The allegations claim that Dr. Chandrashekar, a cardiologist at the health system, caused ARH to bill for diagnostic catheterizations that did not have sufficient documentation to prove medical necessity, according to a Nov. 28 news release from the Justice Department.
Dr. Chandrashekar and his practice, Mountain Health Center, also allegedly billed for appointments preceding patients’ diagnostic catheterizations and admitted patients to an ARH location. ARH then submitted claims for the admissions, but the Justice Department said because the admissions did not meet Medicare or Medicaid requirements, they were false claims.
In the settlement, ARH agreed to pay $2,884,046.50 to resolve its liability for false claims. In a separate agreement, Dr. Chandrashekar and Mountain Health Center agreed to pay $149,815.42.
ARH self-reported its conduct, allowing the system to resolve its liability for 1.5 times the amount of monetary loss caused by its false claims.
The claims resolved by the settlements are allegations and no liability was determined, the release said.
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