According to a Nov. 12 release by the Justice Department, Brandon Eye Associates, with locations in Brandon, Sun City and Plant City, Fla., and a third-party provider of turnkey mobile transcranial Doppler ultrasounds, performed TCDs on patients diagnosed with common health conditions such as diabetes, hypertension and glaucoma.
Before sharing TCD results, Brandon Eye Associates and the third-party provider reclassified the patients as having more serious diagnoses, such as occlusion and stenosis of cerebral arteries, making them eligible for Medicare or Medicaid reimbursement for the TCD. However, nearly none of the patients who received the TCDs had actually received the more serious diagnoses, nor did their results indicate such conditions.
For each TCD administered for Medicare Part B patients, Brandon Eye Associates claimed reimbursement for the technical component, paid the third-party provider based on the volume or value of tests ordered and referred the patient to the provider’s preferred radiology group for the TCD’s professional component.
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