A California-based cancer treatment chain with clinics in multiple states has agreed to pay more than $2 million to resolve a whistleblower’s allegations that its Illinois clinics submitted false claims for radiation oncology services to Medicare, the U.S. Justice Department announced.
According to the Justice Department, Vantage Oncology LLC of Manhattan Beach, Calif., both double billed and overbilled Medicare for certain procedures, billed for services that lacked supporting documentation, and billed for radiation treatments it administered without proper supervision from a physician. The lawsuit alleged that the fraud occurred from 2007 through June 2012.
This $2.08-million settlement resolves a lawsuit filed by former Vantage employee Suleiman Refaei under the qui tam, or whistleblower provisions of the False Claims Act, which allow private citizens with knowledge of fraud against federally funded programs and agencies to sue on behalf of the U.S. government. In exchange, the whistleblower shares up to 30 percent of the recovery. In this case, Mr. Refaei will receive $354,450 for his role in exposing the alleged fraud at the Vantage clinics.
“Billing Medicare for patient care that is not necessary or appropriate contributes to the soaring costs of health care,” said Assistant U.S. Attorney General for the Civil Division Stuart Delery. “The Department of Justice is committed to protecting public funds and guarding against abuse of the Medicare system.”
“Cheating taxpayers by double billing, overbilling and wrongly billing for services without required medical oversight will not be tolerated,” said U.S. Department of Health and Human Services Special Agent Lamont Pugh.
The federal False Claims Act has become one of the government’s most powerful tools in fighting fraud that targets Medicare, Medicaid, and other taxpayer-funded government programs. According to the Justice Department, more than $16.7 billion dollars have been recovered through False Claims Act whistleblower cases since January 2009. Nearly $12 billion of those funds were recovered in cases involving fraud against federal health care programs.