$478,000 SETTLEMENT IN CANCER TREATMENT CENTER INVESTIGATION
A year-long federal investigation into billing practices at the Seattle Cancer Treatment and Wellness Center (SCTWC), ended today with the clinic agreeing to pay $478,000 in restitution to two federal programs, Medicare and Tricare.
The billing investigation began when a former SCTWC employee, Jeffrey Gorumba, filed a "Whistle Blower" complaint under seal (in secret), in Federal District Court in Seattle. Today, the original whistle blower complaint was unsealed after Judge Robert Lasnik approved the settlement. Pursuant to the Settlement Agreement, Gorumba will receive $95,600 of the $478,000 settlement.
The whistle blower complaint alleged that the SCTWC facility was submitting claims to Medicare and Tricare for higher, more complicated levels of services than were actually being performed. Additionally, the investigation developed allegations that SCTWC was billing for medications given to patients on a "take-home" basis, but was billing Medicare for the administration of these drugs by a physician at SCTWC.
In conjunction with the settlement, SCTWC is entering into a Corporate Integrity Agreement with the Department of Health and Human Services, Office of Inspector General. The United States Attorney's Office will not pursue criminal charges. Today's settlement resolves all civil claims. SCTWC is affiliated with Cancer Treatment Centers of America. Cancer Treatment Centers of America was dismissed from the litigation.
The case was investigated jointly by the Department of Health and Human Services, Office of Inspector General and the Department of Defense Criminal Investigative Service.
"In the health care arena, we in the Office of Inspector General, have sought ways to inform and educate the public, including the provider and beneficiary communities, and to enlist their support in reporting improprieties," said Sarah Allen, Special Agent in Charge for the Department of Health and Human Services, Office of Inspector General.
Allen hailed the partnerships between Federal agencies, State and local law enforcement as a key development in the campaign to curb health care fraud. "These partnerships are critical to the Office of Inspector General as we continue to seek more efficient and effective ways of promoting better services to the American taxpayers and prevent fraud, waste, and abuse in health care programs," she said.
"Combating health care fraud remains one of DCIS' top priorities in Western Washington. With our federal and state counterparts, we are committed to investigating and prosecuting allegations of medical fraud" said Richard Gwin, Special Agent in Charge of the Defense Criminal Investigative Service.
Assistant U.S. Attorney Peter A. Winn handled the case for the U.S. Attorney's Office. For additional information, please contact Emily Langlie, Public Affairs Officer for the United States Attorney's Office, Western District of Washington at (206)553-4110.