South Carolina medical practice pays $1.25M to settle improper billing allegations

Colonial Family Practice, a physician-owned primary and urgent care practice with multiple locations in South Carolina, will pay $1.25 million to settle allegations that it billed government insurers for medically unnecessary services, the Justice Department said Oct. 20. 

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Prosecutors alleged that the practice filed claims for medically unnecessary nuclear stress tests, as well as Cystatin-C laboratory tests, which detect kidney dysfunction and are only reimbursed in a small subset of patients. Prosecutors said the alleged improper billing for nuclear stress tests occurred between February 2012 and November 2019, and the improper billing for Cystatin-C laboratory tests took place from August 2013 to November 2019. 

The allegations arose from two separate whistleblower lawsuits, one by a former physician assistant and another by a former clinical manager.

Colonial Family Practice does not admit wrongdoing or liability with the settlement. 

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