An Encino dermatologist paid almost $2.7 million to the federal government to resolve allegations that he submitted bills to Medicare for complex and time-consuming skin cancer surgeries that were medically unnecessary, federal prosecutors have announced.
The physician made the payment without admitting liability.
The case was brought to the attention of authorities by a former employee of the the doctor’s medical clinic, and the ex-worker “whistleblower” received almost a half-million dollars under federal law for her actions.
Dr. Norman A. Brooks, owner of the Skin Cancer Medical Center, paid the settlement on April 10 without admitting liability, according to the U.S. Attorney’s Office.
The settlement was announced after U.S. District Judge Philip S. Gutierrez unsealed and dismissed the complaint that was filed under the False Claims Act.
The suit alleged that Brooks falsely diagnosed skin cancer in some of his patients so that he could perform, and bill for, “Mohs” surgeries.
The specialized procedure is used for removing certain types of skin cancers in specific areas of the body, including the face.
The surgery is performed in stages during which the surgeon removes a single layer of tissue which undergoes a microscopic evaluation. The surgeon performs additional stages, if necessary, until all of the cancer is removed. Given the complexity and time required to perform the procedure, Mohs yields a higher Medicare reimbursement than other procedures used to remove skin lesions.
While each of the surgery stages is done under anesthetic, the pain-killing injections themselves can be uncomfortable for some patients. Injections are needed each time the physician goes back to remove more of the cancer cells.
As part of the settlement announced by the feds Thursday, Brooks entered into a three-year Integrity Agreement with the U.S. Department of Health and Human Services. Under the agreement, Brooks will establish and maintain a compliance program that includes, among other things, mandated training for the doctor and his employees and review procedures for claims submitted to Medicare and Medicaid programs.
The lawsuit was filed by former Brooks employee Janet Burke under the qui tam — or “whistleblower” — provisions of the False Claims Act, which permit private parties to sue on behalf of the government and receive a share of any recovery.
For her role in the case, Burke will receive nearly $482,500, according to the U.S. Attorney’s Office.
— Staff and wire reports