Consumer Fraud

Whistleblower lawsuit against Adventist hospital network recovers $5.4 million for U.S.

whistleblower 5 370x210 Whistleblower lawsuit against Adventist hospital network recovers $5.4 million for U.S.A Florida oncologist will receive more than $1 million for his role in exposing False Claims Act violations in several Florida hospitals operated by the Adventist Health System Sunbelt Healthcare Corporation.

The U.S. Justice Department said that Adventist has agreed to pay $5,412,502 to settle allegations filed in a whistleblower complaint by Dr. Michael Montejo, a radiation oncologist and former employee of Florida Oncology Network P.A., a radiation oncology group.

In his lawsuit, Dr. Montejo claimed that several Adventist hospitals in Florida were providing radiation oncology services to Medicare and TRICARE (the Defense Department’s health care program) beneficiaries that weren’t directly performed or supervised by radiation oncologists or other qualified professionals, as required by law.

The whistleblower lawsuit alleged that these improperly performed services occurred during a four-year period from 2010 through 2013 at several Florida facilities, including  Altamonte Springs, Daytona Beach, Deland, Kissimmee, Orange City, Orlando, Palm Coast and Winter Park.

The Adventist hospitals then billed Medicare and TRICARE for those services in violation of the U.S. False Claims Act. The U.S. Justice Department reviewed Dr. Montejo’s allegations and chose to back his lawsuit.

“Today’s settlement demonstrates our continued vigilance to ensure that federal health care beneficiaries receive the highest quality of patient care,” said Acting Assistant Attorney General Benjamin Mizer of the Justice Department’s Civil Division. “It is critical that health care providers adequately supervise the services they provide to their patients.”

U.S. Attorney A. Lee Bentley III of the Middle District of Florida also helped prosecute the case. “Medicare and TRICARE patients deserve high quality health care,” Mr. Bentley said. “We will not tolerate providers recklessly cutting corners, particularly when furnishing such critical medical services as radiation oncology.”

Adventist Health System Sunbelt Healthcare Corp. operates a large network of hospitals in the South and Midwest. In Florida, it operates under the name Florida Hospital.

Source:

U.S. Department of Justice