A federal investigation sparked by whistle-blowers who used to work for a radiation oncology practice has resulted in a civil settlement in which the practice and its affiliates agreed to pay $3.8 million to settle fraud allegations.
Radiotherapy Clinics of Georgia (Decatur), along with affiliates RCOG Cancer Centers, Physician Oncology Services Management Co., Dr. Frank Critz and Physician Oncology Services, were accused of overbilling Medicare for X-rays and simulations in preparation for radiation therapy and for consults and consult reports, according to a U.S. Justice Department news release
. Critz also was accused of ordering "pre-plans" that were not medically necessary or reviewed.
There has been no determination of liability, and the claims in the settlement agreement are only allegations, the release noted.
The whistleblowers, identified as former employee R. Jeffrey Wertz and Dr. Rebecca Tarlton, will share $646,000.
According to the release, Wertz and Tarlton had filed separate complaints that were investigated by the Health Care Fraud Prevention and Enforcement Action Team
and then rolled into one case pending in the U.S. District Court for the Northern District of Georgia.
The inspector general's office "would like to remind providers that if they know a claim to be false, it is their responsibility to bill the claim properly," said Derrick Jackson, special agent in charge of HHS inspector general's office for the Atlanta region. "The OIG will continue to hold companies like RCOG responsible for improper claims," he said.