Thursday, July 15, 2010

Beverly Hills Radiology Clinic Pays $647,000 to Resolve Qui Tam Lawsuit Alleging It Billed Medicare for Unneeded Tests

On July 2, 2010, Beverly Hills radiology clinic The Oaks Diagnostics, Inc., dba Advanced Radiology, agreed to pay the federal government $647,000 to settle allegations that it filed false claims with Medicare for unnecessary radiological tests. These allegations and the civil lawsuit had been initiated in 2003 and took approximately seven years to resolve.

The payment prompted the government to ask a federal judge this morning to dismiss a civil lawsuit that alleged Advanced Radiology performed unnecessary diagnostic tests and billed Medicare for the procedures.The United States alleged in the civil lawsuit that Advanced Radiology and its owner, Dr. Ronald Grusd, engaged in a scheme to bill Medicare for unnecessary tests performed at Advanced Radiology from 1999 through 2002.

As part of the alleged scheme, an Advanced Radiology contractor recruited Medicare beneficiaries to undergo diagnostic tests such as CT scans and MRIs, even though the beneficiaries did not need the tests. That contractor—Nordelyn Lowder—pleaded guilty to one count of health care fraud in connection with the scheme. Lowder was sentenced in June 2008 to 20 months in federal prison and was ordered to pay $426,455 in restitution.

The settlement resolves allegations initially made against Advanced Radiology in a “whistleblower” lawsuit filed pursuant to the qui tam provisions of the False Claims Act, which allow a private party to file a civil action on behalf of the United States and receive a portion of the recovery. The whistleblower lawsuit was originally filed in 2003 by a former Advanced Radiology employee. The United States intervened and took over prosecution of the case in February 2008.

Advanced Radiology paid the settlement without admitting any wrongdoing. Dr. Grusd is not a party to the settlement, but in light of the settlement with Advanced Radiology the government has opted to dismiss the lawsuit against him. This case was investigated by the Office of Inspector General of the Department of Health and Human Services and the Federal Bureau of Investigation.

Posted by Tracy Green, Esq. Please email Ms. Green at tgreen@greenassoc.com or call her at 213-233-2260 to schedule a complimentary 30-minute consultation.

Any questions or comments  should be directed to Tracy Green, a very experienced California health care fraud attorney, radiology fraud attorney, California Medicare fraud attorney, and California Medi-Cal fraud attorney at tgreen@greenassoc.com.

The firm focuses its practice on the representation of licensed professionals, individuals and businesses in civil, business, administrative and criminal proceedings. They have a specialty in representing licensed health care providers and in health care fraud related matters in California and throughout the country. Their website is: http://www.greenassoc.com/

DISCLAIMER

DISCLAIMER: Green & Associates' articles and blog postings are prepared as a service to the public and are not intended to grant rights or impose obligations. Nothing in this website should be construed as legal advice. Green & Associates' articles and blog postings may contain references or links to statutes, regulations, or other policy materials. The information provided is only intended to be a general summary. It is not intended to take the place of either the written law or regulations. We encourage readers to review the specific statutes, regulations, and other interpretive materials for a full and accurate statement of their contents and contact their attorney for legal advice. The primary purpose of this website is not the commercial advertisement or promotion of a commercial product or service and this website is not an advertisement or solicitation. Anyone viewing this web site in a state where the web site fails to comply with all laws and ethical rules of that state, should disregard this web site.

The information provided on this website is for informational purposes only. It is not intended to create, and does not create, a lawyer-client relationship with Green & Associates, Attorneys at Law. Sending an e-mail to Tracy Green does not contractually obligate them to represent you as your lawyer, or create any type of client relationship. No attorney-client relationship will be formed absent a written engagement or retainer letter agreement signed by both Green & Associates and client and which specifies the scope of the engagement.

Please note that e-mail transmission is not secure unless it is encrypted. E-mail messages sent to Ms. Green should not include confidential or sensitive information.