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Firm settles false billing case for $35 million


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  • | 2:05 p.m. March 9, 2016
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FORT MYERS — The federal government settled a lawsuit against 21st Century Oncology for $34.7 million to resolve allegations the cancer-treatment firm billed for procedures that were not medically necessary.

“The United States Attorney's Office is committed to taking the steps necessary to protect Medicare, Tricare and other federal health care programs from fraud,” says U.S. Attorney Lee Bentley in a statement. “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.”

The settlement relates to 21st Century Oncology's use of a medical procedure called “gamma function” used to measure the exit dose radiating from a patient after receiving treatment. The federal government alleged the Fort Myers-based company improperly billed for this procedure despite serving no medically appropriate purpose.

The government filed the lawsuit against 21st Century Oncology under the whistleblower provisions of the False Claims Act by Joseph Ting, a former physicist at South Florida Radiation Oncology. Under those provisions, a private party can file an action on behalf of the government and receive a portion of the recovery. Ting will receive more than $7 million.

In December, 21st Century paid $19.75 million to settle other allegations that it violated the False Claims Act by billing for medically unnecessary laboratory urine tests, and for encouraging physicians to order these tests by offering bonuses based in part on the number of tests the physicians referred to its laboratory.

 

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