A plastic surgeon in Beverly Hills, Calif., 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 resolves allegations that Joel Aronowitz, MD; 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 falsified the place of service for skin grafts and billed multiple times for single-use skin substitute products.
The U.S. contends that the Tower Medical Billing Solutions manipulated the place of service code on claims for skin grafts to fraudulently maximize reimbursement from Medicare and Medicaid. The U.S. further contends that 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 healthcare providers violate federal healthcare program requirements, they undermine the integrity of these programs and waste taxpayer dollars,” says 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,” adds 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 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,” says 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.”