Cardiac monitoring firms, exec to pay $13M over Medicare false claims allegations
- AMI Monitoring, also known as Spectocor, its owner Joseph Bogdan, Medi-Lynx Cardiac Monitoring, and Medicalgorithmics SA — the current majority owner of Medi-Lynx Cardiac Monitoring — have agreed to resolve allegations that they violated the False Claims Act by billing Medicare for higher and more expensive levels of cardiac monitoring services than requested by the ordering physicians.
- The companies agreed to pay $13.45 million to settle the charges, the U.S. Justice Department announced.
- From 2011 through 2016, AMI and owner Joseph Bogdan required physicians enrolling with its Pocket ECG to choose the most costly of tree cardiac monitoring options, the government alleges. In 2013, Medi-Lynx allegedly adopted the same tactic to sell the Pocket ECG. Medi-Lynx was purchased by Medicalgorithmics in 2016.
Under the agreement, Spectocor and Bogdan will pay $10.56 million and Medi-Lynx and Medicalgorithmics will pay $2.89 million. Eben Steele, the former Spector sales manager who blew the whistle on the companies, will receive about $2.4 million from the settlements.
The settlement underscores HHS and DOJ’s commitment to cracking down on Medicare and Medicaid fraud and abuse.
Last October, Tenet Healthcare announced it would pay $514 million to settle allegations that two former hospitals conspired to violate federal anti-kickback statutes. According to the qui tam lawsuit, which DOJ joined, the hospitals — one in Georgia and the other in South Carolina — paid the Clinica de la Mama for referring undocumented pregnant women to them for deliveries that were paid for by Medicaid.
Also last year, HCA agreed to pay $2 million to settle charges that one of its Georgia hospitals performed unneeded and low-quality cardiac procedures. And Nashville-based drug testing lab Probst Data paid out $9.4 million for FCA charges related to a scheme that exchanged EHR financing help for patient referrals.
During fiscal year 2016, the U.S. recovered $3.3 billion in fraudulent healthcare claims — a return on investment of $5 for every dollar the government spent, according to HHS’ Office of Inspector General. The Medicare Fraud Strike Force also sent 290 fraudsters to prison for sentences averaging more than 48 months.