Radiology practice pays $15.5 million to resolve billing abuse allegations

A New York radiology practice has agreed to a $15.5 million settlement to resolve allegations that it billed Medicaid and Medicare for unnecessary imaging services.

Doshi Diagnostic Imaging Services, P.C., is a radiology medical practice headquartered in Hicksville, N.Y., with 21 locations in New York City and Nassau County. Diagnostic Imaging Group, LLC, also headquartered in Hicksville, provides management and support services for the practice locations. 

The two companies settled claims that between 1999 and 2010 they submitted false billings for medical services including retroperitoneal ultrasounds, Doppler scans, transrectal ultrasounds and pelvic X-rays. According to the settlement papers, more than 40,000 false claims were submitted to the New York Medicare program for various imaging services.

The companies also were alleged to have paid illegal kickbacks to physicians in order to get them to refer their patients for imaging services.

The New York Medicaid program will recover about $3 million, while about $12.4 million will be returned to the federal Medicare program, and about $190,000 to the New Jersey program.

"Fraud committed by medical practices costs New York taxpayers millions of dollars every year. My office will find those who cheat the system, cheat New York taxpayers and cheat our most vulnerable patients," New York Attorney General Eric Schneiderman in an announcement. "In addition to other fraud, these companies were suspected of paying kickbacks. This illegal behavior must--and will--stop."

The allegations against Doshi were based on three whistleblower lawsuits. According to an article in Law360, the first of these lawsuits was filed in September 2009 when Mark Novick, the practice's former associate medical director, allegedly found that a patient had been billed for two ultrasound procedures on the same day, with just one being medically necessary. Novick later was joined by two other employees who said they saw similar billing abuses.

To learn more:
- see the announcement from the attorney general's office
- read the article in Law360

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