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“See Something, Say Something” Applies to Health Care Fraud Fight Too

February 23, 2016

Since 9/11 we have all become used to the expression “see something, say something” as a way to perform our civic duty and protect our fellow citizens and our country from terrorism. What if we applied this to our country’s fight against health care fraud too? That is what whistleblowers do. They are the ones who see something and have the courage to say something.  Health care fraud is a problem that is costing the taxpayers billions of dollars in fraud every year and compromising the quality of care patients receive. In short, it hurts us all. Three recent settlements in Florida remind us how important it is for whistleblowers on the front lines of health care to come forward.

One settlement involved Rose Radiology Centers in Tampa, Florida where the types of health care fraud ran the gamut. Among other things, the Centers performed and billed for medically unnecessary tests, paid kickbacks to other doctors to get business, and allowed unauthorized persons, who were not doctors and who were not supervised by doctors, to perform services, which had the potential for life threatening side effects.

The other two settlements involved the national operations of a large cancer provider (21st Century Oncology) and one of its doctors in Naples, Florida. The government alleged they were performing medically unnecessary for fluorescence in situ hybridization, or “FISH,” tests supposedly to diagnose bladder cancer. The government also alleged that the company encouraged the doctors to order such tests by offering them bonuses that were based in part on the number of tests referred to 21st Century’s laboratory. See also recent DOJ press release.

While these are not the hundred million dollar or more “blockbuster” cases that garner headlines, they are just as important. The whistleblowers were concerned with what they witnessed and took action. We applaud them for saying something when they saw something.