Sooner State rads in trouble for improper duty delegation followed by bad billing
Six radiologists in Oklahoma may face monetary damages and penalties in the millions for having practitioner assistants provide restricted clinical services without radiologist supervision—and then billing CMS as though that base had been covered. Their regional health system may be on the hook too.
The Norman Transcript reports that the fraudulent activities took place between 2008 and 2012.
A radiologist colleague filed a whistleblower suit in 2014. The scandal is coming to light now because a U.S. district court has unsealed the case.
“While federal payers such as Medicare and Medicaid recognize some credentialed professional practitioners such as physician assistants and nurse practitioners, radiology practitioner assistants (RPAs) are not recognized as providers and ‘may not enroll and bill the Medicare program for their services,’ according to court documents,” the newspaper reports. “Billing requires a radiologist to be present when RPAs perform procedures.”
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Dave P. has worked in journalism, marketing and public relations for more than 30 years, frequently concentrating on hospitals, healthcare technology and Catholic communications. He has also specialized in fundraising communications, ghostwriting for CEOs of local, national and global charities, nonprofits and foundations.