June 7, 2012 Volume 33, No. 32
Billing fraud investigation leads to two departures at medical school
Medical school dean to retire in October
Two radiologists have left the School of Medicine after an internal investigation discovered possible billing fraud, Harold Williamson, vice chancellor of the MU Health System, said June 1.
Williamson said he believes Kenneth Rall and Michael Richards violated Medicare and hospital rules by certifying that they had performed services that were actually performed by resident physicians.
Rall and Richards are under federal investigation for the alleged fraud. Any criminal charges will come from the U.S. Justice Department.
It was also announced that medical school dean Robert Churchill will retire in October. In 1998 Churchill hired Rall — who had a criminal history, including an embezzlement charge in the 1980s — as radiology department chair. Rall retired as department chair in December 2011 but remained a faculty member.
There is no evidence that Churchill was complicit in the supposed conduct of Rall and Richards, Williamson said. “But Dr. Churchill does not want to allow distractions that will accompany this matter to delay any of the significant progress made at the medical school in recent years.”
Williamson said the main concern of health system officials throughout the investigation was the possible impact on patients. So far, extensive investigation of computer data and numerous interviews with medical professionals have found no evidence that patient care was compromised, Williamson said.
Health system officials are making changes in the radiology department as the result of the internal investigation, conducted by an outside law firm beginning in November 2011 on behalf of the university. Revisions to the department’s operating process will require changes to the way doctors view and report on patient radiology images.
Additional safeguards will be built into software programs physicians use to analyze images.
Under Medicare and the health system’s procedures, a resident physician can read a patient’s X-ray and work with a patient’s doctor. But Medicare requires that, before it will pay for the X-ray, an attending radiologist must also review the image.
“We believe these two doctors sometimes claimed that they had actually completed this second review without actually looking at the image,” Williamson said.
Radiology patients with concerns can visit muhealth.org or call the health system at 888-754-0963.