A Minnesota dermatologist has agreed to pay $850,000 to settle allegations of false Medicare claims. The U.S. attorney’s office had accused the physician and his practice of falsely billing Medicare for dermatological procedures and services over the span of several years.
The doctor, who maintains offices in Burnsville, Edina, Orono and St. Cloud, came to federal and state prosecutors’ attention after a whistle-blower came forward. The individual who alerted authorities to the alleged fraud had been a physician working in the office.
The practice was accused of falsely billing for free phototherapy drug samples, as well as improperly billing for office visits and procedures.
As Medicare is a public trust, the funds will primarily be restored to the program, but under the False Claims Act, the whistle-blower will receive a share in the recovery. This incentive, introduced by congress in 1985, encourages citizens to report fraud that occurs in the workplace.
Medicare fraud is a costly burden on society
The dermatologist’s settlement comes at a time when the government is seeking to crackdown on healthcare fraud. The Centers for Medicare and Medicaid Services (CMS) estimates that in 2015 alone, more than 10 percent of Medicare’s total budget was lost to fraud, abuse and waste.
Aside from improper billing, some doctors have established fake addresses in order to claim Medicare payments. It’s a type of fraud that can take many forms, and some offenders are particularly brazen.
The Minnesota dermatologist, though he ultimately settled, has denied all accusations of impropriety, and claims that the settlement decision was business-based.
Medicare fraud is a serious issue, and those who encounter it in the workplace should report it. The False Claims Act has provisions in place to protect whistle-blowers, and those who are unsure about speaking up can consult with an attorney to better understand their rights.