Source: United States Department of Justice News
DES MOINES, IA – Eastern Iowa Dermatology, PLC, located in Bettendorf, and Dr. Manish Kumar have agreed to pay $1.66 million to resolve allegations for violations of the False Claims Act by submitting false claims to Medicare for dermatology office visits and the destruction or removal of skin tags and lesions. The False Claims Act considers “up-coding”—the practice of exaggerating the amount or complexity of medical services rendered in order to achieve a higher level of reimbursement—a form a fraud.
Dr. Kumar and Eastern Iowa Dermatology, PLC also agreed to an Integrity Agreement and will submit to ongoing monitoring by the U.S. Department of Health and Human Services.
“Health care providers that try to boost their profits by submitting fraudulent claims to Federal health care programs threaten the integrity of those programs and drive up prices for everyone,” said Tamala E. Miles, Special Agent in Charge with the U.S. Department of Health and Human Services Office of Inspector General. “We work tirelessly alongside our law enforcement partners to protect the integrity of Federal health care programs and to ensure the appropriate use of taxpayer dollars.”
The resolutions obtained in this matter were the result of a coordinated effort between the U.S. Attorney’s Office for the Southern District of Iowa and the U.S. Department of Health and Human Services Office of Inspector General.
Tips and complaints from all sources about potential fraud, waste, abuse and mismanagement can be reported to the Department of Health and Human Services at 800-HHS-TIPS (800-447-8477). False Claims Act cases can also be brought under the qui tam provisions of the Act, which encourage whistleblowers to bring suit on behalf of the United States and share in any financial recovery.
United States Attorney Richard D. Westphal of the Southern District of Iowa made the announcement. This case was handled by Assistant U.S. Attorney David Faith and Investigative Analyst Connie Benton.
The claims resolved by the settlement are allegations only and there has been no determination of liability.