by
Thomas Dworetzky, Contributing Reporter | February 01, 2016
Rose Radiology Centers in Florida prided itself on the fact that being physicianーowned made it above reproach. But faced with less-than-sweet accusations it has agreed to pay $8.71 million to the government to settle charges it broke the False Claims Act.
"There is no room for such practices in our public health care programs," U.S. Attorney Lee Bentley said in a statement.
The firm had engaged in false billings and "breaches of trust," according to a U.S. Attorney's Office release,
reported by the Tampa Bay Times.
"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," said Shimon Richmond, special agent in charge for the Health and Human Services Office of the Inspector General.
Two whistle-blowers who filed the suits that led to the Rose settlement will split $1.7 million. The suits claimed that the firm had billed for radiology procedures based on chiropractor referrals, which Medicare does not cover. Instead, the bills said the procedures had been ordered by a Rose-employed physician.
Rose also allegedly billed for and performed procedures that weren't ordered by by health care providers for patients, and also billed Medicare for services done at non-Medicare-approved facilities.
In addition, Rose was accused of giving referrers kickbacks including lunches, gift cards and tickets to events.
The company, which has about a dozen offices in the Tampa Bay area, is fighting back. In a release on its website it contests the charges and states that the settlement was necessary "to avoid prolonged litigation."
It stated that it had "fully cooperated with a government investigation involving False Claims Act violations, and has agreed to a settlement without any admission of wrongdoing."
Describing the allegations as "baseless and without merit," it stated that they mostly came from staff "operating in what they believed were correct interpretations of vague and conflicting health care regulations."
The firm explained its decision to settle because it "believes it’s near impossible to litigate against the U.S. Government with its infinite resources."
It also claimed that staff interpretation of these regulations were "reasonable." Nonetheless, the firm agreed to refund "several years" of Medicare work.
But it defended the work it performed, stating that "all this Medicare work was medically necessary and done at the highest standards and highest quality," adding that "quality of care was never... questioned during the government investigation."
The firm's founder Dr. Manual Rose stated, "Faced with a lawsuit that could potentially destroy my practice, I elected to settle so needed radiology services could still be provided to our community. It’s so unfortunate that health care professionals are being targeted, especially if they work hard and have a successful practice."
