A La Habra medical scan company has agreed to pay $8.3 million, plus additional money based on future revenue, to resolve claims that it violated federal law by paying extra fees to referring cardiologists to supervise positron emission tomography (PET) scans, the Justice Department announced Friday.
“Paying illegal kickbacks to doctors so they refer patients undermines the integrity of federal health care programs and needlessly increases costs,” said First Assistant U.S. Attorney Bill Essayli. “Patients deserve care based on their medical need and not on a doctor or company’s financial interest. Our office will continue to bring such cases to hold wrongdoers accountable.”
From September 2016 to January 2025, Modern Nuclear Inc, the La Habra-based mobile PET scan company, allegedly knowingly submitted fraudulent claims to federal health care companies in cases where it violated the Anti-Kickback Statute, according to the DOJ. The monetary kickbacks allegedly came in the form of above-fair market value fees, where MNI allegedly paid excessive fees to referring cardiologists to supervise PET scans for the patients they referred to MNI.
MNI allegedly paid referring cardiologists for the time they spent in their offices caring for other patients or while they were not on site at all or for additional services beyond supervision that were never or rarely provided, the DOJ said.
The company claimed to rely on measuring fair market value through an attorney-opinion, said the DOJ, that the U.S. alleged was based on “fundamental inaccuracies” which the consultant ended up withdrawing.
MNI entered into a five-year corporate integrity agreement with the U.S. Department of Health and Human Services Office of Inspector General, which requires that MNI use measures to make sure that arrangements with referring physicians are compliant with the Anti-Kickback Statute, among other provisions.
Under the agreement, MNI must also implement a compliance program to identify and address the Anti-Kickback Statute risks linked with other financial arrangements and retain an Independent Compliance Expert to perform a review of the effectiveness of the compliance program.
“Paying kickbacks to physicians — as alleged in this case — can undermine the integrity of the Medicare program by interfering with impartial medical decision-making,” said Special Agent in Charge Robb R. Breeden of the U.S. Department of Health and Human Services Office of Inspector General. “This resolution demonstrates our agency’s continued commitment to holding Medicare providers accountable and ensuring that medical decisions are driven by patient needs, not illegal incentives.”
“Modern Nuclear Inc.’s civil settlement acknowledges its role in compromising the federal health care system,” said John Helsing, Special Agent-in-Charge of the Department of Defense Office of Inspector General, Defense Criminal Investigative Service (DCIS), Western Field Office. “DCIS remains committed to combating health care fraud by holding providers accountable and protecting TRICARE, the Department’s primary health care program, from abuse. The work done by DCIS, our investigative partners, and the Department of Justice ensures that resources are preserved for the legitimate care of our service members, their families, and retirees.”