tampa Bay Lightning.
The settlement deals with a lawsuit filed by two whistle-blowers under the federal False Claims Act, which allows private parties to bring suit on behalf of the government and to share in any recovery. The lawsuit stated that Rose Radiology Centers Inc. improperly billed for radiology procedures referred by chiropractors, which are not covered by Medicare. Rose Radiology bypassed this constraint when they accepted orders from chiropractors and billed for them as if the tests were actually ordered by a Rose Radiology-employed physician. The whistle-blowers will receive a combined $1.7 million as their share of the recovery from the case.

The radiology center is accused of performing and billing for radiology procedures that were never ordered by the patients’ treatment providers and of sending claims to Medicare for radiology services that were not performed at facilities authorized as Medicare providers, according to the article. In addition to the other allegations, the center is accused of giving kickbacks to referring physicians.

Shimon Richmond, special agent in charge for the Health and Human Service office of the Inspector General stated, “Not only do the kinds of frauds that were alleged in this case rob Medicare of needed funds, they threatened the health of elderly and disabled Americans.”

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Filed under Fla. Stat. 627.736 (2008), Insurance Fraud

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