21st Century Oncology pays $26M to settle False Claims Act allegations after falsely attesting to meaningful use: 5 things to know

Fort Myers, Fla.-based 21st Century Oncology agreed to pay the federal government $26 million to settle allegations of False Claims Act violations.

"21st Century Oncology admitted to causing violation of the meaningful use regulations in order to fund an electronic health records system as well as falsifying records to cover up those actions," said Shimon Richmond, special agent in charge for the OIG. "Separately, the government alleged that same company, through its affiliates and subsidiaries, caused certain physicians to enter into illegal financial arrangements. Providers engaging in similar behavior should expect attention from the OIG."

Here are five things to know:

1. The oncology services chain self-disclosed to the government that it submitted false meaningful use attestations through EHR software and agreed to pay $26 million to settle those claims in addition to separate allegations that the company violated the False Claims Act.

2. Physicians who attested to meaningful use through the Medicare Electronic Health Records Incentive Program received additional payments and avoided downward adjustments to Medicare reimbursement. 21st Century Oncology, which operates locations across the country, admitted in self-disclosure that it knowingly submitted or caused the submission of false attestations.

3. In addition to the initial false attestations, 21st Century Oncology reported its employees:

• Falsified data about how the EHR was used
• Created untrue software utilization reports
• Superimposed EHR vendor logos on reports

4. The government also alleged 21st Century Oncology and some of its subsidiaries and affiliates violated Stark Law "by submitting or causing the submission of, claims for services performed pursuant to referrals from physicians whose compensation did not satisfy any exception to the Stark Law," according to the OIG's release. Former Interim Vice President of Financial Planning for 21st Century Oncology Matthew Moore brought the Stark Law allegations against the company under the qui tam provisions of the False Claims Act.

As a result of his role in reporting the violation, Mr. Moore will receive $2 million of the settlement.

5. 21st Century Oncology entered into a five-year corporate integrity agreement with the OIG to implement substantial internal compliance reforms and hire independent review organizations to review claims and arrangements annually.


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