EL PASO, Texas (KTSM) — Several people and entities will pay a total of $3.1 million to resolve allegations of improper billing for medical imaging services at a surgical hospital in El Paso, the U.S. Attorney’s Office for the Western District of Texas announced in a news release.
The Attorney’s Office said that Desert Imaging Services, L.P., In Tandem Solutions Group, LLC, and Leroy Candelaria agreed to pay the U.S. $693,913; Donald Burris and Vox Intus, LLC agreed to forfeit $325,000; and East El Paso Physician’s Medical Center, LLC, doing business as Foundation Surgical Hospital of El Paso, agreed to the entry of a consent judgment of $2,081,739.
The U.S. Attorney’s Office says that the settling parties “engaged in an illegal kickback and pass-through billing scheme, in which Desert Imaging used Foundation Surgical Hospital’s National Provider Identifier (NPI) to submit claims for medical imaging services,” according to the news release.
The U.S. Attorney’s Office said that although the patients who received these services had no connection with the hospital, billing the claims as hospital outpatient services allowed Desert Imaging to obtain a higher rate of reimbursement from federal healthcare programs.
In exchange for allowing Desert Imaging to use its NPI, Foundation Surgical Hospital retained 17 percent of the payments on the claims, according to the news release.
“The settlements announced today resolve a lawsuit filed under the qui tam or whistleblower provision of the False Claims Act, which permits private parties to file suit on behalf of the United States for false claims and share in a portion of the government’s recovery,” read the news release.
The Attorney’s Office said that the claims resolved by the settlement are allegations only, and there has been no determination of liability.
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