Dermatologist John Y. Chung, M.D., and his practice Skin Cancer & Cosmetic Dermatology Center, P.C., which operates clinics in Rome, Calhoun and Cartersville, have agreed to pay $6.6 million to resolve allegations that they violated the False Claims Act.
This settlement resolves allegations that Dr. Chung and SCCDC knowingly submitted false claims for payment to Medicare, Medicaid, and other government payors for Mohs procedures billed as if both the surgery and pathology portions of the processes were performed by Dr. Chung when, in fact, different individuals completed at least one part. The settlement further resolves allegations that SCCDC regularly billed Medicare for multiple procedures performed on the same patient on the same day in a manner that improperly circumvented Medicare’s “multiple procedure reduction rule.” The alleged misconduct occurred from 2010 through 2020.
The U.S. Attorney’s office in Knoxville says Chung and his practice “knowingly submitting false claims to federal healthcare programs for Mohs Micrographic Surgeries and other dermatological procedures.”
The claims settled by the agreement are allegations only and there has been no determination of liability, according to a media release from the prosecutors’ office.
As part of the settlement, Chung and SCCDC entered an Integrity Agreement (I.A.) with the U.S. Department of Health and Human Services – Office of Inspector General (HHS-OIG), which promotes its future compliance with the statutes, regulations, program requirements, and written directives of Medicare and all other federal health care programs. The IA focuses on the practice’s obligation to bill and properly submit reimbursement claims to government payors accurately.
“Over the last two years, the Skin Cancer and Cosmetic Dermatology Center has been in discussions with the U.S. Attorney’s Office regarding our billing processes. We disagree with most of the accusations of the U.S. Attorney’s Office, and we have taken steps to adjust some billing practices outlined in the complaint. We have decided to settle this matter rather than proceed with litigation because the process has been a distraction for our administration and financially burdensome for our centers.
As referenced in the information provided by the Department of Justice, the settlement agreement was entered into solely based on allegations, and there was no admission of liability or intentional wrongdoing. This is a civil and not a criminal matter. We will continue providing the highest quality of care for our patients just as we have for the last 27 years.”
From CALHOUN TIMES/WZQZ