A major fraud and abuse case in Illinois has targeted the growing trend of leasing arrangements in medical imaging. The Illinois Attorney General has intervened in a whistleblower lawsuit against 11 imaging centers that offer MRI services in the state. Originally filed by an owner of several competing imaging centers, the AG's lawsuit contends that the centers illegally paid kickbacks to referring physicians who entered into "leasing" arrangements with the centers for MRI scans on patients. The lawsuit also alleges that the centers violated state fee-splitting and consumer fraud laws. Thus far, the case has not implicated individual radiologists.

The Attorney General investigated the case for almost a year before deciding to prosecute. Illinois authorities indicate the scope of the arrangements could be nationwide and cost millions of dollars. The complaint requests the court to order the centers to stop paying kickbacks and seeks monetary damages, restitution, and civil penalties.

The complaint charges the imaging centers entered into sham "lease" agreements for more than 18 months with numerous referring physicians in Illinois. Imaging center operators would lease their space to referring physicians to perform MRI scanning services. However, the center and its employees allegedly rendered all the services and billed the referrers for the services. The physicians had no role in performing the scans at the centers. Rather, they paid the centers a "reduced rate" for the MRI scans and charged patients' insurers a higher rate, retaining the difference as an illegal kickback. Illinois law prohibits knowingly offering or paying any "remuneration" (in cash or in kind) from insurance claims proceeds to induce any person to refer patients for services.

It is the ACR's position that all leasing arrangements and referral arrangements must comply with state and federal laws.

Please see the February ACR Bulletin for a full report on the Illinois case and national scrutiny of leasing arrangements in imaging.