Oklahoma Hospital, Radiologists Settle False Claims Allegations

On April 11, United States Attorney for the Western District of Oklahoma Mark A. Yancey, JD, announced that Norman Regional Hospital Authority (NRHA) DBA Norman Regional Health System; Greg Terrell; Chadwick Webber, MD; Merl Kardokus, MD; Rick Wedel, MD; Gautham Dehadrai, MD; Barbara Landaal, MD; and Sanjay Narotam, MD, agreed to pay $1,618,750 to the United States to settle civil claims stemming from allegations that the hospital submitted false claims to Medicare. 

NRHA operates Norman Regional Hospital, which provides radiological and other services to patients in Norman, Oklahoma. Terrell is a former hospital administrator and the physicians are radiologists employed by NRHA. 

The hospital previously employed radiological practitioner assistants (RPAs) in its radiology department. RPAs are not physicians, and the services RPAs provide to Medicare beneficiaries cannot be billed to Medicare unless rendered under the appropriate level of supervision by a physician. Certain radiological diagnostic services require "personal" supervision; a physician must be supervising in the room when the RPA performs the service. If a physician is not in the room, the service cannot be billed to Medicare.

The United States alleges that from January 1, 2008, through September 30, 2016, NRHA and the individual defendants submitted, or caused to be submitted, false claims for payment to Medicare for radiological services performed by RPAs without proper supervision. Specifically, the RPAs performed radiological services that required "personal" supervision, but a physician was not in the room supervising the RPA when the service was performed.

After being notified of the allegations, NRHA cooperated with the United States' investigation. In order to resolve the United States' allegations, NRHA and the individual defendants have agreed to pay $1,618,750. 

The settlement resolves allegations filed in Federal District Court in Oklahoma City by Lance M. Garber, MD, a physician formerly employed by NRHA as a radiologist. This qui tam—whistleblower—suit under the False Claims Act permits private individuals to sue on behalf of the government for false claims and to share in the recovery. The Act also allows the government to intervene in the lawsuit, as the government did in this case.

In reaching this settlement, NRHA did not admit liability, and the government did not make any concessions regarding the legitimacy of the claims. The agreement allows the parties to avoid the delay, expense, inconvenience, and uncertainty involved in litigating the case. 

This case was investigated by the United States Department of Health and Human Services, Office of Inspector General, and the Federal Bureau of Investigation. The case was prosecuted by Assistant United States Attorneys Ronald R. Gallegos, JD, and Scott Maule, JD.

— Source: The United States Attorney's Office — Oklahoma, Western