Suburban Dermatologist Convicted Of Cheating Medicare And Private Insurers Of $2.6 Million In Health Care Fraud Scheme
CHICAGO — A dermatologist in west suburban Lombard was convicted today of defrauding Medicare and private health insurers by submitting false claims for more than 800 patients resulting in losses totaling more than $2.6 million. The defendant, DR. ROBERT KOLBUSZ, falsely diagnosed patients with actinic keratosis, or sun-induced skin lesions that have potential to become cancerous, and then billed public and private health insurers for treatments that were ineffective and falsely documented.
Kolbusz, 57, of Oak Brook, owns and operates the Center for Dermatology and Skin Cancer, Ltd., in Lombard and formerly located in Downers Grove. He was found guilty of three counts of wire fraud and three counts of mail fraud by a jury that began deliberating on Friday after a four-week trial in U.S. District Court.
Kolbusz remains free on bond pending sentencing, which was scheduled for Feb. 13, 2015, by U.S. District Judge John Z. Lee. Kolbusz faces a maximum penalty of 20 years in prison and a $250,000 fine on each count, or an alternate fine totaling twice the gross fraud loss or twice the gain, whichever is greater. The Court must impose a reasonable sentence under federal statutes and the advisory United States Sentencing Guidelines.
According to the evidence at trial, between 2003 and 2010, Kolbusz falsely documented hundreds of patients’ records to support medically unnecessary, cosmetic treatments he ordered. He typically billed for removing 15 or more lesions from hundreds of repeat patients, many for whom he treated on at least 10 or more occasions, and received insurance payments of up to $352.40 per treatment. Overall, he falsely claimed to have removed more than 150 pre-cancerous lesions from each of approximately 350 Medicare patients, more than 450 patients covered by Blue Cross and Blue Shield, and additional patients covered by Aetna and Humana health insurance. In fact, Kolbusz usually provided treatments that were merely cosmetic and that were not eligible for insurance payments.
Eight patients, several employees, and an expert witness testified for the government, while Kolbusz testified in his defense. One patient, who was a teenager at the time, testified that she thought only that she was getting her freckles lightened while Kolbusz claimed that he had destroyed approximately 491 pre-cancerous lesions on her skin.
The guilty verdict was announced by Zachary T. Fardon, United States Attorney for the Northern District of Illinois; Robert J. Holley, Special Agent-in-Charge of the Chicago Office of the Federal Bureau of Investigation; Lamont Pugh III, Special Agent-in-Charge of the U.S. Department of Health and Human Services Office of Inspector General in Chicago; and James Vanderberg, Special Agent-in-Charge of the U.S. Department of Labor Office of Inspector General in Chicago.
The government is being represented by Assistant U.S. Attorneys Stephen Chahn Lee, Abigail Peluso, and Jessica Romero.