Radiotherapy Clinics of Georgia (RCOG), a radiation oncology practice located in Decatur, Ga., and its affiliates have agreed to pay $3.8 million to settle claims that they violated the False Claims Act after allegedly billing Medicare for medical treatments that were unnecessary or went beyond what is permitted by Medicare rules, according to the U.S. Justice Department.
Affiliates of RCOG listed by the Justice Department include RCOG Cancer Centers, Physician Oncology Services Management Company, Frank A. Critz, MD, and Physician Oncology Services.
The civil settlement resolves complaints filed by two whistleblowers, a former employee and a former physician who both worked for RCOG, under the qui tam provisions of the False Claims Act.
The government alleged that RCOG overbilled Medicare for port films and for simulations used in preparation for personalized radiation therapy provided to prostate cancer patients. It also was alleged that RCOG overbilled Medicare for physics consults and for pre-plans ordered by Critz that were either not medically necessary, not reviewed by the physician, or both.
“This settlement demonstrates our office’s continued commitment to stop Medicare fraud,” said Sally Q. Yates, U.S. attorney for the Northern District of Georgia.
The whistleblowers, R. Jeffrey Wertz and Rebecca S. Tariton, MD, will receive $646,000 as their share of the proceeds. Their complaints were filed separately, but were later consolidated into a single case pending in the U.S. District Court for the Northern District of Georgia.
Using the False Claims Act, the Justice Department has recovered more than $6.7 billion since January 2009 in cases involving fraud against federal healthcare programs.