Fort Myers, FL – United States Attorney Maria Chapa Lopez announces that Florida Cancer Specialists & Research Institute, LLC (FCS), an oncology group headquartered in Fort Myers, Florida, has agreed to a civil settlement that will return $2,341,508.91 that was overpaid by the Department of Veterans Affairs (VA) for certain claims relating to physician-administered drugs.
Although the majority of veterans enrolled in the VA healthcare system receive care in VA-operated medical facilities, the VA may also contract with non-VA facilities to provide services that are not readily available from a VA medical facility. The Code of Federal Regulations allows for VA reimbursement of non-VA care providers for certain physician-administered drugs in accordance with Medicare pricing schedules.
Marianne K. Parker, a Claims Resolution Specialist with FCS, filed a qui tam complaint in the Middle District of Florida after contacting the VA Office of Inspector General’s hotline concerning her discovery that FCS was being overpaid by the VA for physician-administered drugs. In response to the hotline complaint, the VA-OIG Office of Audits and Evaluation determined that a mistake in the Fee Basis Claims System had led the Florida Claims Processing Centers to pay the full amount billed by the provider rather than the appropriate Medicare rate. Subsequently, the VA fixed the issue.
The United States worked cooperatively with FCS to identify the remaining amount of the overpayments made by the VA to FCS. The civil settlement will conclude the lawsuit filed by Ms. Parker and she will receive 20% of the recovery.
“Money designated for the medical care of our veterans is a precious commodity,” said United States Attorney Chapa Lopez. “We are pleased that Florida Cancer Specialists cooperated with the investigation and will return the overpayment back to the VA. Any other providers who received such overpayments should follow suit.”
David Spilker, Special Agent in Charge, VA-Office of Inspector General, stated, “The VA’s Community Care program provides veterans with the ability to obtain critical healthcare services from providers in their community. This civil settlement reinforces the VA-OIG’s commitment to safeguarding the integrity of VA’s healthcare programs and preserving taxpayer funds for their intended purposes."
The investigation was handled by Assistant U.S. Attorney Kyle S. Cohen, with assistance from the Department of Veterans Affairs – Office of Inspector General.
The claims resolved by the settlement are allegations only and there has been no determination of liability.
USAO - Florida, Middle;
Department of Veterans Affairs OIG