Jacksonville radiology practice to pay state $161K following Ashley Moody investigation

Image via Tallahassee Democrat.

Florida Attorney General Ashley Moody has reached an agreement with a radiology practice in Jacksonville following an investigation into allegations of health care fraud.

Following a joint investigation by Moody’s Medicaid Fraud Control Unit and the U.S. Attorney’s Office for the Middle District of Florida, the medical practice Mori, Bean and Brooks, P.A. was found to be knowingly submitting false claims to the Medicaid program for the interpretation of radiological images that were ineligible for reimbursement.

The practice agreed to pay the state of Florida $161,694 to resolve the allegations as part of the $1.49 million settlement.

“Upholding the integrity of the Medicaid program is imperative,” Moody said in a news release. “I am proud of the work conducted by our MFCU and the U.S. Attorney’s Office in uncovering this scheme. My office will continue to pursue those who deliberately defraud the Medicaid program.”

The investigation found that from April 27, 2012, through Feb. 5, 2019, MBB billed Medicaid for the interpretation of radiological images outsourced overseas. According to the settlement report, the practice sent images to radiologists in Madrid, Spain; Mumbai, India; and Sydney, Australia to interpret the images during night hours for emergency room visits to Jacksonville hospitals. 

Medicaid requires teleradiology services to be completed within the U.S. in order to qualify for reimbursement. MBB cooperated with the U.S. government upon being informed of the investigation.

The investigation and settlement stems from a lawsuit originally filed in the U.S. District Court for the Middle District of Florida by Thomas Heyck.

Heyck is a radiologist who was previously employed by MBB. The former employee sued under provisions of the False Claims Act, which allow individuals the ability to sue on behalf of the U.S. for false claims and to share in the recovery. Because of this, Heyck will receive 19% of the proceeds from the agreement.

Assistant U.S. Attorneys Shea Gibbons and Sean Keefe for the Middle District of Florida handled the case.