It appears that a federal whistle-blower suit related to allegations of wrongdoing at the John B. Amos Cancer Center has been settled without a trial, according to court documents filed this month.
Former John B. Amos Cancer Center top administrator Richard Barker alleged that the cancer center and its physicians — including well-respected Medical Director Andrew Pippas — repeatedly and knowingly overbilled government insurers.
Barker made the claims in a wide-ranging and detailed lawsuit under the Federal False Claims Act — also known as a qui tam action — in May 2012 in U.S. District Court, Middle District of Georgia. The suit remained under court-ordered seal until June 2013 when the defendants were informed of Barker’s allegations. Barker was placed on administrative leave in June 2013 and his employment with Columbus Regional ended on Sept. 30, 2013, according to Columbus Regional.
Barker’s attorney filed a notice of settlement on July 2, saying an agreement with Columbus Regional Healthcare System, The Medical Center, Inc., John B. Amos Cancer Center, Regional Oncology, LLC, and Columbus Radiation Oncology Treatment Center has been reached.
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A pretrial hearing scheduled for Thursday in front of U.S. District Court Judge Clay Land was cancelled. The Aug. 10 trial date also was cancelled.
Land has given the parties about two months to finalize the settlement agreement. No terms of the settlement have been filed with the court.
Barker also sued Columbus physician Thomas J. (Jack) Tidwell, claiming Columbus Regional purchased the Tidwell Cancer Center for more than fair market value to induce Tidwell to refer patients to Columbus Regional.
A notice to dismiss that case was filed on Monday by Barker’s attorneys, according to court documents.
Columbus Regional Senior Vice President and General Counsel L. M. Layfield III released a statement Thursday on the litigation status.
“The U.S. District Court for the Middle District of Georgia has granted an extension through Sept. 4 for the parties to complete a settlement in this civil action,” the statement read. “Since the settlement is not finalized we are not able to discuss any details. Columbus Regional is committed to continuing to work with the parties to complete the satisfactory resolution of this matter.”
Columbus Regional attorney Michael E. Paulhus, of King & Spalding in Atlanta referred all questions to Layfield.Barker’s attorney, Jamie M. Bennett of the Bennett Law Firm in Middle River, Md., could not be reached for comment. Tidwell’s attorney John D. Dalbey of the Atlanta firm of Chilivis, Cochran, Larkins & Bever LLP, also could not be reached for comment.
Land in an August 2014 order said that Barker’s claims can be divided into three broad categories:
Claims arising from Columbus Regional’s purchase of the Tidwell Cancer Center.
Claims arising from pay agreements between Columbus Regional and an independent corporation called Radiation Oncology of Columbus. Barker contends that this arrangement violates the federal Anti-Kickback Statute and the Stark Law.
Claims arising from charges submitted for payment by employees of the John B. Amos Cancer Center. According to the suit, Columbus Regional had remuneration relationships with Radiation Oncology that violated the Anti-Kickback Statute and the Stark Law because the agreements, including physician compensation arrangements, were not commercially reasonable and were designed to induce referrals to Columbus Regional.
The whistle-blower suit is complex litigation in which a private party — in this case Barker — brings a suit on the government’s behalf. The government, not the private party, is considered the real plaintiff. If the government succeeds, the private party could receive up to 30 percent of the award.
The federal government declined to join Barker’s suit in the beginning, but Assistant U.S. Attorney Charles Byrd monitored the case throughout. Attorneys for the U.S. government and the state of Georgia filed Tuesday with the court to enter the case.
The suit alleges that the John B. Amos Cancer Center has a long-standing practice of improper coding and billing and that five of its physicians working for Regional Oncology LLC “systematically” overcharged Medicare, Medicaid, TRICARE/CHAMPUS and the Federal Employee Health Benefits Program and “reaped” potentially millions of dollars of unearned fees.
The physicians filed bills for office visits at levels that were not supported by the documentation in the medical record and filed bills for services that were included within the reimbursement for the administration of chemotherapy and thus were not separately billable, the suit claims.