Talk of The Villages Florida - View Single Post - Doctor to Repay $1.74 Million in Inflated Medicare Claims
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Old 03-18-2020, 09:27 AM
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blueash blueash is offline
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The details of the allegations and settlement are HERE

For those who don't click links the summary is that he was charged with claiming to do a more complex repair of the hole left by Mohs surgery than he actually did. And because he used a code for a more complex [bigger skin transfer] repair the payment allowed is higher.

He was caught because of whistleblowers who will share in the recovery.

Quote:
The settlement concludes a lawsuit originally filed in the United States District Court for the Middle District of Florida by Dr. Robert Green and Emily Kennedy. Dr. Green and Ms. Kennedy sued under the qui tam, or whistleblower, provisions of the False Claims Act permitting a private citizen to sue on behalf of the United States for false claims and to share in the recovery. The Act also allows the United States to intervene and prosecute the action. Dr. Green and Ms. Kennedy will receive over $305,000 of the proceeds from the settlement with Dr. Tran and Village Dermatology.
Moral of the story.. Don't cheat.

And to CYA... The claims resolved by the settlement are allegations only, and there has been no determination of liability.
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