Skin cancer can be life threatening. (Obviously, that is why it’s important to use sunscreen and cover up when outside to protect your skin from the sun’s dangerous rays.) An article published in The Vero Beach Press Journal shows that there is really nothing new under the sun when it comes to fraud in the Medicare system. The story explains how a plastic surgeon took advantage of some of his patients by billing the government benefits program for unnecessary procedures related to skin cancer.
According to the story, two people filed a lawsuit against the plastic surgeon stating that he violated the False Claims Act by billing Medicare for procedures that he did not actually perform or were not medically necessary. (The whistleblowers included another doctor who referred patients to the plastic surgeon and a woman who previously worked for eight years as a technician in the office run by the plastic surgeon.) Further research on the case revealed allegations surrounding the complex surgery of removing skin cancer. (Perhaps his patients didn’t have skin cancer at all.)
The plastic surgeon agreed to pay $4 million to settle the allegations that his office improperly submitted bills to Medicare. As a result, he is banned from participating in Medicare, Medicaid and any federally funded health care program for at least five years. (How about never again?)
In this case, it wasn’t the sun’s dangerous rays that were the problem, but the doctor who used them as an excuse to steal millions of dollars from the Medicare program. (How many patients had to suffer through unnecessary painful medical procedures?)
The two whistleblowers will split $920,000 as part of the settlement. (Not a bad reward for telling the truth.) Because health care costs continue to skyrocket in part due to the amount of fraud against government programs, whistleblowers are often the best weapon against the illegal actions. Because two people were willing to stand up for what is right, the government was able to cut out this doctor’s fraudulent actions so that Medicare beneficiaries can continue to receive the care they deserve.
The post Nothing New Under the Sun appeared first on Fraud of the Day.