HARRISBURG — This is an official press release from the U.S. Department of Justice (USAO - Pennsylvania, Middle), published as received.

HARRISBURG - The United States Attorney’s Office for the Middle District of Pennsylvania announced that Scranton Heart Institute (SHI) has agreed to pay $48,709.20 to resolve allegations that it violated the False Claims Act by submitting false claims for payment to Medicare for CPT codes associated with PET scan services in violation of the applicable Medicare rules and regulations.

According to the United States Attorney Brian D. Miller, between December 10, 2020 and May 31, 2023, SHI knowingly and willfully received renumeration offered or paid by a mobile PET scan company to induce SHI to refer its Medicare patients to that company for PET scans, in the form of (1) significant hourly payments designated as payments for professional supervision of the mobile imaging services, and (2) allowing SHI to bill for and retain the Medicare professional component reimbursement for the mobile imaging services.  Therefore, the United States contends that SHI submitted false claims to Medicare associated with imaging services using certain CPT codes that resulted from violations of the Anti-Kickback Statute.  Additionally, the United States contends that the renumeration SHI received from the mobile PET scan company created a financial relationship between SHI’s physician and the mobile PET scan company that did not satisfy any exception to the physician self-referral law.

“Kickback schemes can jeopardize medical decision making, which may significantly impact patient care and program costs,” said Special Agent in Charge Maureen Dixon of the U.S. Department of Health and Human Services Office of Inspector General (HHS-OIG). “HHS-OIG is committed to working with the U.S. Attorney’s Office and other partners to investigate alleged violations of the Anti-Kickback Statute in the Medicare program.”

This matter was handled by Assistant U.S. Attorney Tamara Haken and the Affirmative Civil Enforcement Unit of the U.S. Attorney’s Office for the Middle District of Pennsylvania with assistance from the Health and Human Services Office of Inspector General (HHS-OIG).

The claims resolved by the settlement are allegations only and there has been no determination of liability.

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