Scranton Heart Institute to Pay $46,000 for Alleged False Claims Submission

Scranton Heart Institute Pays Over $48,000 to Settle Medicare Fraud Allegations

Federal authorities announced Monday that Scranton Heart Institute has agreed to pay $48,709.20 to resolve allegations that it submitted false claims to Medicare, violating the False Claims Act.

According to the United States Attorney’s Office for the Middle District of Pennsylvania, the cardiology practice allegedly engaged in improper billing practices related to PET scan services, a sophisticated imaging technology commonly used to diagnose heart conditions.

U.S. Attorney Brian D. Miller stated that between December 2020 and May 2023, the institute “knowingly and willfully received remuneration offered or paid by a mobile PET scan company to induce SHI to refer its Medicare patients to that company for PET scans.” This arrangement allegedly violated the Anti-Kickback Statute, which prohibits healthcare providers from accepting payments in exchange for patient referrals.

Investigators identified two key components of the alleged kickback scheme. First, the mobile imaging company provided “significant hourly payments” to Scranton Heart Institute, ostensibly for professional supervision of mobile imaging services. Second, the arrangement allowed SHI to bill Medicare directly and retain reimbursements for the professional component of these services.

The settlement highlights ongoing federal efforts to combat healthcare fraud, particularly in Medicare, which provides health insurance coverage to approximately 65 million Americans, primarily those aged 65 and older. Such enforcement actions have intensified in recent years as healthcare spending continues to rise, with medical imaging services representing a substantial portion of Medicare expenditures.

“Kickback schemes can jeopardize medical decision making, which may significantly impact patient care and program costs,” said Special Agent in Charge Maureen Dixon of the U.S. Department of Health and Human Services Office of Inspector General, which investigated the case alongside the Department of Justice.

Medical kickback arrangements remain a significant concern for federal authorities, as they can lead to unnecessary procedures, compromise patient care, and inflate healthcare costs. In fiscal year 2023, the Justice Department recovered more than $1.8 billion from healthcare fraud settlements and judgments, with a substantial portion related to kickback violations.

PET (Positron Emission Tomography) scans are particularly expensive diagnostic procedures, typically costing Medicare between $1,000 and $2,000 per scan. Mobile PET scanning services have become increasingly common in areas where permanent facilities are unavailable or impractical, providing access to advanced diagnostic technology for patients who might otherwise need to travel significant distances.

The Scranton case highlights the complex relationships between medical practices and service providers in the healthcare industry. While partnerships between specialists and imaging providers can expand access to care, they must be structured to comply with federal regulations designed to prevent financial incentives from influencing medical decisions.

Federal authorities emphasized that the settlement resolves allegations only, and there has been no determination of liability. The agreement allows Scranton Heart Institute to continue operating while avoiding potentially costly litigation.

The case was part of a broader initiative by the federal government to control healthcare costs and ensure proper use of taxpayer funds in Medicare programs. Healthcare fraud enforcement remains a top priority for the Justice Department, which has recovered billions of dollars in recent years through False Claims Act settlements.

Local patients with concerns about their care at Scranton Heart Institute are advised to consult with their insurance providers regarding coverage for past procedures.