Cancer care provider pays $35M to resolve claims of unnecessary radiation testing

One of the nation's largest oncology care providers has agreed to pay $35 million to settle claims it billed for unnecessary radiation testing, according to the Wall Street Journal.

The settlement comes several months after the Department of Justice launched an investigation into 21st Century Oncology's "Gamma" program, designed to measure radiation levels in patients. In December, 21st Century paid nearly $20 million to resolve claims that it incentivized physicians to order unnecessary urine screenings to detect bladder cancer, bringing the company's settlement total to nearly $55 million in the last four months.

The government's probe into the provider's billing practices showed that company employees ignored X-ray images, or physicians were unsure how to interpret the images, according to the WSJ. Sources told the newspaper that the Gamma program collected $74 million in Medicare claims since 2009.

In 2014,an Office of Inspector General investigation into 21st Century's bladder cancer tests highlighted concerns surrounding a self-referral exception in the Stark Law that offered a loophole for providers to bill for unnecessary tests. Within the last year, investigators have zeroed in on unnecessary cardiology procedures, which led to more than $250 million in settlements with more than 500 hospitals. Meanwhile, the Food and Drugs Administration has called for more scrutiny of inaccurate diagnostic testing, citing a spike in healthcare costs.

To learn more:
- read the WSJ article

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