The Daily

Local Quality Fraud in Healthcare Drives Up Costs: Help Us Eradicate it

From DOJ as reported in the Fort Myers News Press (A Gannet paper)

“Today’s settlement demonstrates our unwavering commitment to protect the Medicare trust fund against unscrupulous providers,” said Principal Deputy Assistant Attorney General Benjamin C. Mizer, head of the Justice Department’s Civil Division. “Providers who waste taxpayer dollars by billing for unnecessary services will face serious consequences.

The settlement settles allegations that 21st Century Oncology submitted claims to Medicare and Tricare for fluorescence in situ hybridization, or “FISH,” tests that were not medically necessary. FISH tests are lab tests performed on urine to detect genetic abnormalities associated with bladder cancer. The Justice Department said four urologists ordered the tests. Those doctors were identified as Dr. Meir Daller, Dr. Steven Paletsky, Dr. David Spellberg and Dr. Robert Scappa, all of whom practiced in the Fort Myers area.21st Century Oncology settles $19.75M lawsuit

This is not the first fraud case 21CO was forced to settle in its short run. 21CO Urologist Pays $4M Fine For False Billings

The settlements were announced between December of 2015 and early 2017, about the same time that 21CO allowed hackers to sit in their internal database for more than a month stealing sensitive patient information from millions of its patients that was eventually sold by criminals on the dark web. 21CO’s incompetence (or complicit involvement) was so egregious that they had no idea they’d been hacked until the FBI notified them that their patient information was being sold on the World Wide Web.

I was one of the first lawyers to begin investigating 21CO’s violation of HIPPA. More than 100 local residents hired me to pursue claims, which are now consolidated along with thousands of other claims filed by lawfirms across the country in an action pending in The Middle District Federal Court in Tampa. See, In Re: 21st Century Oncology Customer Data Security Breach Litigation, Case No. 8:16-md-02737-MSS-AEP.

21C0 was an upstart healthcare company that experienced tremendous growth very quickly, becoming a national player within a few short years after its founding in Fort Myers. This is how their internal database came to include millions of patient records. Judging by the operation, quarterly growth and profit – rather than competence and quality care – were the business model. I blog frequently about the constantly changing platform for healthcare delivery in America. While this continues to be a problem adding to uncertainty and skyrocketing costs, quality fraud is a more serious problem. With government regulation under attack in the current administration, it is unlikely that regulators at HHS and DOJ will have the time and resources to bring the problem under control.

The Third Branch of Government will be the tip of the spear in solving this problem: the courts, judges and lawyers devoted to exposing and bringing justice to citizens harmed by quality fraud in healthcare.

The problem in our justice system is that corporations are now treated more like people and provided near immunity for their bad actions in the bankruptcy process. Following the implosion of their culpable business model and the claims of harmed consumers and the Government, 21CO ran for the protection of bankruptcy courts – where they may be given an opportunity to obtain immunity and a reorganization to continue their bad practices anew. Follow this link for information on the bankruptcy reports due regarding 21CO’s claims for protection against their own bad conduct.

My Firm has been devoted exclusively to targeting large corporations that wreak havoc on consumers and our economy. Whether in the fields of medical malpractice, product liability, nursing home abuse, common carrier disasters or other cases – we will continue to fight the powerful on behalf of harmed consumers. My approach is not a cookie cutter method like firms that advertise. I do not rely on an army of paralegals and secretaries to keep me at arms length from my clients. I provide a personal service to people seriously harmed and I take that responsibility very seriously. There are no guarantees of justice – only a chance at it. Maximize your chance by calling me if you have questions or concerns.