FORT MYERS — Cancer-care firm 21st Century Oncology agreed to pay the government $19.75 million to settle allegations that it billed federal health programs for tests that weren't medically necessary.
“Today's settlement demonstrates our unwavering commitment to protect the Medicare trust fund against unscrupulous providers,” says Principal Deputy Assistant Attorney General Benjamin Mizer, head of the Justice Department's Civil Division, in a statement. “Providers who waste taxpayer dollars by billing for unnecessary services will face serious consequences.”
The settlement resolves allegations that Fort Myers-based 21st Century submitted claims to Medicare and Tricare for cancer tests that were not medically necessary. The government alleged that 21st Century submitted claims for unnecessary tests that were ordered by four of its urologists: Meir Daller, Steven Paletsky, David Spellberg and Robert Scappa, all of whom practiced in the Fort Myers area.
The government also alleged 21st Century encouraged these physicians to order unnecessary tests by offering bonuses that were based in part on the number of tests referred to 21st Century's laboratory. The government says the settlement resolves the civil liability of 21st Century only.
In a statement, the company says “21st Century fully cooperated with federal officials during the process and has agreed to the settlement with no admission of wrongdoing.”
In addition, “21st Century Oncology is also committed to compliance and to that end, has further enhanced our comprehensive compliance and auditing programs to ensure transparency and the delivery of the highest quality, most clinically appropriate care to our patients and that only those services that meet the complex Medicare and Medicaid billing criteria are submitted for reimbursement,” the company adds in a statement.