Sometimes it’s better not to be number one. Being number one is usually associated with being a winner, but in today’s ”Fraud of the Day,” a Florida urologist who was deemed the number one referring physician in the country for a particular type of bladder cancer test, got knocked down a notch after a former employee blew the whistle on him, three other associates and their medically unnecessary orders.
The ”number one” urologist in Florida ordered $13,000 unnecessary genetic ”fluorescence in situ hybridization” or FISH tests for his patients. (This test helps to detect genetic abnormalities associated with cancer.) He received $2 million in bonuses from the FISH tests referrals to his company’s laboratories. (Sounds like he was FISHing for fraud.)
This top physician was not the only doctor implicated in an investigation carried out by the Department of Health and Human Services. In all, four physicians employed by the nation’s largest radiation oncology provider were named in a $19.75 million settlement with the government.
The top doc paid nearly $4 million to end the agency’s investigation against him. In addition, he must hire an independent review organization to evaluate his medical records over the next three years to make sure they comply with Medicare and Medicaid regulations. While he has resigned from the oncology practice, he plans to continue to practice medicine.
One of the other doctors involved in the settlement paid $250,000 to the government and retired. Another doctor who paid $1.05 million to settle similar claims was responsible for firing the former medical assistant who blew the whistle by raising concerns about the doctors’ testing practices.
It turns out that the oncology provider was also involved in another $34.7 million settlement with the government regarding unnecessary GAMMA function tests, which measure the amount of radiation emitting from patients after specific medical treatments. The whistleblower was the real winner in this case. She will receive $571,500 for alerting federal investigators plus another $3.4 million regarding other settlements. (I guess the government found her testimony to be quite illuminating.)
Source: Today’s ”Fraud of the Day” is based on an article entitled, ”21st Century Oncology doc pays almost $4M to settle fraud case,” published by Vermont Business Magazine on December 28, 2016.
A 21st Century Oncology physician implicated in a federal crackdown on unnecessary bladder cancer tests has agreed to pay nearly $4 million to end the investigation against him.
Dr. Meir Daller, who operates Gulf Stream Urology practices in Fort Myers, Cape Coral and Bonita Springs, was among the four physicians named in a $19.75 million settlement the government reached with 21st Century Oncology in December 2015.