Norwich Oncology Practice to Pay $316,513 to Settle False Claims Act Allegations

2012-01-15

David B. Fein, United States Attorney for the District of Connecticut, today announced that EASTERN CONNECTICUT HEMATOLOGY AND ONCOLOGY, P.C., with offices located at 330 Washington Street in Norwich, has entered into a civil settlement with the government in which it will pay $316,513 to resolve allegations that the practice violated the False Claims Act.

The allegations against EASTERN CONNECTICUT HEMATOLOGY AND ONCOLOGY, P.C. (“ECHO”) involve fraudulent billing to Medicare, Medicaid, and TRICARE (the health insurance program for active duty service members, retirees and their families) for services provided by medical assistants. In Connecticut, medical assistants are unlicensed. State of Connecticut rulings and guidance indicate that medication administration is a licensed activity that should not be delegated to unlicensed personnel, unless a specific statutory exemption exists. ECHO would regularly have unlicensed medical assistants administer injections of medications, including Epogen, Neupogen, Neulasta, and Aranesp. Medicare, Medicaid, and TRICARE were then billed for the administration of the injections. Because medical assistants are not authorized to administer medication in Connecticut, the government health care programs would not have paid the claims.

“The health care system relies on providers to bill government health care programs honestly and accurately,” U.S. Attorney Fein stated. “Health care fraud is a serious national problem that the United States Attorney’s Office is committed to combating here in Connecticut.”

To settle allegations under the False Claims Act, ECHO agreed to pay $316,513, which covers conduct occurring from January 1, 2001 through March 31, 2008.

This matter was investigated by the Office of Inspector General for the Department of Health and Human Services; the Federal Bureau of Investigation; the Defense Criminal Investigative Service; the United States Food and Drug Administration, Office of Criminal Investigations; the United States Railroad Retirement Board, Office of Inspector General; and the Medicaid Fraud Control Unit, Office of the Chief State’s Attorney. The case was prosecuted by Assistant United States Attorneys Richard M. Molot and David J. Sheldon, along with Auditor Kevin A. Saunders.

In entering into the settlement agreement, ECHO did not admit liability.

Source: U.S. Federal Bureau of Investigation