Oncology Company to Pay $19.75 Million to Settle False Claims Charge

An integrated cancer care company — 21st Century Oncology — will pay $19.75 million to resolve allegations that it violated the False Claims Act by billing federal healthcare programs for laboratory tests that were not medically necessary.

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The company is a nationwide provider of integrated cancer care services that is headquartered in Fort Myers, Florida.

The settlement resolves allegations that 21st Century submitted claims to Medicare and Tricare for fluorescence in situ hybridization, or “FISH,” tests that were not medically necessary.

FISH tests are laboratory tests performed on urine that can detect genetic abnormalities associated with bladder cancer.

The government alleged that 21st Century submitted claims for unnecessary FISH tests that were ordered by four of its urologists, Dr. Meir Daller, Dr. Steven Paletsky, Dr. David Spellberg and Dr. Robert Scappa, all of whom practiced in the Fort Myers area.

The government also alleged that 21st Century encouraged these physicians to order unnecessary FISH tests by offering bonuses that were based in part on the number of tests referred to 21st Century’s laboratory.  Today’s settlement resolves the civil liability of 21st Century only.

The settlement resolves allegations originally brought in a lawsuit filed by a whistleblower under the qui tam provisions of the False Claims Act, which allow private parties to bring suit on behalf of the government and to share in any recovery.

The whistleblower, a former 21st Century Oncology LLC medical assistant, will receive $3.2 million as her share of the recovery in this case.

 

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