Pathologist Dr. Alan Freedman was awarded $4.046 million on Monday, February 11, 2013 for being the relator in a qui tam (whistleblower) lawsuit he filed against dermatologist Dr. Steven Wasserman and his (Dr. Freedman’s) former pathology laboratory. Dr. Wasserman agreed to pay $26.1 million to settle allegations by the federal government that he violated the False Claims act by accepting illegal kickbacks from the pathology laboratory and for billing Medicare for thousands of unnecessary skin surgeries.
The laboratory for which Dr. Freedman used to work is Tampa Pathology Laboratory (TPL). The government alleged that, beginning around 1997, Dr. Waserman entered into a business arrangement with TPL and its owner, Dr. Jose SuarezHoyos, in which Dr. Wasserman sent biopsies from Medicare patients to TPL, which would then process the biopsy, prepare slides, render a written diagnosis and provide a report to Dr. Wasserman.
You might be wondering what’s wrong with that. Nothing except TPL is alleged to have not actually signed out the cases in question. Instead, TPL provided Dr. Wasserman with unsigned reports with a place for Dr. Wasserman to sign as if he interpreted the biopsies. Dr. Wasserman would then bill Medicare for the work, for which he received over $6 million in reimbursement.
Additionally, the government says as part of the agreement with TPL, Dr. Wasserman markedly increased the number of biopsy procedures he performed, thereby increasing the amount of business that would flow to TPL.
Furthermore, Dr. Wasserman allegedly performed thousands of medically unnecessary procedures called adjacent tissue transfers, which I believe is synonymous with advancement flaps.
TPL and Dr. SuarezHoyos settled with the government separately for $950,000.
Unfortunately, I imagine the kind of arrangement profiled here is not the least bit uncommon.
What makes this case even more interesting is the remarkable similarity to the pending whistleblower suit against Bostwick Laboratories (BL) where, among other things, BL is alleged to have provided urologists with draft reports of urine FISH studies that the urologist then signed and billed Medicare as if he/she actually interpreted the FISH test.
I do not know if Drs. Wasserman and SuarezHoyos have been kicked out of Medicare as a result of their settlements.
As of today, Dr. SuarezHoyos’ Florida medical license is clear/active with no discipline or public complaint on file.
The same goes for Dr. Wasserman’s medical license.
I have a very hard time believing the Florida medical board will be able to ignore this massive settlement, and I hope the medical licenses of Drs. Wasserman and SuarezHoyos see some action.
The DOJ’s press release on the case is here.
Update: Dr. Wasserman was kicked out of Medicare, Medicaid and all other federal health programs.