21st Century Oncology, a physician-led integrated cancer care provider, and its wholly owned subsidiary South Florida Radiation Oncology, will pay $34.7 million to settle allegations that they performed and billed for procedures that were not medically necessary.
According to the Department of Justice, the settlement relates to defendants use of a medical procedure—called the Gamma function—to measure the exit dose of radiation from a patient after receiving radiation treatment. According to the allegations, the defendants knowingly and improperly billed for this procedure under circumstances where the procedure served no medically appropriate purpose.
The lawsuit was originally filed 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 United States and receive a portion of the recovery. Ting will receive more than $7 million.
In December 2015, 21st Century Oncology LLC, a wholly owned subsidiary of 21st Century Oncology Inc., paid $19.75 million to settle 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
Since January 2009, the Justice Department has recovered a total of more than $27.4 billion through False Claims Act cases, with more than $17.4 billion of that amount recovered in cases involving fraud against federal health care programs.