Dermatology providers agree to pay $847,394 to settle allegations of False Claims Act (FCA) violations and Medicare fraud. A July 30 press release from the Department of Justice (DOJ) reported that Forefront Dermatology S.C. and Henghold Surgery Center LLC agreed to resolve allegations that they violated the False Claims Act by knowingly submitting falsified Medicaid claims. The government’s investigation was sparked by a whistleblower lawsuit filed under the qui tam provisions of the FCA by former Forefront employee Christopher Wolfe, M.D. As part of the settlement, Dr. Wolfe will receive a $152,531 whistleblower award.
Both the dermatology practice and the surgery center performed skin cancer removal procedures. The settlement resolves allegations that the two practices engaged in “upcoding,” a practice in which medical providers increase the funds they receive from Medicare by improperly reporting to Medicare that more expensive procedures had been performed than actually were through the use of inaccurate billing codes. Both the dermatology practice and the surgery center allegedly obtained higher reimbursement amounts for skin cancer removal procedures than they were entitled to under Medicare.
“Improperly billing Medicare depletes valuable government resources that provide necessary medical care to millions of Americans,” Assistant Attorney General Brett A. Shumate of the Justice Department’s Civil Division said in a statement. “We will hold accountable health care...
[OSEN=Jang Woo-young, reporter] Singer Soyou and actor Lee Yi-kyung have faced sudden rumors. Hiding behind the mask of anonymity, the rumors angered Soyou, while Lee Yi-kyung has declared legal a...