In yet another case of unlawful Medicare billing, Vantage Oncology Center has agreed to pay $2 million to settle allegations it defrauded federal healthcare entities including Medicare and Medicaid. This case comes on the heels of a recent mega-settlement by neighbor Omnicare, Inc., a pharmacy services company alleged to have defrauded the U.S. government and several states out of millions of dollars by way of a prescription drug scheme. The case against Vantage, a Delaware corporation with several centers across twelve states, represents a similar fact pattern. Thankfully, it appears the whistleblower and Department of Justice were able to curtail the fraud before it became a billion-dollar problem.
Details of the Case Against Vantage
The FCA case against Vantage began when a former physicist employed with the company began to notice unusual billing practices. From there, the whistleblower spoke with an attorney about his suspicions, and the U.S. Department of Justice eventually intervened to spearhead the investigation.
In a time period spanning from 2007 through 2012, the whistleblower alleges Vantage engaged in double-billing and over-billing of certain services to be reimbursed by Medicare and Medicaid. In addition, the cancer treatment facility prescribed certain services for patients which were either not necessary or not supervised by the treating physician – including voluminous records of unapproved radiation treatments.
Despite its willingness to remit $2 million to taxpayers in response to these allegations, Vantage maintains its patient care remains top priority. In a statement, Vantage president Michael Fiore remarked he was pleased to see the conclusion of the matter. Vantage also pointed out that physicians currently employed with the facility were not at the helm when the alleged fraud occurred. Vantage further reiterated that none of the allegations pertained to patient care and “Vantage has addressed the matter in a responsible and transparent manner, and chose to settle in order to avoid the considerable expense, delay, and uncertainty involved in protracted litigation.”
Department of Justice Victorious Again
The Department of Justice handled this case along with the help of the Department of Health and Human Services. Special agent in charge with the Office of Inspector General Lamont Pugh, III stated “cheating taxpayers by double-billing, overbilling and wrongly billing for services without required medical oversight will not be tolerated.” Assistant U.S. Attorney Stuart F. Delery reiterated “[b]illing Medicare for patient care that is not necessary or appropriate contributes to the soaring costs of health care….The Department of Justice is committed to protecting public funds and guarding against abuse of the Medicare system.”
We Can all Help Keep Medical Costs Low
Assistant U.S. Attorney Delery made a great point – by working together to combat fraud, we can all contribute to reducing the soaring costs of health care. Fraudulent billing practices are often not detectable to the average patient, especially one enduring weekly cancer treatments. Invoices are designed to look ambiguous and to not draw attention to unlawful billing activity.
If you are a patient or employee of a healthcare facility and are suspicious about certain billing operations, contact a whistleblower attorney as soon as possible. With your help, we can all help keep fraud out of the equation