Consumer Fraud

Whistleblower Sues Arizona Cancer Center For Alleged Medicare Fraud

Pills Stethascope on Money 435x289 Whistleblower Sues Arizona Cancer Center For Alleged Medicare FraudA whistleblower complaint alleging an Arizona cancer treatment company cheated Medicare and other federal health care programs out of millions of dollars is moving ahead after a federal judge rejected the defendant’s motion to dismiss the case.

The Republic/Arizona Central reports that the whistleblower suit alleges the Arizona Center for Cancer Care and its principals engaged in schemes to double-bill the government, overcharge for testing and treatments, and bill for medical services that patients didn’t need. The lawsuit claims these practices helped AZCCC improperly collect more than $8 million since 2011.

Based in the Phoenix metro area, AZCCC operates 35 offices in Maricopa County and employs 65 physicians specializing in oncology, urology, and hematology. The company treats more than 30,000 patients, according to its website.

Jeffrey Scott, the company’s former billing manager, filed the complaint against AZCCC under the whistleblower provisions of the False Claims Act alleging he warned the company repeatedly that it was abusing Medicare and other federal health care programs.

The complaint also alleges that an independent audit in 2013 found that AZCCC overcharged its patients an average of $200 each because of the improper billings.

Instead of addressing Mr. Scott’s concerns, however, the company and its principals employed ‘interwoven schemes of fraudulent coding and billing” to maximize federal reimbursements, the complaint alleges.

According to The Republic, Mr. Scott started warning AZCCC about the fraudulent billing practices in 2011 but “was ignored or berated” for voicing his objections. Mr. Scott ultimately filed the whistleblower complaint on behalf of the U.S. in 2016, accusing the company of not only continuing its fraudulent billing practices but looking for ways to advance them.

“Defendants stripped Scott of his compliance function and gave control of the billing to the very physicians who Scott accused of being engaged in fraudulent billing,” the whistleblower complaint alleges.

AZCCC denies the accusations and has filed a lawsuit seeking $3.5 million in damages from Mr. Scott, alleging he failed to perform his duties.