Centra sues its own oncology provider

Lynchburg, Va.-based Centra Health filed a more than $7 million lawsuit against its own oncology provider group, ABC affiliate WSET reported Jan. 23.

The lawsuit alleges that between 2016 and 2021, Lynchburg Hematology-Oncology Clinic physicians' "inaccurate documentation and coding resulted in higher worked relative value units, which directly affected LHOC's compensation." Work relative value units are used to measure the services, procedures and patient care performed by physicians. Each value has a specific amount of money Centra paid the clinic for performing.

Centra alleges the group was overpaid more than $7.1 million and seeks to have those funds returned.

"Centra takes compliance with regulatory requirements very seriously," it said in a statement to WSET. "We always strive to maintain the highest standards of ethical conduct in all aspects of our operations and have regulatory requirements that we must meet. Unfortunately for all parties involved, we discovered through a routine compliance review certain coding issues that resulted in overpayments from Centra to our professional partner, Lynchburg Hematology/Oncology Clinic. To ensure compliance with applicable law, we are required to recover that overpayment from LHOC. We value our relationship with LHOC and the excellent care they provide to our community. It is our hope to promptly reach a resolution on this matter and put this issue behind us."

Lynchburg Hematology-Oncology Clinic is a physician group that offers medical services at the clinic and hospital owned and operated by Centra. 

"The lawsuit is baseless, and Centra's allegations against LHOC are categorically false," the clinic's defense attorney told WSET. "It impacts all of LHOC's doctors and staff. But more importantly, it impacts community cancer care. LHOC is a small group of physicians, but it is the sole provider of hematology and oncology services in the Lynchburg area. The burden of defending this lawsuit draws into question whether it will be able to continue to provide those services. LHOC intends to do its utmost to continue to provide community cancer care in the Lynchburg area."

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