Rose Radiology to pay almost $9 million to settle false billing allegations

Rose Radiology Centers Inc. will pay $8.71 million to the government to settle allegations that it violated the False Claims Act by billing federal health care programs for unnecessary radiology procedures.  The company has about a dozen offices in the Tampa Bay area. It’s also the “official” radiology practice for the Tampa Bay Rays and Tampa Bay Lightning.

The settlement resolves several allegations involving medical care standards, false billings and “breaches of trust,” according to a news release from the U.S. Attorney’s Office.

“There is no room for such practices in our public health care programs,” U.S. Attorney Lee Bentley said in the release.

The settlement deals with a lawsuit filed by two whistle-blowers under the False Claims Act, which allows private parties to bring suit on behalf of the government and to share in any recovery.

The whistle-blowers will receive a combined $1.7 million as their share of the recovery in this case. Reached by phone, one of the whistle-blowers declined to comment Friday.

The lawsuit said Rose Radiology improperly billed for radiology procedures referred by chiropractors, which Medicare does not pay for.

To circumvent this prohibition, the release said, Rose Radiology accepted orders from chiropractors and billed for them as if the tests were actually ordered by a Rose Radiology-employed physician.

The company was founded in 2001 by radiologist Manuel S. Rose, according to its website, which says the company was created with the philosophy that it “should be owned, managed and staffed by licensed board certified radiologists, thus avoiding conflicts of interest.” It touts being one of the few practices of its kind to be owned by a doctor.

The company also was accused of performing and billing for radiology procedures that were never actually ordered by the patients’ treatment providers and of sending claims to Medicare for radiology services that were not performed at facilities authorized as Medicare providers.

“Not only do the kinds of frauds that were alleged in this case rob Medicare of needed funds, they threatened the health of elderly and disabled Americans,” said Shimon Richmond, special agent in charge for the Health and Human Services Office of the Inspector General.

The center also was accused of giving kickbacks to referring physicians.

It was alleged, the release said, that the center provided key referral services incentives such as lunches, gift cards and tickets to events in exchange for business.

If you know of or suspect healthcare fraud, contact us now.