Baylor University Medical Center in Dallas has agreed to pay more than $900,000 to resolve charges that it submitted false claims to Medicare for radiation oncology services. The settlement, announced by the U.S. Department of Justice on November 27, 2012, resolves a federal whistleblower lawsuit filed in 2010 by a Baylor radiation oncologist and a radiation therapist. According to the government, Baylor double billed Medicare for procedures related to radiation treatment plans between 2006 and 2010. It also billed for higher-reimbursing services instead of less expensive ones, billed for procedures without supporting required documentation, and also billed for radiation treatment without proper proof of physician supervision.
The lawsuit was brought pursuant to the qui tam (“whistleblower”) provisions of the Federal False Claims Act. The False Claims Act allows private individuals to sue in the name of the government to recover losses sustained by the government through fraudulent claims.