The Department of Justice recently made an announcement that sent shockwaves throughout the plastic surgery industry. A plastic surgeon, his son, medical practices, and billing company located in Beverly Hills, California, have agreed to pay a whopping $23.9 million to settle allegations of False Claims Act violations. The state of California will also receive $497,619 for its share of the state’s money involved in the alleged fraud. This settlement is the result of false claims made to Medicare and Medicaid, a practice that the defendants have allegedly been engaging in for a long time.
The U.S. Attorney for the Central District of California, Martin Estrada, noted, “Our investigation revealed a long-running practice to illegally maximize profits, ultimately costing public health programs millions of dollars. The Medicare and Medicaid programs are taxpayer-funded programs, and we are committed to wiping out abuses that line the pockets of unscrupulous providers.” The Justice Department’s Civil Division, headed by Principal Deputy Assistant Attorney General Brian M. Boynton, added that healthcare providers who violate federal healthcare program requirements undermine the integrity of these programs and waste taxpayer dollars.
The civil action and investigation taken by the Department of Justice was initiated from disclosures made by whistleblowers who filed under the qui tam provision of the False Claims Act. Qui tam claims allow private citizens to file lawsuits on behalf of the government if they know of an individual or company defrauding the government. Qui tam whistleblowers are eligible to receive between 15 and 30% of the government’s recovery. In this case, TDP, a billing company, Dr. Jason Morris, a podiatrist, and Harold Bautista, a billing department employee, all worked for Dr. Aronowitz and his associated medical practices and businesses.
The government emphasized that in its efforts to combat healthcare fraud, the False Claims Act is one of the most powerful tools available. This is because it allows for individuals to come forward and report fraud, with the potential for significant financial rewards. The whistleblowers in this case acted with courage and integrity, risking their careers to expose a fraudulent scheme that was defrauding the government and ultimately costing taxpayers millions of dollars.
The settlement is a clear warning to all providers who seek to engage in fraudulent practices that the government is watching and will take decisive action to root out fraud and abuse. It is also a reminder to all whistleblowers that they play an essential role in ensuring that public funds are used appropriately and that those who seek to defraud the government are held accountable for their actions.
This case also highlights the importance of transparency and accountability in the healthcare industry. Patients must be able to trust that their healthcare providers are acting in their best interests and not engaging in fraudulent practices that could harm their health or result in unnecessary medical procedures. By exposing this fraudulent scheme, the whistleblowers and the Department of Justice have sent a clear message that fraudulent practices will not be tolerated in the healthcare industry.