BioTelemetry Inc. and its subsidiary CardioNet LLC have agreed to pay $44,875,000 to resolve allegations that they violated the False Claims Act by knowingly submitting claims to Medicare, TRICARE, the Veterans Health Administration, and the Federal Employee Health Benefits Program for heart monitoring tests that were performed, in part, outside the United States.
The United States alleged that CardioNet improperly billed Medicare and other federal health care programs for certain cardiac monitoring services — including Holter, event monitoring, and mobile cardiovascular telemetry (MCT) tests — that were performed overseas in violation of federal law that prohibits payment for services furnished outside the United States. More specifically, the government alleged that, in 2013, CardioNet contracted with a company located in India for the provision of diagnostic and analysis services of heart monitoring data. Although BioTelemetry set up a workflow that was designed to route electrocardiogram data, including data relating to cardiac events (ECG Data) for federal healthcare beneficiaries, to a domestic independent diagnostic testing facility for review and analysis, the government alleged that BioTelemetry — with the knowledge of then senior management — diverted certain federal beneficiaries’ ECG Data to India when the domestic workflow became backlogged. BioTelemetry also allegedly sent ECG data for other federal beneficiaries directly to India for review. In 2014, over 29% of the ECG Data reviewed in connection with MCT tests, and over 78% of the ECG Data reviewed in connection with event monitoring tests, for Medicare patients were allegedly reviewed by technicians located in India. In 2015, those numbers allegedly rose to over 47% and over 88%, respectively. Although BioTelemetry began implementing technological controls in late 2015 to prevent personnel in India from accessing the domestic workflow, those controls were insufficient, and technicians in India allegedly continued to review and analyze some ECG Data for federal healthcare program beneficiaries thereafter.
“Federal health care beneficiaries deserve care, including remote cardiac monitoring, that complies with federal law and is provided by qualified clinical personnel,” said Principal Deputy Assistant Attorney General Brian M. Boynton. “Today’s settlement reminds all providers that they must observe those standards and reflects the department’s commitment to pursue knowing violations of federal health care program requirements.”
Principal Deputy Assistant Attorney General Brian M. Boynton said, “Providers must act within clear federal healthcare program boundaries to ensure that appropriate care is given to the beneficiaries of those programs.”
“Providers participating in federal health care programs are obligated to obey the laws meant to protect the integrity of those programs and the quality of care furnished to patients,” said Special Agent in Charge Maureen R. Dixon of the Department of Health and Human Services. “With our law enforcement partners, our agency is extremely committed to investigating providers alleged of defying these requirements.”
The United States further alleged that most of the offshore technicians tasked with reviewing ECG Data for federal healthcare program beneficiaries did not have the basic qualifications to perform the tests in question. Of the more than 450 India-based technicians who reviewed Medicare patients’ ECG Data in connection with MCT services that CardioNet billed to Medicare during the 2013 to 2018 period, the majority did not possess the necessary certifications or degrees required to perform cardiac monitoring services. BioTelemetry Inc. and its subsidiary CardioNet LLC agreed to pay $44,875,000 to resolve allegations that they violated the False Claims Act.
BioTelemetry Inc., a company based in Pennsylvania, has agreed to pay $44,875,000 to settle allegations that they knowingly submitted claims to Medicare and other federal health care programs for heart monitoring tests performed, in part, outside the United States. The company will pay the fine to resolve the False Claims Act violations.
BioTelemetry Inc. and its subsidiary CardioNet LLC agreed to pay $44,875,000 to resolve the allegations that they violated the False Claims Act. The majority of the offshore technicians tasked with reviewing ECG Data for federal healthcare program beneficiaries did not have the necessary certifications or degrees required to perform cardiac monitoring services.
BioTelemetry Inc., a company based in Pennsylvania, has agreed to pay $44,875,000 to settle allegations that they knowingly submitted claims to Medicare and other federal health care programs for heart monitoring tests performed, in part, outside the United States. Defendant: BioTelemetry Inc. Criminal Charges: False Claims Act Violations. City and State: Pennsylvania. Exact Date: Not specified. Sentence or Outcome: Paid $44,875,000 to resolve allegations.
BioTelemetry Inc. and its subsidiary CardioNet LLC agreed to pay $44,875,000 to resolve the allegations that they violated the False Claims Act. The companies will pay the fine to resolve the case.
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Key Facts
- State: Pennsylvania
- Category: White Collar Crime
- Source: DOJ Press Release â†â€â€
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