Multi-State Cancer Care Provider Settles False Claims Act Allegations for $34.7 Million
14th March 2016
Cancer care provider, 21st Century Oncology Inc. and its wholly-owned subsidiary, South Florida Radiation Oncology LLC (“21st Century”), have reached a $34.7 million settlement with the U.S. Government regarding allegations that they performed and billed for procedures that were not medically necessary. 21st Century is the nation’s largest physician led integrated cancer care provider and has offices in 16 states.
The “Gamma function,” the medical procedure in question, was used to measure the exit dose of radiation from a patient after the patient received radiation treatment. The U. S. Government alleged that 21st Century knowingly and improperly billed for this procedure under circumstances where the procedure served no medically appropriate purpose. Further alleged is that the procedure was performed at 21st Century Oncology locations by physicians and physicists who were not properly trained to analyze and use the Gamma function results and that 21st Century billed for this procedure when no physician reviewed the Gamma function results until seven or more days after the last day patients received radiation treatment therapy. The U.S. Government also alleged that 21st Century billed for the procedure when no Gamma result was available due to technical failures with equipment.
Joseph Ting, a former physicist at South Florida Radiation Oncology, originally filed this lawsuit under the whistleblower provisions of the False Claims Act, in which a private party, known as a relator, can file an action on behalf of the United States and receive a percentage of the recovery. Ting will receive more than $7 million.
In December 2015, 21st Century Oncology LLC, a wholly-owned subsidiary of 21st Century Oncology Inc., paid $19.75 million to settle False Claims Act allegations that it was billing for medically unnecessary laboratory urine tests and for offering bonuses as an incentive to physicians that was based on the number of tests that were referred to the laboratory.