Sixteen Cardiology Practices Settle $17.7 Million Medicare Overbilling Allegations

• Sixteen cardiology practices from 12 states agreed to pay over $17.7 million to settle allegations of overbilling Medicare for diagnostic radiopharmaceuticals.
• The U.S. Department of Justice (DOJ) alleged that these practices reported inflated acquisition costs to Medicare for drugs used in cardiovascular medical imaging.
• The alleged scheme spanned up to 10 years, involving systematic overbilling for diagnostic drugs.
• Whistleblowers played a crucial role, helping the DOJ uncover the scheme and will receive about $2.7 million from the settlements.
• Overcharging practices compromise healthcare programs and undermine public trust in federal health services, as stated by the DOJ.
• This case highlights the importance of reporting misconduct, which helps prevent abuse of federal healthcare programs.
• Practices involved overbilling Medicare by exaggerating the costs of drugs for heart imaging diagnostics.
• Settlement payments from the practices ranged from $50,000 to $6.75 million, varying based on the scale of involvement.
• Western Kentucky Heart & Lung Associates PSC paid the largest settlement of $6.75 million.
• Other significant payments included $2.6 million from Heart Clinic of Paris P.A. and $2.37 million from Scranton Cardiovascular Physician Services LLC.
• Smaller payments included $50,000 from Wellspring Cardiac Care P.A. and $160,000 from Boulder Medical Center PC.
• The settlement explicitly states there was no admission of guilt or determination of liability.
• Allegations against the practices remain as claims, with the settlement resolving the disputes without a court ruling.
• The case underscores the DOJ's commitment to holding providers accountable for exploiting federal healthcare programs.
• Protecting Medicare from fraudulent practices ensures its sustainability for future patients.
• The involvement of whistleblowers demonstrates the critical role of public vigilance in upholding ethical healthcare practices.

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