A Florida dermatologist has agreed to pay $26.1 million to the federal government to resolve allegations that he violated the False Claims Act by accepting illegal kickbacks from a pathology laboratory and billing the Medicare program for medically unnecessary services. The settlement is the largest ever with an individual under the False Claims Act in the Middle District of Florida and one of the largest with an individual under the False Claims Act in U.S. history. The government alleged that, in or around 1997, Steven Wasserman, M.D., a dermatologist practicing in Venice, Fla., entered into an illegal kickback arrangement with Tampa Pathology Laboratory (TPL), a clinical laboratory in Tampa, Fla., and Dr. Jose SuarezHoyos, a pathologist and owner of TPL, in an effort to increase the lab’s referral business. Under the agreement, Wasserman allegedly sent biopsy specimens for Medicare beneficiaries to TPL for testing and diagnosis. In return, TPL allegedly provided Wasserman a diagnosis on a pathology report that included a signature line for Wasserman to make it appear to Medicare that he had performed the diagnostic work that TPL had performed. The government alleged that Wasserman then billed the Medicare program for TPL’s work, passing it off as his […]
A Florida dermatologist has agreed to pay $26.1 million to the federal government to resolve allegations that he violated the False Claims Act by accepting illegal kickbacks from a pathology laboratory and billing the Medicare program for medically unnecessary services.
The settlement is the largest ever with an individual under the False Claims Act in the Middle District of Florida and one of the largest with an individual under the False Claims Act in U.S. history.
The government alleged that, in or around 1997, Steven Wasserman, M.D., a dermatologist practicing in Venice, Fla., entered into an illegal kickback arrangement with Tampa Pathology Laboratory (TPL), a clinical laboratory in Tampa, Fla., and Dr. Jose SuarezHoyos, a pathologist and owner of TPL, in an effort to increase the lab’s referral business.
Under the agreement, Wasserman allegedly sent biopsy specimens for Medicare beneficiaries to TPL for testing and diagnosis. In return, TPL allegedly provided Wasserman a diagnosis on a pathology report that included a signature line for Wasserman to make it appear to Medicare that he had performed the diagnostic work that TPL had performed. The government alleged that Wasserman then billed the Medicare program for TPL’s work, passing it off as his own, for which he received more than $6 million in Medicare payments. In addition, the government asserted that Wasserman substantially increased the number of skin biopsies he performed on Medicare patients, thus increasing the referral business for TPL.
The government further alleged that, in addition to his involvement in the alleged kickback scheme, Wasserman also performed thousands of unnecessary skin surgeries known as adjacent tissue transfers on Medicare beneficiaries. Adjacent tissue transfers are complicated and often time-consuming procedures physicians sometimes use to close a defect resulting from the removal of a growth on a patient’s skin. The government alleged that Wasserman performed many of these procedures in order to obtain the reimbursement for them and not because they were medically necessary.
“Doctors who take illegal kickbacks and perform unnecessary procedures not only put their own financial self-interest over their duty to their patients, they raise the cost of health care for all of us as patients and as taxpayers,” said Stuart Delery, principal deputy assistant attorney general for the Civil Division of the Department of Justice.
“This settlement represents a watershed achievement in our district’s civil health care fraud enforcement program,” said Robert O’Neill, U.S. attorney for the Middle District of Florida. “Schemes of this magnitude require extraordinary remedies, and we are proud to have reached such an outstanding resolution for the taxpayers and their health programs.”
The allegations resolved by this settlement were initiated by a lawsuit originally filed by Alan Freedman, M.D., a pathologist who formerly worked at TPL. Under the False Claims Act, a private party may file suit on behalf of the United States for false claims and share in any recovery. The United States has a right to intervene in the action, which it did in this case, filing its own complaint in October 2010. Freedman will receive more than $4 million of this settlement.
The United States previously settled with TPL and SuarezHoyos for $950,000 to resolve the allegations asserted against them in the same lawsuit.
