A new year has begun, but in the field of health care, some familiar challenges remain. One is the ever-present specter of Medicare fraud, which continues to be a significant problem in Florida. In one key case, a high-profile doctor has agreed to pay a $400,000 settlement.

That payment will resolve a set of allegations against him that claimed he billed Medicare for services performed by staffers who were unqualified and insufficiently skilled. The services included weight-loss counseling and varicose vein injections, and the individuals performing them included the doctor’s office manager.

The doctor, who has board certification in the area of thoracic surgery, owns a clinic that specializes in treating veins and used to own a weigh-loss center as well. Currently based in Tampa Bay, he once practiced medicine in Pasco County and also had admitting privileges with both Tampa General Hospital and Brooksville’s Oak Hill Hospital.

The case against him began when his former office manager filed a whistleblower complaint. When she filed it, the office manager gave authorities text messages from the doctor. Those messages told her to perform multiple ultrasound-guided procedures. She did so in 2009 and 2010.

Prosecutors alleged that the doctor billed Medicare for a significant number of weight-loss patients. However, he personally only worked with a small number of them. He was also accused of billing for unnecessary vein injections.

This case shows the importance of preventing accusations of Medicare fraud by having all procedures performed by qualified individuals. If they aren’t, a costly Medicare fraud case can result, as happened with this doctor. Anyone who finds themselves in similar circumstances may want to speak with an attorney who has experience in this area of law.

Source: Tampa Bay News, “Tampa Bay doctor to pay $400,000 to settle Medicare fraud case” Jodie Tillman, Jan. 07, 2014

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