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Company admits to falsifying data in $26M settlement


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  • | 3:20 a.m. December 13, 2017
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FORT MYERS — Cancer treatment firm 21st Century Oncology agreed to pay $26 million to the federal government regarding self-disclosed claims that it used false data and other misrepresentations in the government's Medicare Electronic Health Records (EHR) Incentive Program.

As part of its self-disclosure, 21st Century Oncology reported that it “knowingly submitted, or caused the submission of, false attestations to CMS concerning employed physicians' use of EHR software,” according to a statement from the U.S. Attorney's Office. The company further reported that “in support of the attestations, its employees falsified data regarding the company's use of EHR software, fabricated software utilization reports and superimposed EHR vendor logos onto the reports to make them look legitimate,” the release adds.

Under the Medicare EHR Incentive Program, physicians who attest to their meaningful use of certified EHR technology may receive incentive payments and avoid downward adjustments to certain Medicare claims.

“This settlement represents our office's continued commitment to ensuring compliance with important federal health care laws,” Acting U.S. Attorney Stephen Muldrow of the Middle District of Florida says in a statement. “We appreciate that 21stCentury Oncology self-reported a major fraud affecting Medicare, and we are also pleased that the company has agreed to accept financial responsibility for past compliance failures.”

In addition to the civil settlement, 21st Century Oncology entered into a new five-year Corporate Integrity Agreement with the Office of Inspector General of the U.S. Department of Health and Human Services. The agreement requires 21st Century Oncology to undertake substantial internal compliance reforms, including hiring independent review organizations to conduct annual claims and arrangements reviews, the release states.

Fort Myers-based 21st Century Oncology owns and operates subsidiaries and affiliates nationwide that provide integrated cancer care. Its subsidiaries and affiliates employ physicians in specialty fields such as radiation oncology, medical oncology, and urology.

This is one of several settlement agreements 21st Century Oncology has reached with the federal government in recent years. In March 2016 the company settled a case for $34.7 million to resolve allegations it billed for procedures that were not medically necessary. And in December 2015 it paid $19.75 million to settle other allegations 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.

21st Century Oncology also filed for Chapter 11 bankruptcy in May, part of a debt restructuring to reduce the company's long-term net debt by more than $500 million.

 

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