Radiation bills raise questions about supervision

MELBOURNE, FLA — To help ensure that medical radiation is administered safely, Medicare insists that certain highly technical cancer treatments be administered only when a patient’s radiation oncologist is present or nearby.

But when one of Florida’s biggest physician practices submitted 62 claims for treatments by Dr. Todd J. Scarbrough, it turned out that he had not just been absent from the clinic — he had not even been in the country, according to federal officials. Instead, they said, Scarbrough had been in Cancun, Mexico, and Seoul, South Korea.

The physician group also submitted 144 claims for another radiation oncologist, Dr. Nanialei Golden, for treatments done while she was in Hong Kong, Athens, Rome and Quito, Ecuador, federal records show.

These are among the accusations involving the cancer clinic owned by the doctors’ group, Melbourne Internal Medicine Associates, court records show.

A lawsuit by federal officials is focusing only on what the officials say are fraudulent billings from 2003 through at least 2008. But the case points to some of the rising concerns about safety procedures and oversight involving today’s increasingly complex computer-controlled radiotherapy and diagnostic equipment. At the same time, it raises questions about financial incentives and the overuse of high technology, and highly reimbursed, treatments.

By not properly supervising technicians, as the government alleges, the doctors put patients at risk — and then tried to cover it up. By treating patients at the group’s own cancer center, doctors stood to benefit from tests and radiation therapy in which they had a financial interest. And, according to federal officials, the cancer center often ordered more lucrative treatments when less advanced and cheaper ones would have served just as well.

In Florida, the physician group’s chief administrative officer, Al O’Connell, declined to discuss the federal accusations, but said his cancer center provided “outstanding” medical care.