The owner of a medical imaging office in Lewes is accused of running tests on Medicare patients without a doctor's supervision and billing the government millions for scans and images.
A lawsuit filed in U.S. District Court for the District of Delaware alleges that Richard C. Pfarr, owner of Orthopaedic and Neuro Imaging LLC, knowingly submitted false claims to Medicare by administering magnetic resonance imaging scans on Medicare patients without proper supervision by a physican.
Specificially, the lawsuit states that patients were injected with contrast dye, a chemical used to make certain tissues more visible during an MRI.
Medicare requires a physician supervise patients who are injected with contrast dye in the event of an adverse reaction, the lawsuit states.
According to the lawsuit, Pfarr operates imaging facilities in Lewes, Seaford, Millsboro, and Salisbury, Md., which all billed for procedures without a physician directly supervising.
“The intervention of the United States in this matter illustrates our office's commitment to combat healthcare fraud and protect Medicare beneficiaries,” said Acting U.S. Attorney David C. Weiss. “Fraudulent billing practices, like those alleged in this lawsuit, not only harm taxpayers who fund government healthcare programs, they also create needless patient risk.”
The lawsuit filed Sept. 26 is similar to one filed by former employee Robin White in 2013. White worked at ONI from 2002 to 2012 as an MRI techologist, performing imaging tests and training other employees on MRI equipment.
White filed the lawsuit under federal provisions that allow a person to sue on behalf of the United States for false claims of government funds.
In the latest lawsuit, the United States has now taken over primary responsibility for the civil action.
The lawsuit contends that about 1,700 Medicare patients were injected from 2003 to 2014 without direct supervision by a physician. During that time, the suit states, ONI received more than $1 million from Medicare.
The lawsuit notes that ONI provided a physician on site in 2012, but it was brief; ONI continued to list the doctor as a supervising physician after he no longer worked there. Other doctors were similarly listed as direct supervisors, and documents signed by Pfarr stated pay information for them even though the doctors said they neither worked there nor received payment, the suit states.
For years, the lawsuit contends, ONI did not maintain required documentation.
“In order to ensure that patient health and safety is appropriately protected, the Medicare regulations applicable to independent diagnostic testing facilities require them to maintain documentation of sufficient physician resources during all hours of operations to assure that the required physician supervision is furnished,” the lawsuit states. “When the government subpoenaed ONI for those records, no documentation showing supervision of tests requiring physician presence in the office suite was produced.”
In addition to the Lewes office, Pfarr owns and operates offices in Seaford and Millsboro. The lawsuit states a similar pattern for billing for services without a physician supervising.
ONI performed more than 300 procedures in Seaford from 2005 to 2014, receiving payment for about $200,000. In Millsboro, from 2008 to 2014, the office performed more than 200 procedures and was paid more than $100,000, the lawsuit states.
An office in Salisbury, Md., handled about 80 procedures from 2012 to 2014 for more than $25,000.
The lawsuit seeks civil penalties and damages under the False Claims Act. This includes investigative costs and relief the court deems just.
Pfarr could not be reached for comment. His attorney, Dan Lyons, said they disagree with the technical requirements of whether a physician was there when services were provided.
“There’s a disagreement on what we had to have in order to satisfy that a doctor is available,” he said. “There is no claim that we did not provide the services or that the services were not properly provided or there was a problem or bad outcome. There are none of those claims. It has to do with the requirements and whether we met them.”