What You Should Know:
– The Radiology Group (TRG), a teleradiology company based in Atlanta, Georgia, has agreed to pay $3.1M to settle a civil fraud lawsuit filed by the U.S. Attorney’s Office for the Southern District of New York.
– The settlement amount of $3.1M will be divided between the US government and various states.
Key Allegations
The lawsuit alleged that TRG engaged in improper billing practices related to radiology services provided to hospitals and other healthcare providers across the country. Specifically, the government claims that TRG:
- Failed to ensure adequate review of radiology scans: TRG allegedly used contractors located outside the United States, who were not licensed to practice medicine in the US, to prepare draft interpretations of radiology scans. The government alleges that TRG radiologists did not adequately review these drafts before finalizing the reports sent to healthcare providers.
- Misrepresented service providers: The lawsuit alleges that TRG submitted claims to federal health programs where the radiologist listed on the claim was not the one who actually reviewed the scans.
- Improperly billed for services: The government alleges that TRG billed Medicare for radiology services performed by a radiologist located in the UK, which violates program regulations.
Settlement and Admissions
As part of the settlement, TRG has admitted to certain aspects of the government’s allegations, including failing to ensure proper review of draft reports and misrepresenting service providers. The company will pay a total of $3.1M, with the majority going to the United States and the remainder to various states. Proper interpretation of radiology scans is crucial for accurate diagnosis and treatment of patients. The allegations against TRG raise concerns about the quality of care patients may have received and the potential misuse of federal healthcare funds.
“The Radiology Group failed to put in place appropriate safeguards to ensure that their U.S.-licensed radiologists adequately reviewed non-credentialed contractors’ findings before transmitting the reports to physicians who relied on the findings to make patient care decisions. This Office is committed to holding healthcare providers accountable when they violate clear rules and regulations designed to ensure the integrity of taxpayer-funded healthcare programs and protect patient quality of care,” said U.S. Attorney Damian Williams.
