Newspaper article Sarasota Herald Tribune

Skin in the Game

Newspaper article Sarasota Herald Tribune

Skin in the Game

Article excerpt

Medicare fraud case has wide-ranging implications

A $26 million fine against a Venice dermatologist is a milestone in the federal government's effort to thwart Medicare overbilling.

We hope the outcome will serve as a deterrent and help bring down medical costs, which have an enormous impact on Americans, their economy and the federal budget.

The fine, announced Monday by the U.S. Department of Justice and the U.S. Attorney for Florida's Middle District, settles a civil case. No criminal charges were filed and the agreement did not establish guilt or liability.

The document details accusations that from 1997 to 2005, Dr. Steven Jay Wasserman received illegal kickbacks for sending skin biopsy business to Tampa Pathology Laboratory. Additionally, it alleges that Wasserman wrongly "upcoded" certain medical procedures, getting higher reimbursements from Medicare, and billed for expensive surgery techniques that weren't medically justified.

High fine

The lab settled previously, agreeing to pay the government $950,000.

Wasserman -- in addition to being required to pay $26 million (plus interest) -- won't be permitted to treat or bill patients in Medicare, Medicaid and all other federal health care programs for at least five years, according to his settlement agreement.

It is a record penalty in the Middle District. Still, the nature of the civil case against Wasserman is different and less severe than a criminal one involving Sarasota dermatologist Michael Rosin.

Rosin was accused of inflicting numerous unnecessary, disfiguring skin-cancer surgeries on many patients. He was convicted of Medicare fraud and sentenced, in 2007, to a 22-year prison term plus multimillion-dollar fine.

It perhaps shouldn't surprise anyone that Sarasota County -- loaded with retirees and skin-damaging sunshine -- has been the site of two Medicare dermatology scandals. …

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