The University of Maryland Shore Regional Health is part of the University of Maryland Medical System, which provides healthcare services to thousands of residents in the mid-Shore region in Maryland. Part of their services includes an extensive cancer care program with a team that includes oncologists, radiologists, pathologists, nurses, and rehabilitation workers. They have been recognized for the quality of care they provide to their patients. This is largely because they are involved in all stages of cancer diagnosis, from prevention and pre-treatment evaluations to rehabilitation. However, in spite of their good work, they have also recently committed violations of the False Claims Act.
In May of 2022, Shore Health settled a case brought forward by a whistleblower for improper Medicare billing. According to the allegations, from 2014 to 2018, they had billed radiation therapies and diagnostic services to Medicare, falsely stating that these procedures were performed under the direct supervision of a doctor. In reality, on many occasions, this doctor was performing radiation oncology services at a different location while unsupervised services were performed at Shore Health. This inconsistency was noted by J. Phillip Sawyer, who filed the lawsuit under the qui tam provision of the False Claims Act. As a result, the federal government recovered $296,870 paid by Medicare under false pretenses, and the whistleblower received $51,952 for the whistleblower’s efforts.
Thankfully, no patients were harmed as a result of the conduct and Shore Health is taking steps to comply with Medicare and Medicaid guidelines. Nonetheless, the federal government loses millions of dollars in improper medical reimbursements every year. Thanks to the work done by the Department of Justice, and whistleblowers like J. Phillip Sawyer, the government can recover the money lost to fraud and violations and ensure that the medical community follows the regulations set in place.