Sixteen different cardiology practices and associated physicians across 12 states have agreed to pay a combined $17.7 million to settle allegations of overbilling Medicare for diagnostic radiopharmaceuticals.
Diagnostic radiopharmaceuticals are used for targeting certain tissues, organs or cells in the human body, diagnosing and even, in certain cases, treating certain diseases.
Medicare Part B reimburses providers for diagnostic radiopharmaceuticals based on their purchase costs in 13 states and Washington, D.C. Medicare contractors have issued guidelines in these areas requiring providers to accurately report their invoice costs. The Justice Department claimed that the practices in the settlement inflated the costs, with certain violations occurring over a decade, according to a Dec. 20 Justice Department news release.
Claims filed under the whistleblower provisions of the False Claims Act were also involved in the case, and more than $2.7 million of the settlement will go to whistleblowers.
Here are the amounts that each settling practice and associated physician has agreed to pay:
- Western Kentucky Heart & Lung Associates and Mohammed Kazimuddin, MD: $6,750,000 (Bowling Green)
- Heart Clinic of Paris (Texas) and Arjumand Hashmi, MD: $2.6 million
- Scranton (Pa.) Cardiovascular Physician Services and Jasjit Walia, MD, and Preet Randhawa, MD: $2.4 million
- Shannon Clinic: $996,856 (San Angelo, Texas)
- Edward Leahey Professional Association and Edward Leahey,MD: $894,679 (Morristown, N.J.)
- Metropolitan Cardiovascular Consultants and Ayim Djamson, MD: $846,888 (Lanham, Md.)
- Cardiology Center of New Jersey, Mario Criscito, MD, Frank Iacovone, MD, and Sameer Kaul, MD: $740,000 (Clifton)
- Clovis (N.M.) Cardiology Associates and Mahamadu Fuseini, MD: $600,000
- Family Medical Specialty Clinic, Melecio Abordo, MD, and June Abadilla, MD: $409,594 (Paducah, Ky.)
- James Higgins, MD: $395,537 (California, Md.)
- TrustCare Health: $279,407 (Ridgeland, Miss.)
- Taj Medical: $240,000 (Los Angeles)
- White River Diagnostic Clinic, Margaret Kuykendall, MD, and Seth Barnes, MD: $234,490 (Batesville, Ariz.)
- VeinGuard Heart and Vascular Center and Fareeha Khan, MD: $195,000 (Tysons, Va.)
- Boulder (Colo.) Medical Center: $160,000
- Wellspring Cardiac Care P.A.: $50,000 (Towson, Md.)