Wednesday, May 23, 2018
Business

Rose Radiology, facing $8.7M settlement, says violations of Medicare rules were inadvertent

TAMPA — Rose Radiology Centers says it did not mean to break Medicare rules despite missteps that led it to agree to pay nearly $9 million to settle a pair of federal whistle-blower lawsuits.

Instead, Rose Radiology says, it was tripped up by complex health care regulations. In a statement, the company said its staff members had worked off of what they thought were "correct interpretations of vague and conflicting health care regulations."

The $8.7 million settlement, announced last week, addressed several allegations brought in 2012 and 2013. The whistle-blowers who brought the lawsuits will receive $1.7 million each.

Rose Radiology, which has 11 locations around the Tampa Bay area, settled the lawsuits without admitting any wrongdoing. The company said it decided to settle rather than "go through the turmoil of litigating with the U.S. government, where you lose even if you win."

"Rose Radiology believes it's near impossible to litigate against the U.S. government with its infinite resources," the company said in a statement.

Dr. Manuel Rose, who founded the practice, said he feared an unfavorable ruling could have knocked Rose Radiology out of business.

Rose said his practice changed its procedures years ago to meet federal regulations. And it has become especially cautious about interpreting health care rules, consulting with attorneys when it has doubts about the law.

"We're just questioning everything," Rose said in an interview. "We're putting this behind us."

The company says it will pay the government back over several years, effectively treating Medicare patients free of charge.

Rose has deep ties in Tampa Bay. He was staff radiologist for a year at MacDill Air Force Base and returned to the area permanently in 1995. He opened his own practice in 2001 after working in Largo.

A longtime hockey fan, he serves as the Tampa Bay Lightning's radiology consultant, and he owns ice rinks in Clearwater and Oldsmar, an effort to drum up interest in the sport, he said. One of his properties, the Clearwater Ice Arena, is in the midst of a $5 million project to add a second, NHL-regulation rink. Those plans won't be affected by the settlement, he said.

According to accusations unsealed in federal court last month, the radiology practice:

• Charged Medicare for tests patients' physicians didn't order. A whistle-blower alleged that tests were performed without a prescription a few times a week in her office, which obtained or wrote one retroactively.

• Billed for services the government won't pay for, like those requested by chiropractors. The suit cited five instances in which radiologists signed chiropractors' prescriptions before sending them for reimbursement.

• Billed Medicare for tests performed at offices that weren't accredited by the agency. Two of the company's offices, which have since closed, were not enrolled with Medicare; services provided there were marked as having taken place at an accredited office.

• Offered "kickbacks" to doctors who referred their patients to the practice. The practice changed its rates depending on which doctor referred a patient.

• Didn't have physicians on hand when patients received injections of dye, which helps radiologists read MRI results. A whistle-blower estimated that in 2012, physicians observed only about a third of injections.

"There is no room for such practices in our public health care programs," U.S. Attorney A. Lee Bentley III said in a statement. "We will continue to do everything within our power to protect the public against such violations, when and where they are found."

Contact Thad Moore at [email protected] or (813) 226-3434. Follow @thadmoore.

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