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-   -   Doctor to Repay $1.74 Million in Inflated Medicare Claims (https://www.talkofthevillages.com/forums/villages-florida-general-discussion-73/doctor-repay-1-74-million-inflated-medicare-claims-303974/)

togabill 03-17-2020 09:45 PM

Doctor to Repay $1.74 Million in Inflated Medicare Claims
 
Officials say a Florida doctor has agreed to pay $1.74 million to resolve allegations that his surgery center submitted fraudulent Medicare claims. The U.S. Attorney's Office in Orlando said in a statement sent Friday that Dr. Thi Thien Nguyen Tran and the Village Dermatology and Cosmetic Surgery center were accused of submitting claims for higher reimbursements than were performed.

Drdoug49 03-17-2020 10:10 PM

Lock him up. Lock him up. Lock him up

Bonnevie 03-18-2020 08:34 AM

I never went to him, but people I know who did always seemed to have a LOT of biopsies done.

golfing eagles 03-18-2020 08:48 AM

Quote:

Originally Posted by Drdoug49 (Post 1729167)
Lock him up. Lock him up. Lock him up

I agree, except there is no provision under Medicare to do that. BUT.....they can fine him heavily, make him pay back the money, and exclude him from billing Medicare for I believe up to three years. Do it, we don't need A holes like this in our profession.

skip0358 03-18-2020 08:53 AM

He's one of my Doctors, very busy and does a good job. Every sample goes out to be tested thankfully all have come back negative. Going back Friday to have sutures removed from 2 more spots, both negative!

retiredguy123 03-18-2020 09:05 AM

Medicare is loaded with fraud. I think there should be a dollar reimbursement limit for Medicare providers on an annual basis. Some doctors bill Medicare for more procedures than they could possibly perform.

seoulbrooks 03-18-2020 09:10 AM

Lock him up! Just taking advantage of the elderly and their payment system. Might be a good doctor but honesty seems to be in question.

golfing eagles 03-18-2020 09:11 AM

Quote:

Originally Posted by retiredguy123 (Post 1729383)
Medicare is loaded with fraud. I think there should be a dollar reimbursement limit for Medicare providers on an annual basis. Some doctors bill Medicare for more procedures than they could possibly perform.

Interesting idea, comrade.

Why stop there---fee limits on lawyers, dentists, accountants and while we're at it grocery clerks, Walmart greeters and used car salesmen. Punish those that defraud the system, but don't kill incentive for those that work hard and do a good job

BTW, it's not all that hard to identify medical fraud----just pull a list of the top 500 non-institutional billers and you'll hit the jackpot!

blueash 03-18-2020 09:27 AM

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.

golfing eagles 03-18-2020 11:06 AM

Quote:

Originally Posted by blueash (Post 1729401)
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.



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.

So if this only ONE over coded office procedure, where does 1.7 million come from????


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