According to the Justice Department, the FCA case was based on allegations that Dr. Malik submitted “inappropriate claims for myocardial perfusion studies,” which are commonly called nuclear stress tests. These tests are usually performed in two separate phases – stress and rest – and they must be coded and submitted as one test. The government alleged that Dr. Malik and his companies violated these requirements and “double-billed for multiday nuclear stress test studies.” In addition, the government alleged that Dr. Malik and his companies “billed under codes that did not apply to the nuclear stress test studies he administered and billed for services already included in the payment for nuclear stress test codes, such as intravenous injections, drug infusions, 3D rendering, and drug administration.”
According to the release, the case covers Medicare, District of Columbia Medicaid, Maryland Medicaid, TRICARE, and the Federal Employees Health Benefits Plan. The State of Maryland and the District of Columbia had joined the lawsuit under their respective state False Claims Acts.
John Sinatra is a partner in the Business Litigation Practice at Hodgson Russ LLP. You can reach him at jsinatra@hodgsonruss.com.