An Illinois-based cardiology imaging services provider and its chief executive agreed to pay a total of more than $85 million to settle charges levied by the Department of Justice (DOJ) addressing alleged violations of the False Claims Act regarding unlawful kickbacks.
Cardiac Imaging was ordered to pay $75 million and its CEO Sam Kancherlapalli nearly $10.5 million in reaching settlement, according to a DOJ press release Tuesday. The company and Kancherlapalli allegedly paid referring cardiologists excessive fees to supervise PET scans, violations of the Anti-Kickback Statue and Stark Law.
The settlement resolves claims against Cardiac Imaging brought under the qui tam provisions of the False Claims Act by Lynda Pinto, a former billing manager at the company. Pinto will receive an undetermined amount.
The details: Between March 2014 and May 2023, Cardiac Imaging and Kancherlapalli paid above-fair market value fees of $500 or more per hour for cardiologists to supervise PET scans for patients they referred to the company, the DOJ alleged.
The agency said it found hourly compensation to the cardiologists at times was based on work conducted while they were away from mobile scanning units, were not even on site, or for additional services not provided.
Compliance considerations: The DOJ noted the penalty amounts were based on both the company and Kancherlapalli’s ability to pay.
Cardiac Imaging and Kancherlapalli agreed to a five-year corporate integrity agreement with the Department of Health and Human Services’ Office of Inspector General, according to the settlement agreement.
The corporate integrity agreement requires certain compliance provisions, including the company implementing a centralized annual risk assessment and internal review process to identify risks associated with the False Claims Act and Stark Law, and retention of an independent review organization to perform a systems and transactions review of arrangements.
Company response: In an emailed statement, a Cardiac Imaging spokesperson said the company stands committed to its mission of “providing accessible cardiac care and will continue all operations, including our supervision program.”
“We have been transparent with the government on our processes and operations, and we are fully confident in our compliance program, which will be further enhanced by the framework of the corporate integrity agreement,” the statement read.
In an accompanying statement, Kancherlapalli said, “We are pleased to reach the resolution.”
Cardiac Imaging agreed to the settlement without a determination of liability. The company and Kancherlapalli denied the DOJ’s allegations.