The Radiology Group, a medical imaging company based in Atlanta, Georgia, and its CEO, Dr. Anand Lalaji, have been ordered to pay a total of $3.1 million in a settlement with the federal government and several states. The company has been accused of defrauding federal health care programs by billing for services that did not meet federal standards. The settlement includes a payment of $2.7 million to the federal government and around $400,000 to the states involved in the case.
The allegations against The Radiology Group were initially brought to light by two whistleblowers. It is unclear how many patients may have been affected by the company’s actions, but their clients include hospitals, clinics, and medical practices in multiple states.
In response to the allegations, the company and Lalaji have claimed that the violations occurred between 2012 and 2018 and were the result of a rogue employee who was subsequently terminated. However, the government has argued that the company should have been aware that the reports were being approved too quickly.
The Radiology Group, which is licensed in over 40 states, was founded by Dr. Anand Lalaji, who serves as the CEO. The company prides itself on its ability to streamline communication and prioritize accuracy. Their website advertises quick turnaround times for evaluating medical images, ranging from 8.43 minutes for stroke patient images to 24.35 minutes for interpreting ER CT scans.
Dr. Lalaji, who is licensed to practice as a radiologist in approximately 20 states, has faced scrutiny in the past regarding his interpretation of medical scans. The Kentucky Board of Medicine reported instances where Lalaji had misread images, including one case involving a missed brain tumor. The board suspended his license temporarily, citing concerns for patient safety.
The federal settlement also raised concerns about The Radiology Group listing Lalaji as the author of reports actually written by a different radiologist in the United Kingdom. Billing Medicare for services rendered outside of the United States is not permissible. Lalaji and the company have argued that they relied on erroneous advice from a billing company regarding the legality of this practice.
The settlement agreement does not specify whether any specific patients were harmed or how the fine money will be allocated. Patients seeking information about potential concerns regarding their care providers may face difficulty, as regulatory bodies often keep allegations confidential during investigation.
The Joint Commission, an organization that evaluates health facilities nationwide, accredits The Radiology Group. Information regarding any violations or issues is not disclosed on the Commission’s website, as their accreditation is voluntary and some information remains confidential.
The American College of Radiology, a professional organization that sets guidelines for radiology practices, declined to comment on the specific rules violated by The Radiology Group. However, they emphasized that the person interpreting the examination and submitting the report should be the same individual.
As the story continues to develop, The Radiology Group faces questions about their outsourcing practices and the qualifications of those involved. In response to inquiries, Dr. Lalaji stated that all scans were officially interpreted within the United States by board-certified radiologists.
It is important for patients to be aware of their rights to access their medical records, including information about the doctors who provided their care. Patients can start by asking their primary doctors for this information, although there may be associated fees for obtaining copies of the records.