The developer of a mobile heart monitoring platform has agreed to pay more than $6 million to resolve federal charges that it sought reimbursement for remote patient monitoring services when less-expensive, office-based services were the accepted standard of care.
BioTelemtry, based in Malvern, Pa., will pay $6.4 million to settle the False Claims Act allegation, in which its subsidiary, CardioNet, was accused of billing Medicare and other federal programs for Mobile Cardiac Outpatient Telemetry (MCOT) services that were "not reasonable or medically necessary."
CardioNet became BioTelemetry, Inc., in April 2013 when company officials moved to a holding company structure. Besides CardioNet, BioTelemetry now serves as the parent to CardioCore, a research services company, and Braemar, a monitoring devices company.
CardioNet's MCOT monitors are worn by heart patients for a specified period of time, during which their heart rate is transmitted wirelessly through a cellphone monitor to a diagnostic call center.
Government investigators said CardioNet was aware that MCOT services weren't reimbursable for Medicare patients who'd suffered only mild or moderate heart issues, but submitted claims with inaccurate diagnostic codes and billing codes.
“Billing for a higher-level service that is not necessary to treat a patient’s condition to receive higher reimbursement from federal healthcare programs will not be tolerated,” Acting Assistant Attorney General Benjamin C. Mizer of the Justice Department’s Civil Division said in a press release. “Such conduct wastes critical federal health care program funds and drives up the costs of health care for all of us.”
“Federal employees deserve healthcare providers, including remote monitoring companies, that meet the highest standards of ethical and professional behavior,” Inspector General Patrick E. McFarland of the U.S. Office of Personnel Management said in the release. “Today’s settlement reminds all providers that they must observe those standards, and reflects the commitment of federal law enforcement organizations to pursue improper and illegal billings that increase the cost of medical care.”
