The nation’s largest physician-led integrated cancer care provider, 21st Century Oncology Inc., and its subsidiary, South Florida Radiation Oncology LLC, have agreed to settle allegations that they performed and billed for procedures that were not medically necessary.
The lawsuit involved medical procedures that measure the exit dose of radiation from a patients after they undergo radiation treatment, a procedure known as the Gamma function. The United States alleged that 21st Century Oncology knowingly and improperly billed for these procedures when they were not medically appropriate, including having physicians or physicists perform them in spite of their not being properly trained to interpret and utilize the results. The government also alleged that defendants billed for the procedure when no Gamma result was available due to imaging equipment technical failures.
Whistleblower Joseph Ting, a former physicist at South Florida Radiation Oncology, originally filed the lawsuit under the qui tam or whistleblower provisions of the False Claims Act (FCA). Under FCA provisions, a private party, known as a relator, can file an action on behalf of the United States and receive a portion of the recovery – more than $7 million in Ting’s case.
Since 2009, the United States Justice Department (DOJ) has recovered over $27.4 billion through FCA cases, more than $17.4 billion of which has involved health care fraud allegations.
Read the full DOJ press release.
To report Health Care Fraud, please contact Frohsin & Barger.