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Florida Physician Group, DOJ Close to Settlement on False Claims

by Hoyer Law Group, PLLC | Jan 13, 2011 | Firm News


Melbourne Internal Medicine Associates (MIMA), one of Brevard County, Florida’s largest physician groups, says it is in the process of settling with the U.S. Department of Justice regarding a False Claims suit, which alleges that MIMA had engaged in Medicare fraud. The original qui tam(whistleblower) suit was brought by the director of radiation oncology at MIMA Cancer Center (MCC) in 2008. The U.S. intervened in the suit in June 2009.

According to the U.S. Government complaint filed in October 2009 in the Middle District of Florida, unsealed last week, MCC allegedly defrauded Medicare and the TRICARE (the health care program for active duty service members, reserves, retirees and dependents) systems through false claims for alleged “improper and unjustifiable radiation oncology services.” The complaint claims that the defendants allegedly billed for services without providing the necessary supervision; rendering the service billed; or including the necessary documentation to support the medical billing code. Codes connected with radiation oncology require detailed documentation due to the complex nature of the tumors and parts of the anatomy treated.

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