Mich. cardiologist pays $2M to settle billing case

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A Michigan cardiologist and his practice paid the U.S. government $2 million to resolve allegations they violated the False Claims Act by knowingly billing federal healthcare programs for diagnostic testing that was either unnecessary or not performed.

Federal investigators claimed that from 2006 to 2017, Dr. Dinesh Shah and his practice, Michigan Physicians Group, knowingly billed government programs such as Medicare, Medicaid, and Tricare for unnecessary diagnostic testing. Investigation into Shah and his practice focused on nuclear stress tests and the unnecessary ordering and performing of those tests.

Other diagnostic tests included in the investigation were ankle brachial index and toe brachial index tests (ABI/TBIs) that were routinely performed on patients without first being ordered by a physician and without regard to medical necessity, according to the claim.

The settlement comes after a years-long investigation by the Office of Inspector General for the U.S. Department of Health and Human Services and the Defense Health Agency acting on behalf of the Tricare Program, a program for veterans.

On top of the civil settlement agreement, Shah and his practice entered into an agreement with the Office of Inspector General that provides some oversight of Shah and his group's billing practices for a three-year period.

Shah and his practice have offices located in Berkley and Livonia, MI with administrative offices, labs, and testing sites at other locations within the metropolitan Detroit area.

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