Adventist Health System Settles False Medicare Claims for $5.4M; Whistleblower to Get $1M

Posted: 03/20/2015  browse the blog archive
Adventist Health System Settles False Medicare Claims for $5.4M; Whistleblower to Get $1M

Adventist Health System Sunbelt Healthcare Corporation (Adventist) has agreed to pay $5.4 million to settle allegations that the company knowingly submitted or caused the submission of false claims to federal health care programs Medicare and TRICARE by providing radiation oncology services to beneficiaries that were not properly supervised, the U.S. Department of Justice announced yesterday.

Radiation oncology services provided to patients served by Medicare and TRICARE, the Department of Defense’s health care program, must be directly supervised by a radiation oncologist or similarly qualified personnel.  The United States alleged that Adventist violated this supervision requirement for radiation oncology services provided to federal health care program beneficiaries at several Florida locations, including in Altamonte Springs, Daytona Beach, Deland, Kissimmee, Orange City, Orlando, Palm Coast and Winter Park.  These services included radiation simulation, dosimetry, radiation treatment delivery and devices, and intensity-modulated radiation therapy.

The settlement partially resolves allegations made in a qui tam lawsuit under the False Claims Act filed in Tampa, Florida, by Dr. Michael Montejo, a radiation oncologist and former employee of Florida Oncology Network P.A., a radiation oncology group.  The act permits private individuals to sue on behalf of the government for false claims and to share in any recovery.  Dr. Montejo will receive $1,082,500 as his share of the recovery. 

The Chanler Group, in association with the Hirst Law Group, represents whistleblowers who take action under the False Claims Act to report fraud committed against the federal and state governments.  We have years of experience representing whistleblower clients who expose every kind of fraud against the government, including health care fraud, contract fraud, and tax fraud.  Read more about our expertise in False Claims Act cases and how you can take action.