A Tampa, FL, dermatology practice that cares for senior living residents has agreed to pay $4 million to settle allegations that it submitted false claims to obtain Medicare and Medicaid reimbursements for the treatment of non-melanoma skin cancer with superficial radiation therapy, the Justice Department announced this week.
Dermatology Healthcare provides dermatology consultations and bedside services to residents of assisted living communities, retirement communities and skilled nursing facilities, according to its website.
From 2011 through 2016, court documents alleged, the practice did not adequately supervise the administration of superficial radiation therapy, up-coded claims for procedures related to superficial radiation therapy, and over-utilized radiation simulations.
“The rules are simple: bill government health programs only for services actually needed and provided. No more, no less,” Shimon R. Richmond, special agent in charge for the Office of Inspector General of the U.S. Department of Health and Human Services, said in a statement. “We will continue to protect federal healthcare programs and beneficiaries by holding providers accountable.”
The settlement ends a lawsuit originally filed in the U.S. District Court for the Middle District of Florida by Sunshine State dermatologist Theodore, A. Schiff, M.D. Schiff filed the lawsuit under the qui tam provisions of the False Claims Act, which permit a private citizen to sue on behalf of the United States for false claims and to share in the recovery.
In 2013 and 2014, Schiff filed similar lawsuits against another Florida dermatologist, who later settled for $18 million but subsequently vowed to sue Schiff for defamation and libel, according to the Palm Beach Post.