Labs In Court

Michigan Cardiologist Shells Out $2 Million to Settle False Billing Charges

Case: The feds claim that over an 11-year period the physician and his metropolitan Detroit area practice and lab sites violated the False Claims Act by billing Medicare, Medicaid and TRICARE for tests that were either not medically necessary or not performed at all, including Ankle Brachial Index and Toe Brachial Index (ABI/TBIs) tests. The ABI compares blood pressure in the ankle to blood pressure in the arm to evaluate blood flow; the TBI is an addition test to assess blood pressure readings at the toes. The investigators also found that the physician routinely ordered unnecessary Nuclear Stress Tests, a high-priced diagnostic procedure in which a small amount of radioactive tracer is injected into a vein to enable a special camera to produce images evaluating blood flow to the heart.

Significance: The cardiologist was also one of the eight physicians involved in the alleged Beaumont Health system kickbacks scheme which was settled for $84.5 million in 2018. So, it’s not surprising that as part of the settlement, the cardiologist agreed to enter into a 3-year Integrity Agreement. Both cases began as whistleblower lawsuits.

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