In a significant settlement following allegations of fraudulent billing practices in El Paso healthcare, several parties, including Desert Imaging Services, In Tandem Solutions Group, and other affiliates, agreed to pay a total of $3.1 million to resolve the case. The allegations pertained to an illicit kickback and pass-through billing scam involving higher reimbursement rates from Federal healthcare programs. This was achieved through the use of the Foundation Surgical Hospital's National Provider Identifier (NPI) to submit claims for medical imaging services unrelated to the hospital's operations.
As reported by the U.S. Attorney's Office, Desert Imaging Services and their related parties agreed to cough up $693,913. In a similar vein, Donald Burris and Vox Intus, LLC consented to forfeit $325,000. Foundation Surgical Hospital of El Paso, caught up in the billing scheme, consented to a judgment of $2,081,739 to clear the air on these allegations. While engaging in this scheme, the hospital retained 17% of all the illicit payments received using its NPI number.
The case, which came about through the qui tam provision of the False Claims Act, was exposed through a whistleblower lawsuit. The provision is significant in that it allows private citizens to sue on behalf of the government in cases of false claims, providing a means for tipsters to partake in financial recoveries secured by the government. The specific case, titled United States and Texas ex rel. Motts v. East El Paso Physician’s Medical Center, et al., was managed for the government by Assistant United States Attorney Thomas Parnham and former Assistant United States Attorney Eddie Castillo.
The settlements were announced recently, though it is important to note that they don't imply guilt or determination of liability. These are merely allegations resolved out of court, as stipulated in the settlement agreement. The law requires such statements — no strings attached to the money changing hands. It's an important distinction because it preserves the settling parties' right to maintain their innocence while doing away with the legal rigmarole.
