21st Century Oncology Inc., the nation’s largest 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.
21st Century is headquartered in Fort Myers, Florida, and has offices in 16 states.
The settlement relates to the use of a medical procedure – called the Gamma function – to measure the exit dose of radiation from a patient after receiving radiation treatment.
Federal officials alleged that the company knowingly and improperly billed for this procedure under circumstances where the procedure served no medically appropriate purpose.
For example, the government alleged that the procedure was performed by physicians and physicists at 21st Century Oncology locations who were not properly trained to interpret and utilize the Gamma function results.
The government also alleged that the defendants billed for this procedure when no physician reviewed the Gamma function results until seven or more days after the last day patients received radiation treatment therapy.
The government alleged that the defendants billed for the procedure when no Gamma result was available due to technical failures in the imaging equipment.
This lawsuit was originally filed under the qui tam or whistleblower provisions of the False Claims Act by Joseph Ting, a former physicist at South Florida Radiation Oncology.
Under those provisions, a private party, known as a relator, 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 laboratory.