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Fort Myers urologist Dr. Robert Scappa agreed to a $250,000 payment to resolve allegations he ordered unnecessary medical tests and then submitted the claims to federal health care programs.
Scappa, according to a release from the U.S. Attorney's Office, is with Scappa Urology, which was a division of Fort Myers-based cancer treatment firm 21st Century Oncology. Authorities contend that in January 2009, Scappa began to refer patients to take a FISH (fluorescence in situ hybridization) test, which are laboratory tests performed on urine that can detect genetic abnormalities associated with bladder cancer. But Medicare, according to the release, does not consider a FISH test reasonable or necessary “unless it's used to monitor for tumor reoccurrence in a patient previously diagnosed with bladder cancer or unless, after performing a full urologic workup, the physician has reason to suspect a patient with hematuria, such as blood in the urine, may have bladder cancer.”
Scappa, according to the statement, referred all the FISH tests he ordered to a laboratory owned and operated by 21st Century. He was paid bonuses by the company based in part, authorities allege, on the number of FISH tests he referred to 21st Century. The settlement is based on Scappa's ability to pay, the statement adds.
“In fighting health care fraud, it is important that individual physicians, as well as their employers, be held accountable,” U.S. Attorney for the Middle District A. Lee Bentley says in the statement. “Doctors should not be able to escape personal liability for health care fraud.”
Allegations that doctors affiliated with 21st Century ordered unnecessary FISH tests were originally made by a whistleblower lawsuit filed a under the False Claims Act, which allow private parties to bring suit on behalf of the government and share in any recovery. The whistleblower in this case, a former medical assistant who worked at Naples Urology Associates, also a division of 21st Century Oncology, will receive $37,500 as her recovery share, the release states. That's in addition to a $3.2 million share she will receive as the result of the $19.75 million settlement previously reached with 21st Century Oncology.
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