FORT MYERS, Florida (Legal Newsline) — The Department of Justice has announced 21st Century Oncology Inc., the largest physician-led integrated cancer care provider in the country, will settle for $34.7 million in a case alleging it violated the False Claims Act.
According to the department’s claims, the defendants improperly used a medical procedure called the Gamma function. This is a test to measure the exit dose of radiation from patients receiving radiation treatment. Allegedly, the defendants improperly billed for the procedure in cases when the procedure was not medically necessary.
“Today’s settlement demonstrates our unwavering commitment to protect the Medicare trust fund against unscrupulous providers,” said principal deputy assistant attorney general Benjamin C. Mizer, head of the Justice Department’s Civil Division. "Providers who waste taxpayer dollars by billing for unnecessary services, including services that are not used or improperly performed, will face serious consequences.”
Joseph Ting, a former employee, will receive $7 million for bringing the issue forward to the department under the whistleblower provisions of the False Claims Act.
“The U.S. Attorney’s Office is committed to taking the steps necessary to protect Medicare, TRICARE, and other federal health care programs from fraud,” said U.S. Attorney A. Lee Bentley III for the Middle District of Florida Health care providers may bill for new technologies only when they have been proven to be useful and when individual physicians and staff have been trained to use them properly.”