Two companies operating Open MRI locations in Savannah, Brunswick and Douglas have settled with the U.S. government after being accused of submitting false claims of more than $1.2 million for procedures that were not properly supervised.
Diagnostic Systems, Inc. operating as Open MRI of Savannah and Southeast Georgia Open MRI operating Open MRI at Fountain Lake, and Open MRI of Douglas, have agreed to pay the United States $1,273,126.
They payment would settle allegations they submitted inaccurate claims to Medicare, Georgia Medicaid, TRICARE, and the Federal Employees Health Benefit Program (FEHBP), for MRI procedures that were not supervised by a physician as required by law, according to a Department of Justice press release sent Friday.
In certain MRI procedures, the release said, a contrast agent, such as dye, may first be injected into a patient to produce a clearer diagnostic picture. The use of contrast, however, could pose significant health risks to a patient, so under Medicare regulations, MRI procedures with contrast require a physician to be present or immediately available to handle any emergencies that may arise.
MRI facilities generally receive a higher rate of reimbursement for procedures that use a contrast agent, as opposed to MRIs without contrast.
Federal investigators alleged that from about January 2007 to October 2011, Open MRI facilities in Brunswick, Douglas, and Savannah performed hundreds of MRI procedures using contrast without physician supervision. In most instances, only clerical staff and a technician were on site during the procedures, the release stated. Open MRI then billed various federal health care programs for those unsupervised procedures.
“Health care providers cannot put profits above patient safety,” U.S. Attorney Edward J. Tarver said in the statement. “Medicare, Medicaid and other federal health care programs operate on the honesty of its providers, and this office will actively pursue those who misuse the programs for financial gain.”
Open MRI also entered into a five-year corporate integrity agreement with the U.S. government, which contains provisions intended to ensure the company’s compliance with Medicare regulations in the future.