State, Feds reach settlement with Quincy Medical Group over Medicare and Medicaid fraud claims

SPRINGFIELD, Ill. – Quincy Medical Group has agreed to pay $500,000 to resolve allegations that it violated the False Claims Act by submitting claims for medically unnecessary cardiac catheterization procedures performed by a physician who was formerly employed by the group.

The settlement comes on the heels of a related settlement in August with Blessing Hospital for approximately $2.82 million. 

The settlement will be apportioned as follows: the United States will receive approximately $459,000, the State of Illinois will receive nearly $40,000, and the States of Iowa and Missouri will receive the remainder. The settlement resolves allegations that Quincy Medical Group obtained payments from Medicare and Medicaid for the professional services component of cardiac catheterization procedures performed between August 1, 2012, and August 30, 2018, in which the physician implanted medically unnecessary coronary arterial stents.   

“This second part of the combined over 3 million dollar settlement is fair to both sides and demonstrates what should occur when alleged fraud is uncovered,” said Acting United States Attorney Douglas J. Quivey for the Central District of Illinois. “It is very important that all medical providers institute quality control and billing safeguards to protect both patient safety and billing integrity.”

“The physician performing these allegedly needless procedures exploited patients and the Medicare and Medicaid programs,” stated Curt L. Muller, Special Agent in Charge with the Department of Health and Human Services Office of Inspector General. “We will continue to work with our law enforcement partners to protect the integrity of federal health programs and hold accountable those individuals or entities responsible for compromising our programs.”

“The  Illinois State Police is dedicated to investigating healthcare fraud and to ensuring that tax dollars are used appropriately for the care of patients,” said Illinois State Police Director Brendan F. Kelly.

The claims resolved by the settlement are allegations only, and there has been no determination of liability. 

The settlement was the result of a coordinated effort by the U.S. Attorney’s Office for the Central District of Illinois, the Civil Division of the Department of Justice, the Inspector General’s Office of the Department of Health and Human Services, and the Illinois State Police Medicaid Fraud Control Unit. Assistant U.S. Attorney John Hoelzer and Department of Justice Senior Trial Counsel Laurie Oberembt represented the government during the settlement process