Norman hospital settles over Medicare false claims allegations – NewsOK.com
NORMAN — The Norman Regional Hospital Authority, a former hospital administrator and six radiologists have agreed to pay the federal government more than $1.6 million to settle a federal lawsuit over Medicare false claims allegations.
The hospital and those employees were accused of submitting false claims to obtain Medicare reimbursement for diagnostic services performed by radiological practitioner assistants (RPAs) without proper supervision by physicians.
“There are certain radiological diagnositic services that require ‘personal’ supervision,” the Oklahoma City U.S. Attorney’s Office said in a news release. “This means that a physician must be in the room supervising the RPA when the RPA performs the service. If a physician is not in the room, the service cannot be billed to Medicare.”
Joining Norman Regional Hospital Authority in agreeing to pay the settlement were former hospital administrator Greg Terrell and doctors Chadwick Webber, Merl Kardokus, Rick Wedel, Gautham Dehadrai, Barbara Landaal and Sanjay Narotam.
The $1,618,750 settlement resolves allegations that originally were made in a whistleblower’s lawsuit filed in Oklahoma City federal court by Dr. Lance Garber, who formerly worked as a radiologist at Norman Regional Hospital.
The lawsuit was filed under a provision of the law that allows a private individual to sue on behalf of the federal government to recover money collected through false claims. The lawsuit allows the the government to intervene in the lawsuit, which the government did in this case.
When the government intervenes, the whistleblower is entitled to receive a portion of the amount that is recovered. In this case, Dr. Garber will be paid $291,375, or 18 percent of the settlement amount, said Scott Williams, spokesman for the U.S. Attorney’s Office.
The Norman Regional Hospital Authority and other plaintiffs also agreed to pay $31,398 for Dr. Garber’s attorney’s fees, Williams said.
The Norman Regional Hospital System issued a news release Tuesday saying the settlement was not an admission of liability.
“NRHS and the named defendants denied the allegations outlined in the complaint and denied engaging in any wrongful conduct,” the news release said. “Neither the signing of the settlement agreement, nor the performance of any obligation arising under the settlement agreement is an admission of facts or liability by the defendants.”
The hospital system said it was refunding to the federal government the actual amount paid for the services, plus penalties.
A radiological practitioner assistant is a registered radiographer who has completed an additional educational program, certified by the Certification Board for Radiology Practitioner Assistants, and is credentialed to perform minor invasive procedures, Norman Regional officials said. “Norman Regional Health System has a robust compliance program that focuses on billing accuracy and compliance with all federal health benefit programs,” Chief Executive Officer Richie Splitt said. “We are entering into this settlement agreement to resolve the allegations so that our employees, physicians, and administration can focus on our mission to serve our community as the leader in health and wellness care.”