A U.S. federal false claims case against Atlanta-based American Health Imaging (AHI) and its CEO highlights risky marketing and referral agreement strategies for executives of independent diagnostic testing facilities (IDTFs).
From 2011 to 2019, AHI relied on a variety of inducements, such as sporting events, fishing trips, happy hours, sponsorships of “open houses” at physician offices, and gifts of alcohol, gas cards, and free scans to generate referrals, according to the U.S. Department of Justice (DOJ) in a December 2 statement. Examples include tickets to the SEC football championship game, tickets to concerts, monthly dinners with referral sources, and outings to nail salons.
Settled at a cost of nearly $5.3 million, the civil case involved generating business for AHI’s IDTFs, as well as service agreements with physicians for compensation above fair market value for interpreting scans, in violation of the Anti-Kickback Statute, according to the U.S. Attorney’s Office for the Northern District of Georgia.
There was no determination of liability, according to the DOJ, but AHI and its former founder and CEO Scott Arant agreed to pay $5.25 million to settle the allegations brought by former employee Tanya Benjamin in a qui tam action, whistleblower lawsuit, in September 2015. Benjamin will receive $892,500, according to the settlement.
The government alleged that the defendants knowingly submitted or caused the submission of false or fraudulent claims to Medicare and Georgia Medicaid. The defendants denied the allegations.