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UI will implement training, pay over $16,000 to resolve X-ray Medicare claims
Federal rules require images to be reviewed by attending physicians
CEDAR RAPIDS — The University of Iowa has agreed to implement training and will pay $16,444 to resolve allegations that the university, through its academic medical center in Iowa City, incorrectly submitted Medicare claims for X-ray interpretations by resident doctors.
According to the U.S. Attorney’s Office, certain civil claims had been filed against the university for submitting Medicare claims for resident X-ray interpretations that were not reviewed by attending physicians as required between July 2018 and May 2020.
Under federal Medicare rules on the interpretation of diagnostic radiology in a teaching setting, a physician fee schedule payment may be made for X-ray interpretations only if the interpretation is reviewed or performed by a physician other than a resident.
Under the settlement agreement, UI will implement mandatory physician training regarding Medicare requirements for interpretations of diagnostic radiology in teaching settings, according to the news release.
UI cooperated fully during the investigation and did not admit to any liability as part of the settlement agreement.
This civil matter was brought under the whistleblower provisions of the False Claims Act, according to the news release. The whistleblower will share in the financial recovery.
The case was handled by Assistant U.S. Attorneys Melissa Carrington and Jacob Schunk, and investigated by the U.S. Department of Health and Human Services Office of Inspector General and the Department of Defense Office of Inspector General.
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