The U.S. Department of Justice has announced that a radiation oncology practice in Georgia has agreed to pay $3.8 million to settle allegations that it violated the False Claims Act by allegedly overbilling for claims submitted to Medicare.
Radiotherapy Clinics of Georgia, its affiliates RCOG Cancer Centers, Physician Oncology Services Management Company, Physician Oncology Services, and its founder and medical director, radiation oncologist Dr. Frank Critz, were charged with allegedly overbilling Medicare for medical treatment provided to prostate cancer patients, as well as for billing Medicare for services that were not clinically necessary for their patients.
Radiotherapy Clinics of Georgia specializes in prostate cancer treatment, stating on its website that it is "home to the oldest and most successful prostate seed program in existence."
The civil settlement resolves a qui tam complaint filed in the U.S. District Court for the Northern District of Georgia by whistleblowers Dr. Rebecca Tarlton, a radiation oncologist, and Jeffrey Wertz, PhD, a medical physicist, both of whom had worked at one of the practice's eight clinics located in the metropolitan Atlanta area, Indiana, and Kentucky.
The claim alleged that Radiotherapy Clinics of Georgia submitted Medicare claims for port x-ray exams, simulation exams, and consultations with medical physicists, as well as for treatment plans ordered by Critz that were either not medically necessary or were never reviewed by him.
The case was jointly investigated by the FBI, the Office of the Inspector General of the U.S. Health and Human Services Department, the U.S. Attorney's Office for the Northern District of Georgia, and the commercial litigation branch of the Justice Department's Civil Division. The agreement to settle the claim was based on allegations only. No determination of liability was made, according to the Justice Department's statement.
Tarlton and Wertz will receive a payment of $646,000.
Since January 2009, the Justice Department has recovered more than $9 billion in False Claims Act cases.
