Doc Wishes He Showed Up at the Office — But . . .


Imagimed LLC, an MRI Center, its owners and chief radiologist, agreed to pay the government $3.57 million to settle false claims allegations for MRI services. The government alleged that Imagimed billed for MRI scans performed with contrast dye without the direct supervision of a qualified physician, as required under the physician supervision rules. This is one of several cases over the last few years that highlight the importance of complying with the physician supervision requirements.

However, in this case simply showing up would not have saved the day, as the government also alleged that Imagimed billed for services based on referrals from physicians with whom it had financial relationships that were not Stark-compliant. In exchange for the referrals, Imagimed allegedly entered into sham on-call arrangements and provided various gifts to certain referring physicians in violation of the Stark Law and the anti-kickback statute. The government also claimed that preauthorization services provided by Imagimed without charge also were improper, despite the issuance of several advisory opinions permitting preauthorization services without charge. It is therefore important to remember that advisory opinions are binding only with respect to the parties to whom the opinion is addressed.

Topics:  Anti-Kickback Statute, Billing, Healthcare Professionals, Physicians, Settlement, Stark Law, Supervision

Published In: Government Contracting Updates, Health Updates, Insurance Updates

DISCLAIMER: Because of the generality of this update, the information provided herein may not be applicable in all situations and should not be acted upon without specific legal advice based on particular situations.

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