Oncology radiation treatments that were not supervised by a doctor and which were paid for by Medicare, Medicaid and/or Tricare led to settlement of a whistleblower lawsuit under the False Claims Act. The settlement is for $3.5 million.
All three programs, Medicare, Medicaid and Tricare, require a physician be present when the radiation treatments are performed. Records in this case showed that treatments were performed when the doctor who was supposed to be present was actually on vacation or at another location. So the clinics defrauded Medicare, Medicaid and Tricare by claiming to have performed services that they did not perform as the programs require. The False Claims Act allows a whistleblower to file suit essentially on behalf of the government to recover money that a contractor or, as here, health care provider, has received by use of a false claim for services.
Source: Northwest Florida Daily News
