Federal investigators are looking into allegations Williamsville, N.Y.-based CCS Oncology defrauded Medicare between $10 million and $15 million per year by upcoding or billing for medically unnecessary procedures, The Buffalo News reports.
Representatives from the Department of Justice, CMS, the FBI and the Department of Veterans Affairs have interviewed a former CCS Oncology employee about possible billing irregularities as part of the investigation. The inquiry comes as a whistleblower filed a qui tam lawsuit under the False Claims Act alleging CCS' physicians and other staff participated in fraud and misconduct, a source familiar with the suit told The Buffalo News. The complaint is filed under seal in the U.S. District Court in Buffalo and dated July.
W. Sam Yi, MD, CCS Oncology CEO, medical director and a radiation oncologist at the practice, confirmed to The Buffalo News a federal investigation was initiated. Dr. Yi told the publication he has not been interviewed or subpoenaed, but anticipates a request for an interview to come soon.
"We are 100 percent confident we have done nothing wrong," Dr. Yi told The Buffalo News. "We have always conducted ourselves professionally and by the book."
Federal investigators plan to interview another individual who doesn't work for CCS, according to the report.
CCS Oncology and its nononcology practice, Williamsville-based CCS Healthcare, employ 36 physicians across 23 offices and clinics, the report states.