//
you're reading...
Politics, Congress, Investigation, Republicans, FBI, internet, health, Economy, Education, Wikipedia, local news, Press Release, Justice Department, Democrats, meta, Fraud, National News, Environment

PRESS RELEASE: 21st Century Oncology to Pay $19.75 Million to Settle Alleged False Claims for Unnecessary Laboratory Tests

Department of Justice
Office of Public Affairs
FOR IMMEDIATE RELEASE
Friday, December 18, 2015

21st Century Oncology to Pay $19.75 Million to Settle Alleged False Claims for Unnecessary Laboratory Tests

21st Century Oncology LLC, has agreed to pay $19.75 million to the government to resolve allegations that it violated the False Claims Act by billing federal health care programs for laboratory tests that were not medically necessary, the Justice Department announced today. 21st Century is a nationwide provider of integrated cancer care services that is headquartered in Fort Myers, Florida.

“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 will face serious consequences.”

The settlement announced today resolves allegations that 21st Century submitted claims to Medicare and Tricare for fluorescence in situ hybridization, or “FISH,” tests that were not medically necessary. FISH tests are laboratory tests performed on urine that can detect genetic abnormalities associated with bladder cancer. The government alleged that 21st Century submitted claims for unnecessary FISH tests that were ordered by four of its urologists, Dr. Meir Daller, Dr. Steven Paletsky, Dr. David Spellberg and Dr. Robert Scappa, all of whom practiced in the Fort Myers area. The government also alleged that 21st Century encouraged these physicians to order unnecessary FISH tests by offering bonuses that were based in part on the number of tests referred to 21st Century’s laboratory. Today’s settlement resolves the civil liability of 21st Century only.

“Charging the government for clearly unnecessary medical services squanders taxpayer dollars,” said U.S. Attorney A. Lee Bentley, III of the Middle District of Florida. “Our office will continue to pursue health care providers who defraud the United States, thereby threatening the viability of government health care programs, such as Medicare.”

“These tests were ordered to increase profits, not improve the healthcare of patients,” said Special Agent in Charge Shimon Richmond of the Department of Health and Human Services Office of Inspector General (HHS-OIG). “This kind of unvarnished fraud is an attack on Medicare by unscrupulous providers and the OIG and its federal partners will take whatever steps are necessary to stop them.”

“This settlement demonstrates the commitment of the Defense Criminal Investigative Service (DCIS) and its law enforcement partners to protect the integrity of the U.S. military health care program (TRICARE) against fraudulent claims for medical services, said Special Agent in Charge John F. Khin of DCIS’s Southeast Field Office.”

The settlement resolves allegations originally brought in a lawsuit filed by a whistleblower under the qui tam provisions of the False Claims Act, which allow private parties to bring suit on behalf of the government and to share in any recovery. The whistleblower, a former 21st Century Oncology LLC medical assistant, will receive $3.2 million as her share of the recovery in this case.

The investigation was handled by the Civil Division’s Commercial Litigation Branch and the Fort Myers Division of the U.S. Attorney’s Office of the Middle District of Florida with assistance from HHS-OIG, DCIS and the FBI.

This settlement illustrates the government’s emphasis on combating health care fraud and marks another achievement for the Health Care Fraud Prevention and Enforcement Action Team (HEAT) initiative, which was announced in May 2009 by the Attorney General and the Secretary of Health and Human Services. The partnership between the two departments has focused efforts to reduce and prevent Medicare and Medicaid financial fraud through enhanced cooperation. One of the most powerful tools in this effort is the False Claims Act. Since January 2009, the Justice Department has recovered a total of more than $26.7 billion through False Claims Act cases, with more than $16.8 billion of that amount recovered in cases involving fraud against federal health care programs.

The lawsuit is captioned United States, State of Florida, ex rel. Mariela Barnes v. Dr. David Spellberg, 21st Century Oncology and Naples Urology Associates, Civil Action No. 2:13-cv-228-FtM-38DNF (M.D. Fla.). The claims resolved by the settlement are allegations only, and there has been no determination of liability.

About FREDERICA CADE

Most of the information you will see comes from some Federal/state Government documents or Federal/State Governm Agency. -----------------------------------------------The fellow that can only see a week ahead is always the popular fellow, for he is looking with the crowd. But the one that can see years ahead, he has a telescope but he can't make anybody believe that he has it. ~~~~Will Rogers __The woman who follows the crowd will usually go no further than the crowd. The woman who walks alone is likely to find herself in places no one has ever been before.~ Albert Einstein ~"I never work better than when I am inspired by anger; for when I am angry, I can write, pray, and preach well, for then my whole temperament is quickened, my understandingsharpen​ed, and all mundane vexations and temptations depart.” ~Dr. Martin Luther King Jr. _________________________________________________________________________________________ ~"The bosom of America is open to receive not only the Opulent and respectable Stranger, but the oppressed and persecuted of all Nations and Religions; whom we shall welcome to a participation of all our rights and privileges, if by decency and propriety of conduct they appear to merit the enjoyment".~___________________________________ George Washington, Address to the Members of the Volunteer Association of Ireland, December 2, 1783 Fredericacade@gmail.com

Discussion

No comments yet.

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s

Frederica Cade’s Blog (Politics, News, Analysis, Investigation, Press Releases, Education, Economics, Internet, News Releases, Featured stories, Fraud, and History, U.S. Laws, Posted stories, Index of reports, meta,Home page)

Blog Stats #

  • 737,181 hits

Frederica Cade’s Archives

Recent Post

February 2016
M T W T F S S
« Jan   Mar »
1234567
891011121314
15161718192021
22232425262728
29  

Frederica Cade’s Blog (Politics, News, Analysis, Investigation, Press Releases, Education, Economics, Internet, News Releases, Featured stories, Fraud, and History, U.S. Laws, Posted stories, Index of reports, meta,Home page)

Politics, local News, National News, Foreign news, Congress, President, Government, Economics, Analysis, Art, Health,Investigation, FBI, Justice Department, Fraud, Press Releases, Health Care, News Releases, Law, and History Tags

2012 Elections Affordable Care Act Alabama Albuquerque ALEC Alexandria American Legislative Exchange Council AMERICAN LEGISLATIVE EXCHANGE COUNCIL (ALEC) Analysis Arizona Atlanta Attorney General Eric Holder California charter schools Chicago Congress Connecticut Democrats Deputy Attorney General James M. Cole Donald Trump Economics Economy Education Environ Environme Environmen Environment EPA FBI Federal Election Commission (FEC) Florida fraud FreedomWorks General Georgia Governor Nikki Haley Grover Norquist Hammond Health Health Care Heritage Foundation HHS Secretary Kathleen Sebelius Hillary Clinton History https://fredericacade.wordpress.com https://fredericacade.wordpress.com/wp-admin/edit.php?category_name=politics-congress-investigation-republicans-fbi-internet-health-economy-education-wikipedia-local-news-press-release-justice-departm Idaho Illinois Inc. Indiana Internet Investigation Iowa IRS jobs Jr. Justice Department Kansas Kara Pally Keystone XL Knoxville Koch Koch Brothers Koch Industries Laws local news Louisiana Maryland Massachusetts Matte Kibbe Memphis meta Miami Michigan Minnesota Mississippi Missouri Mitt Romney Montana Nashville National News Nebraska New Jersey New Mexico News New York Nikki Haley North Carolina Ohio Oklahoma Oregon outsourcing Paul Ryan Pennsylvania Philadelphia Politics President President Obama Press Release Public Schools Puerto Rico record Republicans Rhode Island South Carolina South Dakota Sr. Tennessee Texas Top Story TransCanada Vincent Sheheen Virginia Voting Rights Act Voting Rights Act of 1965 WASHINGTON Washington D.C. West Virginia Wikipedia Wisconsin

Frederica Cade’s Blog (Politics, News, Analysis, Investigation, Press Releases, Education, Economics, Internet, News Releases, Featured stories, Fraud, and History, U.S. Laws, Posted stories, Index of reports, meta,Home page)

Follow me on Twitter

Frederica Cade’s Blog (Politics, News, Analysis, Investigation, Press Releases, Education, Economics, Internet, News Releases, Featured stories, Fraud, and History, U.S. Laws, Posted stories, Index of reports, meta,Home page)