The United States has lodged a complaint under the False Claims Act against Rick Nassenstein, a former executive of Cardiac Imaging Inc. (CII), based in Illinois. Nassenstein, residing in Florida, previously served as the president, chief financial officer, and co-owner of CII, a provider of mobile cardiac positron emission tomography (PET) scans.
The complaint alleges Nassenstein’s involvement in a scheme where CII paid excessive fees to doctors who referred patients for cardiac PET scans, violating the Physician Self-Referral Law, commonly known as the Stark Law. This law prohibits healthcare providers from billing Medicare for designated health services referred by physicians with whom the provider has a financial relationship not meeting statutory exceptions.
The lawsuit claims that Nassenstein orchestrated compensation arrangements with referring cardiologists, paying them as if they were fully occupied supervising CII’s scans, even when they were attending to other patients or not on site. It further alleges that CII’s fees supposedly covered additional services beyond supervision that were not actually provided. Cardiac PET scans are nuclear medicine tests used to assess heart function and diagnose cardiac disease.
The complaint, filed by Lynda Pinto, a former billing manager at CII, initially under the qui tam provisions of the False Claims Act, asserts that private parties can file actions on behalf of the United States and may receive a portion of the recovery. The government has intervened in the case. If found liable, the defendant could be liable for three times the amount of losses plus applicable penalties.
“Improper compensation arrangements unnecessarily drive-up healthcare costs and cloud a physician’s medical judgment,” said U.S. Attorney Alamdar S. Hamdani. “This complaint alleges that in an effort to increase profits, Nassenstein caused CII to enter into improper compensation arrangements with cardiologists who referred patients for cardiac PET scans. We are committed to enforcing the Stark Law and protecting Medicare from these types of improper financial relationships.”
The Justice Department, along with the U.S. Attorney’s Office for the Southern District of Texas, is handling the case with support from the Department of Health and Human Services (HHS) Office of Inspector General. The investigation highlights the government’s commitment to combat healthcare fraud, emphasizing the importance of reporting potential fraud, waste, abuse, and mismanagement to HHS.
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