By: Christopher A. Parrella, Esq., CPC, CHC, CPCO
Parrella Health Law, Boston, Ma.
A Health Care Defense and Compliance Firm

In a significant legal development, the United States has initiated a False Claims Act (FCA) lawsuit in the U.S. District Court for the Southern District of Texas against Rick Nassenstein, formerly associated with Cardiac Imaging Inc. (CII), an Illinois-based provider of mobile cardiac positron emission tomography (PET) scans. This case underscores the rigorous enforcement of laws designed to maintain the integrity of healthcare practices and prevent financial conflicts that could negatively influence patient care.

At the heart of this lawsuit is the allegation that Nassenstein was instrumental in orchestrating a scheme in which CII compensated referring physicians well above fair market value for patient referrals for cardiac PET scans, contravening the Physician Self-Referral Law, commonly referred to as the Stark Law. This federal mandate is crucial in the healthcare sector as it prohibits billing Medicare for certain services referred by physicians with whom the provider has a financial relationship, barring exceptions defined by statute or regulation. The Stark Law’s enactment was motivated by a need to shield Medicare patients from potentially biased medical decisions and unnecessary services stemming from improper financial relationships.

The complaint details how from at least 2017 through June 2023, Nassenstein led CII to engage in compensation arrangements with cardiologists for referrals. These arrangements reportedly compensated cardiologists as though they were fully engaged in supervising CII’s scans, even when these physicians were attending to other duties or were not present at the scan locations. It is asserted that these payments also covered non-provided additional services beyond supervision, thus breaching the Stark Law and, subsequently, the FCA.

This lawsuit, initiated by a whistleblower under the qui tam provisions of the FCA, exemplifies the critical role of individuals in exposing and addressing fraudulent activities that jeopardize the healthcare system’s ethical and financial foundation. Under the FCA, whistleblowers can file lawsuits on behalf of the United States and may receive a portion of any financial recovery.

For healthcare providers, this case serves as a potent reminder of the importance of compliance with the Stark Law and the FCA. It highlights the legal risks associated with improper compensation arrangements and the necessity of implementing rigorous compliance programs to prevent violations. As this case progresses, it will undoubtedly offer valuable insights into the enforcement trends of healthcare law and the critical importance of ethical medical practices.

In conclusion, the lawsuit against Nassenstein is not just a legal battle but a clarion call to all healthcare providers about the paramount importance of adhering to laws designed to safeguard the integrity of patient care. It underscores the necessity for healthcare providers to meticulously evaluate their practices and ensure they align with legal and ethical standards, thereby reinforcing the trust and confidence of patients and the broader healthcare community.

If you have any questions concerning the implications of this Qui Tam lawsuit or how similar legal principles may apply to your healthcare practice, Parrella Health Law stands ready to assist. Our team is well-versed in the complexities of healthcare law, including compliance with the False Claims Act and the Stark Law. We understand the importance of navigating these legal frameworks carefully to ensure your practices are both compliant and effective in delivering quality patient care. Please feel free to reach out to us at 857-328-0382 or at info@parrellahealthlaw.com for a discussion on how we can support you in addressing these critical legal concerns. Parrella Health Law is committed to providing expert guidance and support to the healthcare community.