Two former employees of East Tennessee Heart Consultants, a forty physician cardiology practice in Tennessee, tipped off federal prosecutors, who then filed a qui tam claim alleging the cardiology practice had a policy of retaining overpayments for services provided unless refunds were specifically requested, and that the practice maintained its billing records to conceal the credit balances.
Under the terms of the settlement agreement, the cardiology practice will pay $1.5 million to the federal government, $200,000 to the State of Tennessee, $44,000 to Blue Cross Blue Shield, $123,000 to private insurers, and $1 million to thousands of patients. East Tennessee Heart Consultants has also entered into a 5-year corporate integrity agreement with the Office of Inspector General, the terms of which can be viewed on the OIG website accessible through the health law links on this Blog.
