Radiation oncologist loses whistleblower suit accusing former employer of filing fraudulent claims
A radiation oncologist has lost his long-running legal battle accusing his former employer of violating the False Claims Act.
Robert C. O’Laughlin, MD, and his attorneys first took Radiation Therapy Services and its physicians to court in late 2016, citing qui tam provisions of the FCA. They charged the Kentucky-based provider group—doing business as the Ashland Bellefonte Cancer Center—had submitted fraudulent claims to Medicare and Medicaid for radiation oncology and chemotherapy services that were not properly supervised or performed by specialists.
However, despite multiple amendments to his complaint, O’Laughlin could not provide concrete evidence proving Radiation Therapy Services knowingly submitted false claims to federal authorities. The U.S. Court of Appeals rejected his latest attempt to revive the suit on Aug. 21, citing the lack of sound proof.
“The only evidence that O’Laughlin pleaded in support of his conspiracy claim was that all the defendants committed FCA violations. After all, coordinated false and fraudulent claims by the defendants would be strong evidence of a conspiratorial agreement. And yet O’Laughlin has not provided enough proof of these violations. So, the conspiracy claim fails,” the court opinion states.
O’Laughlin was a radiation oncologist practicing out of three cancer centers in Kentucky from 2012 to 2015. Through his work, he had accused his employers of submitting numerous false claims to Medicare and other federal programs, leading to the filing of the original suit in December 2016, brought on behalf of the U.S. government. Authorities investigated and reached a settlement with one of the centers. However, it declined to intervene on the remaining claims, with the radiation oncologist moving forward on his own. (Under the FCA, a private citizen can file suit against a defendant, with the feds intervening if they see merit, and the accuser potentially collecting a portion of the proceeds, if the case prevails.)
O’Laughlin had charged that Medicare only allows radiation oncologists or radiologists to perform the professional component of radiation therapy and simulation services. Yet, no such qualified physicians were present at the cancer centers when those services took place, he had alleged. But the contentions were dismissed, with the court citing the accuser’s lack of evidence and inadequacy of his claims.
“This case highlights the high burden of proof required in FCA cases and provides a helpful guideline to both plaintiffs and defendants in how to effectively navigate discovery and litigate strategically,” law firm Crowell & Moring noted in a blog post last year following one of O’Laughlin’s failed appeals. “Both sides need to keep in mind that reliance on generalized allegations of fraud, without identifying specific instances, is insufficient to meet the evidentiary burden required to survive summary judgment in an FCA matter.”
Marty Stempniak has covered healthcare since 2012, with his byline appearing in the American Hospital Association's member magazine, Modern Healthcare and McKnight's. Prior to that, he wrote about village government and local business for his hometown newspaper in Oak Park, Illinois. He won a Peter Lisagor and Gold EXCEL awards in 2017 for his coverage of the opioid epidemic.