Ronald Bergman, DO, and his medical practice, Bergman Cosmetic Surgery, P.C., of Des Moines, Iowa, have agreed to pay $800,000 to the United States and the State of Iowa to resolve allegations that Bergman wrongfully billed Medicare and Medicaid for services rendered by others and billed Medicare for medically unnecessary and unreasonable applications of skin substitute products.
Specifically, the government alleged that from 2013 to 2020, Bergman submitted inappropriate claims for payment to government healthcare programs in three ways. First, the government alleged that Bergman submitted claims to Medicare and Medicaid in his own name when, in fact, the services were rendered by auxiliary personnel, and when there was insufficient physician involvement for the claims to be billed in Bergman’s name.
Second, the government alleged that Bergman submitted claims to Medicare and Medicaid in his own name when, in fact, the services were rendered by medical fellows without Bergman, as the teaching physician, being physically present. Third, the government alleged that Bergman submitted claims to Medicare for medically unnecessary and unreasonable applications of skin substitute products.
“Our federal healthcare system depends on accurate and honest billing by medical providers,” said United States Attorney Timothy T. Duax. “We are committed to ensuring that physicians and other providers are held to account for inappropriate billing practices.”
“We expect health care providers who serve Medicare and Medicaid beneficiaries to refrain from harming the integrity of the programs on which their patients rely. Billing in any fashion that results in overpayment from the programs threatens that integrity,” says Special Agent in Charge Curt L. Muller with the U.S. Department of Health and Human Services Office of Inspector General (HHS-OIG). “In coordination with fellow law enforcement agencies, HHS-OIG ceaselessly works to examine allegations involving inappropriate billing and HHS beneficiaries.”
This civil matter arose from an action brought under the whistleblower provisions of the False Claims Act. Pursuant to that Act and the settlement agreements, the whistleblower will share in the United States’ financial recovery. The claims asserted against Bergman are allegations only; there was no determination or admission of liability.