KNOXVILLE, Tenn. — A dermatologist and his practice have agreed to pay millions of dollars to resolve allegations of knowingly submitting false claims to federal healthcare programs, according to a release from the Department of Justice.
John Y. Chung, M.D., and his practice Skin Cancer & Cosmetic Dermatology Center, P.C. (SCCDC), operates 13 dermatology clinics in southeast Tennessee and north Georgia. According to the release, they violated the False Claims Act, a federal law that imposes liability on persons and companies who defraud governmental programs.
“When health care providers submit improper claims to federal health care programs, they waste valuable taxpayer dollars,” Special Agent in Charge Tamala E. Miles of the Department of Health and Human Services Office of Inspector General said. “Working with our law enforcement partners, our agency will continue to protect federal health care programs from fraud, waste, and abuse to ensure they can be used for their intended purposes.”
The settlement resolves allegations that Chung and SCCDC knowingly submitted false claims for payment to Medicare, Medicaid and other government payors for Mohs Micrographic Surgeries, and other dermatological procedures. The department said that people were billed as if both the surgery and pathology portions of the procedures were performed by Chung when at least one portion was often performed by other individuals.
The settlement also resolves allegations that SCCDC regularly billed Medicare for multiple procedures, performed on the same patient on the same day, according to DOJ. The alleged misconduct happened from 2010 to 2020.
As part of the settlement, Chung and SCCDC entered an integrity agreement, which focuses on the practice’s continuing obligation to accurately bill and submit reimbursements to government payors, with the U.S. Department of Health and Human Services, DOJ said.
“To protect the integrity of federal health care programs and the patients they serve, it is important that providers are compliant with billing rules and procedures,” Tennessee Valley Office of Inspector General Ben Wagner said. “The TVA OIG is committed to identifying and investigating healthcare false claims that negatively impact the people of the Tennessee Valley.'
The claims settled by this agreement are allegations only and there has been no determination of liability, according to the department.