U.S Department of Justice Announces $12 Million Settlement in Florida Case of Alleged False Claims
March 22, 2010
Radiation oncologist Todd J. Scarbrough, M.D., and Melbourne Internal Medicine Associates P.A. (MIMA), have agreed to pay the United States government a $12 million settlement following an investigation into claims that the Florida-based oncology center and oncologist violated the False Claims Act, announced the U.S. Department of Justice (DOJ) on March 23, 2010.
MIMA and Dr. Scarbrough, as medical director and the practicing radiation oncologist at a center in Melbourne, allegedly submitted false claims to Medicare and the military’s health care program, TRICARE, the DOJ contended in a complaint filed on Oct. 16, 2009. The department alleges that Dr. Scarbrough and the Melbourne center “improperly billed for certain radiation oncology services and caused false and fraudulent claims to be submitted….”
The DOJ contends that the MIMA center improperly inflated claims “through various schemes specifically designed to cloak the fraudulent practices. In particular, the MIMA Cancer Center billed for services not supervised, duplicate and unnecessary services, services not rendered and upcoded services – a practice in which provider services are billed for higher procedure codes than were actually performed.”
“The Justice Department is committed to vigorously pursuing those who defraud Medicare,” said Tony West, assistant attorney general in the DOJ Civil Division. “Health care providers who improperly charge for care, whether they be corporations or individual practitioners, will be held accountable.”
The allegations against Dr. Scarborough and MIMA were initiated by Fred Fangman, a former director of radiation oncology at the center, under the False Claims Act. The law allows a private party whistleblower to file a lawsuit on behalf of the United States for fraud and receive a share of the funds recovered, with Fangman receiving $2.64 million of this settlement.
The DOJ press release can be found at www.justice.gov/opa/pr/2010/March/10-civ-299.html.
|
