Dermatologist in FL must pay CMS $10M for radiation fraud

[Gfunk6]

http://www.prnewswire.com/news-rele...ologist-medicare-fraud-lawsuit-300403678.html

Incredible level of fraud:

* He conspired with a pathologist to falsely diagnose benign lesions as malignant

* These "malignant" lesions were treated with radiation therapy

* He billed CMS a much higher rate based on radiation equipment he didn't have.

Really hope this guy sees serious jail time.


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[nkmiami]

I cant believe this happened in South Florida of all places.

 

[evilbooyaa]

I cant believe this happened in South Florida of all places.

I feel like Florida is where a bunch of craziness happens regularly.

That being said, this guy should probably go to jail, right? Loss of license?

 

[medgator]

I cant believe this happened in South Florida of all places.

Lol.

I had brought up this case in the skin cancer rt thread, it's been in the news for years, including the wsj related to the Medicare data dump, glad to see it is finally resolved

 

[medgator]

I feel like Florida is where a bunch of craziness happens regularly.

That being said, this guy should probably go to jail, right? Loss of license?

Yup, and south fl has to be the real hot zone. I've heard that the OIG has a fraud office in S FL because of all of it

When it comes to the Medicare ban (and subsequent loss of license, you can't have a license if you're banned from Medicare/Medicaid iirc), I've heard it depends on how willful and egregious the acts are. This guy sounds pretty bad, kinda in the same niche as the med onc in Michigan giving chemo to people who didn't even have cancer, he ended up with jail time.

 

[evilbooyaa]

Yup, and south fl has to be the real hot zone. I've heard that the OIG has a fraud office in S FL because of all of it

When it comes to the Medicare ban (and subsequent loss of license, you can't have a license if you're banned from Medicare/Medicaid iirc), I've heard it depends on how willful and egregious the acts are. This guy sounds pretty bad, kinda in the same niche as the med onc in Michigan giving chemo to people who didn't even have cancer, he ended up with jail time.

Agree with the bolded. It's probably not as bad in reality as giving chemo, but as bad on the principle of the matter.

 

[Phantom1]

http://www.prnewswire.com/news-rele...ologist-medicare-fraud-lawsuit-300403678.html

Incredible level of fraud:

* He conspired with a pathologist to falsely diagnose benign lesions as malignant

* These "malignant" lesions were treated with radiation therapy

* He billed CMS a much higher rate based on radiation equipment he didn't have.

Really hope this guy sees serious jail time.


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Pathologist may be equally if not more to blame if he was conspiring to willfully misdiagnose patients.. Derm could argue he was treating based off path results. Both should get some jail time and licensees revoked.

 

[medgator]

http://www.prnewswire.com/news-rele...ologist-medicare-fraud-lawsuit-300403678.html

Incredible level of fraud:

* He conspired with a pathologist to falsely diagnose benign lesions as malignant

* These "malignant" lesions were treated with radiation therapy

* He billed CMS a much higher rate based on radiation equipment he didn't have.

Really hope this guy sees serious jail time.


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Sounds like it is an $18 mil judgement actually, and that will increase to $41 mil if he doesn't pay the initial $5 mil by a fixed date. That $5 mil would settle the judgement completely if paid on time.

Complicated terms, seems like he got off easy if he can take care of this with $5 mil, in FL they cannot touch his primary residence at all, valued at $28 mil

http://www.palmbeachpost.com/news/c...-settle-medicare-suit/i9UkrbaaP9Bbz2h261yA3K/

 

[Reaganite]

Trust me when I say this was not uncommon during the heyday of Xoft. Soooo much shady **** was going on that put urorads to shame. I'm sure I could retire from the portion of the whistleblower settlement I'd receive... There were guys who just stopped doing Moh's altogether and treated ALL skin cancer with Xoft. Many of the path reads were done by the derms themselves and would intentionally be vague...i.e. "probably benign but can't rule out cancer." Better treat that to be safe...and make 25k.

 

[winstonfoot5]

I'm sure I could retire from the portion of the whistleblower settlement I'd receive

how does the whistleblower get paid in these scenarios? for example, how much is this Dr. Schiff pulling in from this?

 

[winstonfoot5]

how does the whistleblower get paid in these scenarios? for example, how much is this Dr. Schiff pulling in from this?

nevermind, "Under the terms of the federal whistleblower act, Schiff would be eligible for 15 percent to 25 percent of any money the government recovers. A settlement agreement shows he is to get 22 percent. If Marder pays $5.2 million, that would be about $1.1 million."

 

[Neuronix]

in FL they cannot touch his primary residence at all, valued at $28 mil

I'm pretty sure that doesn't apply to criminal judgments like fraud.

 

[medgator]

I'm pretty sure that doesn't apply to criminal judgments like fraud.

I know it doesn't apply to med mal or bankruptcy. Article suggests they can't go after it regarding this case either

 

[Neuronix]

I know it doesn't apply to med mal or bankruptcy. Article suggests they can't go after it regarding this case either

Interesting. So you can sock away all that medicare fraud money into your waterfront mansion and they can't take it away from you? Doesn't seem right. But in south Florida I can believe anything.

 

[radiaterMike]

I suspect that he will be subject to civil suits, as well as criminal lawsuits. I suspect that the civil suits can't touch his house. Not sure about criminal. You need some cash flow to maintain a 28 million dollar house.


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[PruritisAni]

I suspect that he will be subject to civil suits, as well as criminal lawsuits. I suspect that the civil suits can't touch his house. Not sure about criminal. You need some cash flow to maintain a 28 million dollar house.


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AirBNB. Done.

 

[RadOncDoc21]

Interesting how he gets off (at least right now) easier than the med one in Michigan. I know giving chemo is more toxic, but giving radiation to the skin can cause issues as well. It's one thing to over treat, it's another to make up things to treat, which both docs did.

 

[OliveTree]

Interesting how he gets off (at least right now) easier than the med one in Michigan. I know giving chemo is more toxic, but giving radiation to the skin can cause issues as well. It's one thing to over treat, it's another to make up things to treat, which both docs did.

Randomly giving healthy people chemo-- wonder how someone sleeps at night

 

[medgator]

Interesting how he gets off (at least right now) easier than the med one in Michigan. I know giving chemo is more toxic, but giving radiation to the skin can cause issues as well. It's one thing to over treat, it's another to make up things to treat, which both docs did.

This is another example of a shady FL dermatologist who managed to end up with a much bigger settlement as well as a Medicare/Medicaid ban (which automatically kills your FL license I believe) for doing unnecessary surgery: http://www.theledger.com/news/20130212/tampa-doctor-getting-4-million-for-exposing-medicare-fraud

I would think this case would end up in a similar fashion given how prolific and egregious this guy was

 

[scarbrtj]

I'm pretty sure that doesn't apply to criminal judgments like fraud.

The derm settled, so no judgment per se (also no admission of wrongdoing in settlements by plaintiffs, but also no admission claims were not well-founded by the US, etc etc). Plus, fraud itself can be civil or criminal. And almost all these medical whistle blower cases allowed to settle are only civil. If it were criminal fraud, yes, they can get your house.

 

[MOHS_01]

Holy ****, people suck. Honest guys don't always stay busy, shady f's buy beach homes. This blows.

 

[Neuronix]

I'm pretty busy. Living in a condo though. Not so bad I guess.

 

[medgator]

The dermatologist at the heart of this is planning to sue the whistleblower and several news outlets for defamation and libel

http://www.palmbeachpost.com/news/c...ans-sue-whistleblower/MQsHZM4BBlAVnMqZbXvxXL/

 

[Palex80]

Holy ****, people suck. Honest guys don't always stay busy, shady f's buy beach homes. This blows.

Well, his house is not extraordinary, but the property certainly is...
Google it, lol

 

[medgator]

He forged medical physics signatures on patient charts....sounds like possible criminal charges and jail time

Feds charge Palm Beach dermatologist Marder with health care fraud

In court papers filed Sept. 29, Assistant U.S. Attorney Ellen Cohen accuses Marder of bilking Medicare and TriCare, a federal insurer that serves the military and their families, out of $369,000 from January 2011 through January 2016. Although Marder told the insurers he paid a medical physicist, which is a radiation specialist, to determine how much radiation patients should receive when they were treated for skin cancer, he did not have a medical physicist at Allergy and the medical files were fraudulent, she claims.

“Gary L. Marder directed his employees to respond to all requests for medical records from the insurance companies by creating false and fraudulent patient files, referred to by the Allergy staff as ‘make it ready files,’” Cohen wrote in a six-page charging document.

Further, she claims that to persuade the insurers to reimburse him, these patient files included the forged signature of a physicist, identified only as F.S.K, to make it appear the physicist had reviewed and signed patient files. “In fact,” she wrote, “F.S.K. had not.”

In addition, she claims, from July 28, 2015 to Aug. 12, 2015, Marder obstructed an FBI investigation by “falsifying and altering” patient files that had been subpoenaed by a federal grand jury.

Allegations that Marder falsely claimed he used a medical physicist were raised in the civil lawsuit federal attorneys filed against him that was settled this year. As part of that lawsuit, radiation physicist Farhad Kader submitted an affidavit, saying that from August 2010 to March 2016 he had never reviewed Marder’s patient files.

 

[medgator]

Port St. Lucie dermatologist pleads guilty to obstruction of justice and healthcare fraud

Dr. Gary Marder pleaded guilty to felony charges of obstruction of justice and healthcare fraud.

He could face up to 15 years in prison and a $500,000 fine.

Marder admitted he billed insurance companies for the work of a radiation specialist who never actually worked on those cases.

He also admitted that he ordered his staff to falsify about two dozen patient files after the government issued a subpoena for them.

As part of his plea agreement, he has to give up his medical license.

The whistleblower case ended with Marder paying $5.2 million to the federal government for allegedly overbilling Medicare.

But the federal government also had been building a criminal case against Marder.

Marder, who lives in a $27 million mansion, will remain free on a $1 million bond until sentencing in February.

 

[medgator]

The derm settled, so no judgment per se (also no admission of wrongdoing in settlements by plaintiffs, but also no admission claims were not well-founded by the US, etc etc). Plus, fraud itself can be civil or criminal. And almost all these medical whistle blower cases allowed to settle are only civil. If it were criminal fraud, yes, they can get your house.

Sounds like criminal fraud now