The former president and co-owner of a mobile cardiac imaging company is headed to court with the U.S. government, which has taken up a False Claims lawsuit that accuses him of participating in a scheme where the company paid cardiologists exorbitant fees to exclusively refer patients to it for care and to supervise the PET scans it performed.

From at least 2017 to June 2023, Rick Nassenstein, who also served as Cardiac Imaging Inc.’s (CII) chief financial officer, and others paid fees above fair market value to physicians in exchange for referrals to the company for PET scans to diagnose cardiac diseases and assess heart function, said the government in its case, U.S. ex rel. Pinto v. Nassenstein.

These actions violate the Physician Self-Referral Law (Stark Law), which prohibits healthcare providers from billing Medicare for services referred by providers whom they share a financial relationship or history with, including in a compensation agreement.
Lynda Pinto, a former billing manager at CII, filed the suit under the qui tam or whistleblower provisions of the False Claims Act, which allows civilians to sue on behalf of the U.S. government. Should the U.S. choose to take up the case, the whistleblower will share in a portion of any monetary rewards recovered. The U.S. can recover three times the amount of its losses and enforce other applicable penalties on the defendant if they are found guilty of violating the FCA.

“Improper compensation arrangements unnecessarily drive up healthcare costs and cloud a physician’s medical judgment,” said U.S. Attorney Alamdar Hamdani, for the Southern District of Texas, in a statement. “This complaint alleges that in an effort to increase profits, Nassenstein caused CII to enter into improper compensation arrangements with cardiologists who referred patients for cardiac PET scans.

According to the U.S. complaint, CII also paid referring physicians $500 or more to provide physician supervision required under Medicare rules. Not only were the fees too much, but the cardiologists were paid even when they were actually providing care to other patients in their offices or were not even on site. They were also allegedly paid for other services beyond supervision that they did not perform.

For the same case back in October, CII and its founder and CEO Sam Kancherlapalli together paid over $85 million to resolve allegations that Kancherlapalli set the terms and conditions to which CII paid fees and submitted claims. He also allegedly received significant profits and dividends from CII’s business operations, benefiting from its unlawful conduct. As part of that deal, CII will pay $75 million and additional amounts depending on future revenues, and Kancherlapalli will pay $10,480,000, for a total of $85,480,000.

The case was filed in the U.S. District Court for the Southern District of Texas.

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