In a recent False Claims Act settlement out of California, an oncologist has agreed to pay $500,000 to settle claims of using and seeking reimbursement for unapproved chemotherapy drugs in violation of FDA regulations. This practice is just one type of dangerous healthcare fraud that, with the help of the False Claims Act, could face elimination.
The False Claims Act, unlike other civil statutes aimed at preventing fraud, actually relies on the suspicions and observations of regular individuals as they engage in their daily occupations and tasks at work, especially when working with vulnerable patients in need of medical procedures or certain medications. This set-up often helps highlight certain types of frauds that are not only costly to taxpayers, but place patients at risk and could actually cause severe injury or loss of life. As such, anyone with information of healthcare fraud should meet with an experienced attorney right away, as there is more at stake than just financial resources.
Details of the case against California oncologist
According to recent allegations, a California oncologist has agreed to pay $500,000 to settle claims he billed Medicare, Medicaid, and TRICARE for chemotherapy drugs that were not approved for use by the FDA, thereby potentially placing oncology patients in grave danger upon exposure to these toxic chemicals.
More specifically, the doctor purchased several doses of chemotherapy cocktails from a manufacturer known as Warwick Healthcare Solutions, Inc., which is based in the United Kingdom. Not only were the drugs not approved by the FDA, but Warwick did not maintain a license to distribute its drugs in the United States.
Special Agent in Charge, Ivan Negroni of the U.S. Department of Health and Human Services Office of Inspector General, said in a statement:
“Patients — especially those battling cancer and other life-threatening illnesses — should be able to trust that their physicians only use medicines approved by the FDA, medicines proven to be safe and effective.”
Implications for oncology and other patients
The details of the allegations highlight an alarming trend among healthcare professionals: placing patients at risk in order to increase profit margins and overbill the government. While some forms of healthcare fraud are less likely to place patients in harm’s way (i.e., upcoding, billing for services that never took place), the onslaught of medically unnecessary procedures occurring in the United States is a trend in need of immediate abolition.
For instance, doctors have been accused of performing unnecessary heart, spinal, and dental procedures on patients for no other purpose than to bill the government for the service. These patients are placed on the operating table, administered anesthesia, and forced to endure painful recoveries for surgeries that were never necessary in the first place. Fortunately, the False Claims Act and lawsuits filed thereunder are working to combat this abhorrent practice – for which many practitioners have faced criminal culpability and jail time, as well.
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