LOS ANGELES
A plastic surgeon in Beverly Hills, along with his son, medical practices, and billing company, has agreed to pay $23.9 million to resolve allegations of submitting or causing the submission of false claims to both Medicare and Medicaid.
The settlement announced Friday resolves fraud allegations that Dr. Joel Aronowitz; Daniel Aronowitz; Joel A. Aronowitz, M.D.
Also, it resolves allegations against Tower Multi-Specialty Medical Group; Tower Wound Care Center of Santa Monica, Inc.; Tower Outpatient Surgery Center, Inc.; and Tower Medical Billing Solutions (the Settling Parties).
According to officials, they allegedly falsified the place of service for skin grafts and billed multiple times for single-use skin substitute products.
The claims resolved by the settlement are allegations only—no determination of liability.
The federal government contends that the settling parties manipulated the place of service code on claims for skin grafts to fraudulently maximize reimbursement from Medicare and Medicaid.
The federal government further contends that Dr. Aronowitz failed to dispose of unused portions of single-use skin graft materials properly and used them in later procedures involving other Medicare and Medicaid beneficiaries, resulting in thousands of instances of double billing.
“Our investigation revealed a long-running practice to illegally maximize profits, ultimately costing public health programs millions of dollars,” said U.S. Attorney Martin Estrada. “The Medicare and Medicaid programs are taxpayer-funded, and we are committed to wiping out abuses that line the pockets of unscrupulous providers.”
“When health care providers violate federal health care program requirements, they undermine the integrity of these programs and waste taxpayer dollars,” said Principal Deputy Assistant Attorney General Brian M. Boynton, head of the Justice Department’s Civil Division.
In connection with the settlement, the United States Department of Health and Human Services, Office of Inspector General (HHS OIG), negotiated the voluntary exclusion of Dr. Aronowitz and Tower Multi-Specialty Medical Group from Medicare, Medicaid, and all other federal health care programs for 15 years.
Daniel Aronowitz will be excluded for three years.
Medicaid is funded jointly by the states and the federal government. The state of California paid for a portion of the Medicaid claims at issue and will receive about $497,619 from the settlement.
The civil settlement includes the resolution of claims brought under the qui tam, or whistleblower, provisions of the False Claims Act by parties that worked for Dr. Aronowitz and his associated medical practices and businesses: TDP, a billing company; Dr. Jason Morris, a podiatrist; and Harold Bautista, a billing department employee.
Under the qui tam provisions, a private party can file an action on behalf of the government and receive a portion of any recovery.
The matter was handled by Assistant U.S. Attorney Aaron Ezroj of the Civil Fraud Section and Trial Attorney Lyle Gruby of the Justice Department’s Civil Division.
The investigation and resolution of this matter illustrates the government’s emphasis on combating healthcare fraud. One of the most powerful tools in this effort is the False Claims Act.
Tips and complaints from all sources about potential fraud, waste, abuse and mismanagement can be reported to the Department of Health and Human Services at 800-HHS-TIPS (800-447-8477).