A Minnesota dermatology practice has agreed to pay the U.S. $850,000 to settle a federal False Claims Act lawsuit brought by a whistleblower who accused the practice of improperly billing Medicare for products and services that didn’t qualify for reimbursement.
Minnesota’s U.S. Attorney’s Office said that Skin Care Doctors, P.A. and its founder and CEO Michael J. Ebertz, M.D., submitted false claims for payment to the Medicare program over a period starting in January 2008 and ending in December 2015.
Federal prosecutors say questionable billing practices spanned four different areas, including billing Medicare for free samples of a phototherapy drug, upcoding office visits, lesion removal procedures, and phototherapy services.
Dr. Ebertz and his practice, which operates four offices in the Minneapolis/St. Cloud area, denied the allegations and the case was resolved before any determination of liability was made, the U.S. Attorney’s Office said.
“Medicare is a public trust,” said Assistant U.S. Attorney Ann Bildtsen in Minnesota. “This resolution against both the company and its CEO safeguards that trust and restores needed funds to Medicare. This Office is committed to taking necessary actions to rectify inflated billing to federal programs.”
According to the U.S. Attorney’s office, the settlement between Dr. Ebertz and the U.S. government resolves a civil lawsuit brought by a whistleblower, a doctor who formerly worked with Dr. Ebertz. The physician filed the lawsuit under the whistleblower provisions of the False Claims Act, which allows private parties with evidence of false claims to file suit on behalf of the U.S. government.
The False Claims Act awards whistleblowers between 15 and 20 percent of the total recovery made as a result of their case, or up to 25 percent if the U.S. government chooses not to become an active litigant in a case. The U.S. government has not said how much of the recovery the whistleblower in this case would receive, but the award will fall somewhere between $127,000 and $170,000.