Source: United States Department of Justice News
A plastic surgeon in Beverly Hills, California, along with his son, medical practices, and billing company, have agreed to pay $23.9 million to resolve allegations that they violated the False Claims Act by submitting or causing the submission of false claims to both Medicare and Medicaid.
The settlement announced today resolves allegations that Dr. Joel Aronowitz; Daniel Aronowitz; Joel A. Aronowitz, M.D., a medical corporation; Tower Multi-Specialty Medical Group; Tower Wound Care Center of Santa Monica, Inc.; Tower Outpatient Surgery Center, Inc.; and Tower Medical Billing Solutions (the settling parties) falsified the place of service for skin grafts and billed multiple times for single-use skin substitute products. The United States contends that the Settling Parties manipulated the place of service code on claims for skin grafts to fraudulently maximize reimbursement from Medicare and Medicaid. The United States further contends that Dr. Aronowitz failed to properly dispose of unused portions of single-use skin graft materials and, instead, used them in later procedures involving other Medicare and Medicaid beneficiaries, resulting in thousands of instances of double billing.
“When health care providers violate federal health care program requirements, they undermine the integrity of these programs and waste taxpayer dollars,” said Principal Deputy Assistant Attorney General Brian M. Boynton, head of the Justice Department’s Civil Division. “This settlement demonstrates the department’s commitment to preventing providers from misappropriating public funds for their own private gain.”
“Our investigation revealed a long-running practice to illegally maximize profits, ultimately costing public health programs millions of dollars,” said U.S. Attorney Martin Estrada for the Central District of California. “The Medicare and Medicaid programs are taxpayer-funded programs, and we are committed to wiping out abuses that line the pockets of unscrupulous providers.”
In connection with the settlement, the Department of Health and Human Services Office of Inspector General (HHS-OIG), negotiated the voluntary exclusion of Dr. Aronowitz and Tower Multi-Specialty Medical Group from Medicare, Medicaid, and all other federal health care programs, as defined in 42 U.S.C. § 1320a-7b(f), for a period of 15 years. Daniel Aronowitz will be excluded for three years.
“HHS-OIG, along with our law enforcement partners, is committed to holding providers accountable for defrauding federal health care programs,” said Special Agent in Charge Timothy B. DeFrancesca of HHS-OIG. “Those who egregiously exploit Medicare and Medicaid put their personal financial gain before patients’ needs and safety.”
Medicaid is funded jointly by the states and the federal government. The state of California paid for a portion of the Medicaid claims at issue and will receive a total of approximately $497,619 from the settlement.
The civil settlement includes the resolution of claims brought under the qui tam, or whistleblower, provisions of the False Claims Act by parties that worked for Dr. Aronowitz and his associated medical practices and businesses: TDP, a billing company, Dr. Jason Morris, a podiatrist, and Harold Bautista, a billing department employee. Under the qui tam provisions, a private party can file an action on behalf of the government and receive a portion of any recovery. The civil lawsuits are captioned as follows: United States ex rel. TDP RCM Servs., LLC v. Aronowitz, et al. (C.D. Cal.), United States ex rel. Morris, et al. v. Tower Wound Care Ctr. of Santa Monica, Inc., et al. (C.D. Cal.), and United States ex rel. Bautista et al. v. Tower Outpatient Surgery Center, Inc., et al. (C.D. Cal.). The amount to be recovered by the private parties has not been determined.
The resolution obtained in this matter was the result of a coordinated effort between the U.S. Attorney’s Office for the Central District of California and the Justice Department’s Civil Division, Commercial Litigation Branch, Fraud Section. HHS-OIG assisted in the investigation.
The matter was handled by Assistant U.S. Attorney Aaron Ezroj for the Central District of California and Trial Attorney Lyle Gruby of the Civil Division. The exclusions of the individual and entity were negotiated by Senior Counsel Patrice Drew of the HHS-OIG.
The investigation and resolution of this matter illustrates the government’s emphasis on combating healthcare fraud. One of the most powerful tools in this effort is the False Claims Act. 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).
The claims resolved by the settlement are allegations only. There has been no determination of liability.