MIMA pays $12M to resolve Medicare fraud case

In a settlement concluded late yesterday, Melbourne International Medicine Associates (MIMA) of Brevard County, Florida, will pay $12 million to resolve a whistleblower lawsuit alleging hidden schemes to defraud Medicare and other federal programs in connection with radiation cancer treatment.  The case was successfully pursued by Finch McCranie, LLP (www.qui-tam-litigation.com) and Simpson Law Firm, LLC, (www.marksimpsonlaw.com), both of Atlanta.

After investigating the whistleblower's claims, the U.S. Department of Justice joined the lawsuit and filed its own complaint alleging a sustained fraudulent course of conduct by the MIMA Cancer Center and its former Medical Director, Todd Scarbrough, MD.  The government's complaint contended that MIMA submitted millions of dollars of claims for radiation oncology services that were provided without required physician supervision, were never provided at all or were otherwise improper, and sought to hide the fraud through "sham" practices.  The complaint also alleged that executives at MIMA were aware of a substantial number of the fraudulent billing practices.

"Health care fraud is incompatible with patient safety," said Michael A. Sullivan, attorney with Finch McCranie, LLP, and author of the leading whistleblower blog www.whistleblowerlawyerblog.com.  "These doctors were paid for personally supervising radiation treatments for cancer patients, but did not provide the supervision that they gave the appearance of providing."

Sullivan, along with G. Mark Simpson of the Simpson Law Firm, initiated the case in July 2008 by filing a qui tam complaint under the False Claims Act.  "The False Claims Act is the government's primary tool for recovering damages caused by fraud," explained Simpson.  "If the government intervenes, as it did in this case, a whistleblower is entitled to receive between 15-25 percent of the monies recovered under the Act."  The award here was 22 percent, or $2,640,000.

"The large amount recovered for taxpayers in this case was the direct result of hard work and diligence in a team effort by both the government counsel and investigators, and by private counsel," said Sullivan.  "American taxpayers are fortunate to have dedicated prosecutors working on their behalf such as Renee Brooker, Eva Gunasekera and Ralph Hopkins, who along with Special Agent Robert Murphy of the U.S. Department of Health and Human Services, worked this case with such perseverance."