Posted: Mar 5, 2013 8:15 PM by Mike Manzoni -- email@example.com
Updated: Mar 5, 2013 11:08 PM
CORPUS CHRISTI -- The U.S. Attorney's office on Tuesday announced that it had settled a federal lawsuit with a Driscoll Children's Hospital-owned clinic and a radiology office over illegal billing practices.
Federal prosecutors said Children's Physician Services of South Texas and Radiology Associates each billed the government for the same procedure over a span of five years. The double-billing, prosecutors said, "...resulted in at least $12.3 million in wrongful reimbursement...."
According to court papers, the revenue manager at Radiology Associates discovered the double-billing after noticing that "...the office manager for Driscoll Genetic Services...was evasive and difficult when approached about billing matters." Prosecutors said "...both companies apparently knew about the double-billing...."
Prosecutors said the children's clinic billed the government twice, once for the cost of taking the genetic ultra sound and once for the cost of interpreting the ultra sound, despite an agreement with the radiology clinic that each office would only bill for one component of the exam.
The patients were women whose doctors ordered ultra sounds because of the high-risk nature of their respective pregnancies.
Under the terms of the settlement, Driscoll Health System agreed to pay $1.5 million while Radiology Associates agreed to pay $800,000.
A statement released by Driscoll Children's Hospital spokesman William Larsen read in part: "[The hospital system]...decided to settle the case...to avoid the delay, uncertainty, inconvenience and expense of protracted litigation...." The statement called the claims a "...matter of interpretation...."
"Improper double-billing by health care providers defrauds the government funded health care programs, adds to the government's deficit, and, most importantly, reduces the funds available to meet the patients' medical needs," U.S. Attorney Kenneth Magdison said in a statement.
A phone call to Radiology Associates for comment was not returned.
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