Villages Dermatologist Agrees To Pay More Than $1.7 Million To Settle False Claims Act Liability For Inflated Medicare Claims
Orlando, FL – United States Attorney Maria Chapa Lopez announces today that Dr. Thi Thien Nguyen Tran and Village Dermatology and Cosmetic Surgery, L.L.C. have agreed to pay the United States $1.744 million to resolve allegations that they violated the False Claims Act by submitting inflated claims to Medicare for wound repairs related to Mohs surgery.
The settlement relates to Dr. Tran’s submission of claims for adjacent tissue transfers performed at Village Dermatology. Dr. Tran and Village Dermatology performed wound repairs that were allegedly billed to Medicare as more complex adjacent tissue transfers, which carry a higher level of reimbursement. According to the settlement agreement, from January 1, 2011, through July 31, 2016, Dr. Tran and Village Dermatology billed for 14,000-level tissue transfers, which should have been billed as lower-level wound repairs. These submissions resulted in inflated claims that were paid by Medicare.
“Protecting federal healthcare programs and the patients who receive their care is among our top priorities,” said U.S. Attorney Maria Chapa Lopez. “The U.S. Attorney’s Office will continue to hold accountable those who inflate claims to Medicare or abuse any of our nation’s healthcare programs.”
“Physicians who seek to profit by systematically overbilling Medicare will instead pay dearly for their illegal behavior,” said Special Agent in Charge Omar Pérez Aybar of HHS-OIG. “We will continue to work closely with our law enforcement partners to thoroughly investigate such schemes.”
The settlement concludes a lawsuit originally filed in the United States District Court for the Middle District of Florida by Dr. Robert Green and Emily Kennedy. Dr. Green and Ms. Kennedy sued under the qui tam, or whistleblower, provisions of the False Claims Act permitting a private citizen to sue on behalf of the United States for false claims and to share in the recovery. The Act also allows the United States to intervene and prosecute the action. Dr. Green and Ms. Kennedy will receive over $305,000 of the proceeds from the settlement with Dr. Tran and Village Dermatology.
This settlement resulted from a coordinated effort by the U.S. Attorney’s Office for the Middle District of Florida and the U.S. Department of Health and Human Services Office of Inspector General. Assistant United States Attorney Jeremy R. Bloor led the investigation.
The case is captioned United States ex rel. Green and Moore v. Tran, Case No. 5:15-cv-60-OC-41PRL. The settlement resolves the United States’ claims in that case. The claims resolved by the settlement are allegations only, and there has been no determination of liability.