![]() ![]() “Greed was the clear motive in this case," said Shimon R. ![]() “Our office will continue to pursue and hold accountable health care providers who defraud the United States.” “Charging for clearly unnecessary medical services defrauds the government, threatens the viability of public health care programs, and breaches the sacred trust that physicians owe their patients,” said U.S. This amount is in addition to a $3,437,000 million share she already received as a result of the settlements previously reached with David Spellberg, M.D, Robert Scappa, D.O., and 21 st Century Oncology. at Naples Urology Associates, which was also a division of 21 st Century Oncology, will receive $571,500 as her share of this recovery. The whistleblower, a former medical assistant who worked for David Spellberg, M.D. As a result, the United States’ total recovery relating to the investigation of the use of FISH tests by doctor’s affiliated with 21 st Century is now $24,860,000. Daller, the United States previously entered into settlements relating to similar allegations with 21 st Century Oncology for $19.75 million and urologists David Spellberg, M.D. In addition to the settlement announced today with Dr. Daller to retain an Independent Review Organization to perform a Claims Review, as well as an Electronic Health Records Review to evaluate the appropriateness of any revisions made to the medical record after initial entry, pursuant to Medicare and Medicaid requirements. The Integrity Agreement, among other obligations, requires Dr. Daller has entered into a three-year Integrity Agreement with the Office of Inspector General of the United States Department of Health and Human Services. David Spellberg, 21st Century Oncology and Naples Urology Associates, Civil Action No. The original lawsuit was captioned United States, State of Florida, ex rel. The allegations that doctors affiliated with 21 st Century were ordering unnecessary FISH tests were originally brought in a lawsuit filed by a whistleblower under the qui tam provisions of the False Claims Act, which allow private parties to bring suit on behalf of the government and to share in any recovery. Daller received approximately $2 million in bonus payments from 21 st Century associated with these FISH tests. Daller was paid bonuses by the company based, in part, on the number of FISH tests he referred to 21 st Century laboratory. Daller ordered over 13,000 separate FISH tests on his Medicare patients, making him the number one referring physician in the country with respect to FISH tests. Daller began referring all of the FISH testing ordered by him to a laboratory owned and operated by 21 st Century. Medicare does not consider a FISH test reasonable or necessary unless it is used to monitor for tumor reoccurrence in a patient previously diagnosed with bladder cancer or unless, after performing a full urologic workup, the physician has reason to suspect that a patient with hematuria (i.e., blood in the urine) may have bladder cancer.īeginning in 2009, Dr. FISH tests are laboratory tests performed on urine that can detect genetic abnormalities associated with bladder cancer. Daller submitted claims to Medicare and Tricare for fluorescence in situ hybridization, or “FISH,” tests that were not medically necessary. The settlement announced today resolves allegations that Dr. As part of its business, 21 st Century employs and affiliates with physicians in specialty fields such as radiation oncology, medical oncology, and urology. 21 st Century is a nationwide provider of integrated cancer care services that is headquartered in Fort Myers. Daller was a urologist practicing as part of Gulfstream Urology, which was a division of 21 st Century Oncology, LLC. has agreed to pay $3.81 million to the government to resolve allegations that he violated the False Claims Act by causing claims to be submitted to federal health care programs for laboratory tests that were not medically necessary.ĭuring the relevant time period, Dr. Lee Bentley, III announces that Meir Daller, M.D. Fort Myers, FL – United States Attorney A. ![]()
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