On February 11, 2013, the U.S. Department of Justice (DOJ) announced the largest settlement ever reached with an individual under the False Claims Act (FCA) in the United States District Court for the Middle District of Florida. The settlement is also one of the largest with an individual under the FCA in U.S. history. According the Notice of Settlement filed with Judge Susan C. Bucklew of the Middle District, Dr. Steven J. Wasserman, M.D., a dermatologist practicing in Venice, Florida, agreed to pay $26.1 million to resolve the case, with the entire settlement amount due within 180 days. The settlement agreement contains no admission of liability by Dr. Wasserman. However, Dr. Wasserman will be excluded from all federal healthcare programs, including Medicare and Medicaid. The government alleged that beginning in 1997, Dr. Wasserman was engaged in an illegal kickback arrangement with Tampa Pathology Laboratory, a clinical lab in Tampa to which Dr. Wasserman sent biopsy specimens from his practice, and the lab’s owner, Dr. Jose Suarez-Hoyos. According to the government, when the lab furnished Dr. Wasserman with pathology reports for specimens he submitted for evaluation, the reports included a signature line for Dr. Wasserman to sign so that it would appear that Dr. Wasserman had performed the diagnostic work reflected in the reports. Dr. Wasserman then allegedly billed Medicare, passing off the lab’s work for his own. The government also alleged that Dr. Wasserman substantially increased the number of skin biopsies he performed on Medicare patients, many of which were medically unnecessary, thereby increasing the number of referrals he made to the pathology lab. In addition to the alleged kickback scheme described above, the government alleged that Dr. Wasserman performed “thousands” of unnecessary skin surgeries called adjacent tissue transfers on Medicare beneficiaries. Adjacent tissue transfers are procedures physicians use to close a defect resulting from the removal of a growth on a patient’s skin. The government alleged that many of these procedures that Dr. Wasserman performed were medically unnecessary and were performed solely to obtain reimbursement from Medicare. According to the government’s amended complaint, on at least a dozen days Dr. Wasserman billed Medicare for more than 24 hours of surgical time each day, in addition to billing for between 20 and 50 office visits. This case was initiated based on information from a whistleblower, Dr. Alan Freedman, who worked at the pathology lab from 2000-2003. Dr. Freedman will receive approximately $4 million out of the settlement funds for first alerting the government as to this case. The government previously settled with the pathology lab and Dr. Suarez-Hoyos for $950,000.
