A dermatologist at Minnesota-based office, Skin Care Doctors, took a courageous stand. He exposed false Medicare billings of unnecessary surgical procedures of his fellow doctors. Brave whistleblowers like this dermatologist help to stop fraud, and the government rewards them for it.
About Billing Fraud
Medicare and Medicaid lose an estimated $60 billion or more annually to billing fraud. Since 1990, the Government Accountability Office labeled Medicare a high-risk program. Whistleblowers shine a light on ways providers defraud the government. Researchers don’t expect this rate of qui tam cases to slow down. This is especially true since whistleblowers may have even more incentive to bring charges.
Billing Fraud Is Common
Many companies try different ways to get extra money from government programs like Medicare and Medicaid. This is what happened at Skin Care Doctors. One dermatologist at the office noticed that a colleague knowingly treated benign lesions and billing Medicare as if they were pre-cancerous. Additionally, he would bill Medicare for unnecessary procedures. Then, the doctor overbilled Medicare for patient visits and encouraged other doctors in the practice to do the same.
The accused doctor made no admission of guilt but will pay the whistleblower’s attorneys fees along with $850,000 to the government. Under the False Claims Acts (FCA), the whistleblower will receive a reward of $153,000. Along with the money, the doctor received thanks from the government.
A spokesperson said that the doctor “could have kept quiet and moved on, but instead, he stood up for taxpayers and future SCD patients. He’s a model of medical ethics and a beacon for doctors and other medical professionals who witness wrongdoing by their colleagues.”
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