New York-based Doshi Diagnostic Imaging Services and Diagnostic Imaging Group LLC agreed to pay $15.5 million to settle whistleblower allegations that they colluded to defraud Medicare and paid physicians for referrals.
The radiology providers allegedly submitted claims for reimbursement for services that weren’t prescribed by a treating physician, weren’t medically necessary and, in some cases, weren’t performed at all, according to the office of New York Attorney General Eric Schneiderman.
Doshi Diagnostic is a radiology medical practice with 21 locations in New York City and Nassau County. Diagnostic Imaging Group provides management and support services for Doshi’s locations.
"Between 1999 to 2010, the companies submitted false billings for expensive imaging services, included retroperitoneal ultrasounds, Doppler scans, transrectal ultrasounds and pelvic x-rays," according to a press release from the Attorney General’s office. "More than 40,000 false claims were submitted to the New York Medicaid program for the various imaging services."
The office further accused Doshi and DIG of paying illegal kickbacks to physicians to induce them to refer more patients for radiology services. The agreements were deemed fraudulent because physicians were paid more than fair market value for their supervision in referred nuclear stress tests, officials said.
The vast majority of the recovered funds were returned to the federal Medicare coffers, with New York’s Medicaid program receiving $2.9 million and New Jersey’s program receiving about $190,000.