Wednesday, February 03, 2016

Urologist David Spellberg Paying $1 Million To Settle False Claims Charge

Former Assistant Gets $20 Million For 'Blowing Whistle' On Company

Fort Myers, FL – David Spellberg, M.D., has agreed to pay $1,050,000 to the government to resolve allegations that he violated the False Claims Act by causing claims to be submitted to federal health care programs for laboratory tests that were not medically necessary. 

The allegations that Spellberg was ordering unnecessary FISH tests were originally brought in a lawsuit filed by a whistleblower under the qui tam provisions of the False Claims Act, which allow private parties to bring suit on behalf of the government and to share in any recovery. The whistleblower, a former medical assistant who worked directly for Dr. Spellberg, will receive $199,500 as her share of this recovery. 

This amount is in addition to a $3.2 million share she will receive as the result of the $19.75 million settlement previously reached with 21st Century Oncology.

Spellberg was a board certified urologist practicing as part of Naples Urology Associates, which was a division of 21st Century Oncology, LLC. 21st Century is a nationwide provider of integrated cancer care services that is headquartered in Fort Myers.

The settlement announced today resolves allegations that Spellberg submitted claims to Medicare and Tricare for fluorescence in situ hybridization, or “FISH,” tests that were not medically necessary. FISH tests are laboratory tests performed on urine that can detect genetic abnormalities associated with bladder cancer. Medicare does not consider a FISH test reasonable or necessary unless it’s used to monitor for tumor reoccurrence in a patient.

In January 2010, Spellberg became an employee of 21st Century and began referring all of the FISH testing ordered by him to a laboratory owned and operated by 21st Century. He was paid bonuses by the company based, in part, on the number of FISH tests he referred to the 21st Century laboratory.

The lawsuit is captioned United States, State of Florida, ex rel. Mariela Barnes v. Dr. David Spellberg, 21st Century Oncology and Naples Urology Associates, Civil Action No. 2:13-cv-228-FtM-38DNF (M.D. Fla.).

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