The Radiology Group Issues Settlement Statement

The Radiology Group, LLC (TRG) has reached a global settlement with federal and state agencies to resolve significantly dated allegations that arose out of claims submitted to the Medicare and Medicaid programs for certain teleradiology services furnished in 2012-2018. The case was originally filed under seal by two whistleblowers who worked at TRG for a brief period of time. The services at issue were in large part performed by a single radiologist who did not follow direction or appropriate protocols and was ultimately terminated. Other allegations arose from services and advice provided by TRG’s third-party billing company. This company was hired specifically to ensure that TRG claims were appropriate and payable under the circumstances. Unfortunately, TRG’s reliance on that billing company was misplaced as it failed TRG repeatedly. TRG is currently exploring all possible options available to it with respect to the billing company.

Unfortunately, the Radiology Group and its executive team trusted these experts in billing as well as their key employee at the time to set up a protocol that was compliant with CMS standards, and they failed to do so without informing the Radiology Group and its leadership team that the process was not occurring appropriately and/or that the process of billing was not compliant with standards.

TRG has always believed that it acted lawfully and responsibly. However, after nearly 6 years of investigation, TRG reached this settlement in order to avoid the delay, expense, and uncertainty of protracted litigation, and to allow TRG to focus its attention on providing the best patient care, including creating one of the first direct to patient teleradiology products available as well as its new AI Radiology Product adopted in several health systems within the USA.

Since 2019 and over the course of this prolonged process, TRG has spent a considerable amount of time and resources on improving its hiring of radiologists, compliance professionals, and outside vendors, ensuring that it is identifying and retaining only the best, most qualified partners as it continues to provide cutting-edge teleradiology services for clients throughout the country. It has also streamlined and invested in its workflow processes to ensure compliance with all applicable rules and regulations governing this critical service line.  As evidence of TRG’s commitment to compliance, this settlement did not require the company to adopt a corporate integrity agreement or other similar compliance oversight by outside agencies. TRG is pleased to move forward from this settlement so it can focus on best serving its clients and patients.

Update July 2024

The Radiology Group LLC has filed a motion to set aside the settlement due to inaccuracies and untruths within the DOJ‘s press release.  The, SDNY office made public a press release on their website which indicated multiple items that were not stipulated to or agreed to by the Radiology group LLC. The AUSA/SDNY office included the original claim, which was not agreed to and in fact, majority of the items were inaccurate.

A decision on the motion will be likely forthcoming in January 2025. Regardless of the decision by the judge in the southern District, The Radiology Group intends to use all its potential legal remedies to fix the damage done by the mistaken press release.

The Radiology Group would like to reiterate that it is pursuing an action against the original billing company, which caused the billing error. The Radiology Group contends that the whistleblower conspired to create a faulty system to create damage for The Radiology Group approximately 10 years ago.

The Radiology Group has interpreted greater than 20 million exams over the course of its company history and has an unprecedented low error rate of less than .006%. The interpretation of these exams is 100% compliant with CMS guidelines and have undergone thorough review on a quarterly basis. The TRG Assist process is also fully vetted and fully compliant with CMS guidelines. Again, to reiterate, there has been no corporate integrity agreement, there is no supervisory operational process post settlement, and the TRG process has been fully vetted with the SDNY indicating compliance with CMS.  

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