In a recent announcement, a cluster of medical entities and individuals, including Desert Imaging Services, has agreed to pay a hefty sum to settle accusations of fraudulent billing. According to the U.S. Department of Justice, Desert Imaging, together with In Tandem Solutions Group, LLC, and Leroy Candelaria, will cough up $693,913. Meanwhile, Donald Burris and Vox Intus, LLC have consented to forfeit $325,000. Foundation Surgical Hospital of El Paso, where these alleged improprieties took place, is on the hook for a $2,081,739 consent judgment.
Underpinning this settlement, the federal government argued a scheme was afoot, with Desert Imaging wrongfully using the hospital's National Provider Identifier (NPI) to bill for medical imaging services. The patients served were not connected to the hospital, but charging the services as outpatient visits to the hospital meant hitting pay dirt, billing Federal healthcare programs at an inflated rate. For their part in the scheme, Foundation Surgical Hospital got to retain a 17% slice of the payments.
The legal action that brought the issue to light came by way of a whistleblower, under the False Claims Act's qui tam provision, which allows private citizens to sue on the government's behalf and potentially share in the recovery. These settlements spring from the lawsuit dubbed United States and Texas ex rel. Motts v. East El Paso Physician’s Medical Center, et al., Case No. EP-18-CV-348-LS (W.D. Tex.).
Although the Assistant United States Attorney Thomas Parnham and former Assistant United States Attorney Eddie Castillo, in rolling out the settlement details, said that these amounts put to bed claims that are still just claims. As of right now, there's been no legal finding of wrongdoing. According to the U. S. Department of Justice, "The claims resolved by the settlement are allegations only and there has been no determination of liability."
