Radiologist Fined $5.7 Million For Fraudulent Services Claims

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In another step for the Health Care Fraud Prevention and Enforcement Action Team (HEAT) initiative, announced in 2009 by Attorney General Eric Holder and Health and Human Services Secretary Kathleen Sebelius, Las Vegas radiologist Rakesh Nathu, MD, has agreed to pay the U.S. government $5.7 million plus interest to settle allegations that he submitted false claims to federal health care programs for various radiation oncology services, including intensity modulated radiation therapy.

From 2007 to 2009, Nathu allegedly submitted to Medicare, TRICARE, and the Federal Employees Health Benefits Plan improper claims in which he double billed for several procedures affiliated with radiation treatment plans; as well as for certain high reimbursement radiation oncology services when a different, less expensive service should have been invoiced and for medically unnecessary radiation oncology services.

Tony West, Assistant Attorney General for the U.S. Department of Justice’s Civil Division, deems the settlement the result of a coordinated effort among his division, the U.S. Attorney’s Office for the District of Nevada, and the Department of Health and Human Services’ Office of Inspector General. Since January of 2009, the Justice Department has recovered more than $7.3 billion in cases involving fraud against federal health care programs.