Kentucky cardiology firms settle federal suit about overbilling for diagnostic drugs

Last week the U.S. Attorney’s Office in the Western District of Kentucky announced that 16 cardiology practices and their associated physicians across 12 states agreed to pay amounts totaling more than $17.7 million in order to resolve allegations that they overbilled Medicare for diagnostic radiopharmaceuticals, which was a violation of the False Claims Act.

Diagnostic radiopharmaceuticals are radioisotopes used to diagnose and target specific organs in the body, and in some cases treat certain cancers and diseases.

Medicare Part B reimburses healthcare providers for diagnostic radiopharmaceuticals based on the provider’s acquisition cost. 

The government alleged that the settling cardiology practices regularly reported inflated acquisition costs to Medicare for these drugs. 

In each of the settlements, the questionable conduct occurred for at least a year, and in some instances more than 10 years.

U.S. Western District of Kentucky Attorney Michael Bennett said the settling practitioners overbilled the Medicare program by grossly exaggerating the acquisition costs of the drugs used in diagnostic imaging of the heart.

The United States District Court for the Western District of Kentucky has offices located in Bowling Green, Louisville, Owensboro, and Paducah.