{"id":18451,"date":"2015-12-18T17:48:58","date_gmt":"2015-12-19T01:48:58","guid":{"rendered":"https:\/\/cjnotebook.com\/?p=18451"},"modified":"2015-12-18T17:48:58","modified_gmt":"2015-12-19T01:48:58","slug":"cancer-health-care-provider-pay-19-7-million-unnecessary-fish-medical-tests","status":"publish","type":"post","link":"https:\/\/cjnotebook.com\/?p=18451","title":{"rendered":"Cancer Health Care Provider to Pay $19.7 Million for Unnecessary “FISH” Medical Tests"},"content":{"rendered":"
\"21st-century-oncology\"<\/a>
21st Century Oncology employs 500 at its headquarters in Fort Myers and operates 145 treatment centers in the U.S. and 36 in Latin America.<\/figcaption><\/figure>\n

FLORIDA<\/span><\/strong><\/p>\n

\n

The 21st Century Oncology LLC<\/strong> agreed to pay $19.75 million to the government to resolve allegations that it violated the False Claims Act by billing federal health care programs for laboratory tests.<\/span><\/p>\n

The Justice Department said the tests weren’t medically necessary.<\/span><\/p>\n

21st Century’s false billings came to light after a whistleblower filed a lawsuit, officials said.<\/span><\/p>\n

21st Century is a nationwide provider of integrated cancer care services that is headquartered in Fort Myers, Florida.<\/span><\/p>\n

\u201cToday\u2019s settlement demonstrates our unwavering commitment to protect the Medicare trust fund against unscrupulous providers,\u201d said Deputy Assistant Attorney General Benjamin C. Mizer, head of the Justice Department\u2019s Civil Division.\u00a0<\/strong> \u201cProviders who waste taxpayer dollars by billing for unnecessary services will face serious consequences.\u201d<\/span><\/p>\n

The settlement announced today resolves allegations that 21st Century submitted claims to Medicare and Tricare forfluorescence in situ hybridization, or \u201cFISH,\u201d tests that were not medically necessary.<\/span><\/p>\n

FISH tests<\/strong> are laboratory tests performed on urine that can detect genetic abnormalities associated with bladder cancer, officials said.<\/span><\/p>\n

The government alleged that 21stCentury submitted claims for unnecessary FISH tests that were ordered by four of its urologists, Dr. Meir Daller, Dr. Steven Paletsky, Dr. David Spellberg<\/strong> and Dr. Robert Scappa<\/strong>, all of whom practiced in the Fort Myers area, according to authorities.<\/span><\/p>\n

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\u2019s laboratory.<\/span><\/p>\n

Today\u2019s settlement resolves the civil liability of 21st Century only.<\/span><\/p>\n

\u201cCharging the government for clearly unnecessary medical services squanders taxpayer dollars,\u201d said U.S. Attorney A. Lee Bentley, III<\/strong>\u00a0of Florida.\u00a0 \u201cOur office will continue to pursue health care providers who defraud the United States, thereby threatening the viability of government health care programs, such as Medicare.\u201d<\/span><\/p>\n

\u201cThese tests were ordered to increase profits, not improve the healthcare of patients,\u201d said Special Agent in Charge Shimon Richmond of the Department of Health and Human Services Office of Inspector General (HHS-OIG)<\/strong>. \u201cThis kind of unvarnished fraud is an attack on Medicare by unscrupulous providers and the OIG and its federal partners will take whatever steps are necessary to stop them.\u201d<\/span><\/p>\n

The settlement resolves allegations originally brought in a lawsuit filed by a whistleblower under the qui tam provisions of the False Claims Act,<\/strong> which allow private parties to bring suit on behalf of the government and to share in any recovery, according to authorities.<\/span><\/p>\n

The whistleblower, a former 21st Century Oncology LLC medical assistant, will receive $3.2 million as her share of the recovery in this case, according to authorities.<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"

FLORIDA The 21st Century Oncology LLC agreed to pay $19.75 million to the government to resolve allegations that it violated the False Claims Act by billing federal health care programs for laboratory…<\/p>\n","protected":false},"author":1,"featured_media":12931,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[16,3],"tags":[2026,2027,44],"class_list":["post-18451","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-home-main-slider","category-u-s-department-of-justice","tag-cancer","tag-fish-test","tag-medicare-fraud"],"yoast_head":"\nCancer Health Care Provider to Pay $19.7 Million for Unnecessary "FISH" Medical Tests<\/title>\n<meta name=\"description\" content=\"FLORIDA The 21st Century Oncology LLC agreed to pay $19.75 million to the government to resolve allegations that it violated the False Claims Act by\" \/>\n<meta name=\"robots\" content=\"index, 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