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

Alia Paavola -

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. 

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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