A long-running effort to stop kickbacks between testing centers and referring doctors has resulted in last week’s filing by the Illinois Attorney General of a complaint against a single imaging clinic, accusing it of a sham billing procedure that allowed doctors to take a piece of insurance payments meant for testing, as a reward for referrals.
According to the complaint, Elk Grove MRI set up sham lease agreements which granted referring physicians the right to bill insurance companies for MRI procedures done by Elk Grove. The physician would then pocket a portion of the insurance claim payment.
Attorney General Lisa Madigan says this system violates the Illinois Insurance Claims Fraud Prevention Act and the Illinois Consumer Fraud Act by not disclosing to insurers and patients the nature of the agreements and that the scheme causes public harm by encouraging doctors to order unnecessary scanning services.
Friday’s suit stems from a 2007 complaint against Elk Grove and other MRI facilities which was dismissed due to lack of details about specific false claims made by physicians.
A refiled complaint later in 2007 was voluntarily dismissed so that the Attorney General could pursue more detailed claims against individual imaging centers.
Madigan wants the court to permanently enjoin Elk Grove from continuing its alleged kickback scheme and is seeking a penalty of $5,000 to $10,000 for each violation