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.
It is sad to see the rampant greed in medicine, often at the expense of patients and not just their insurance. Unnecessary surgery, shouldn’t that be assault with a deadly weapon? If you cut someone on the street, wouldn’t you serve jail for that? It’s sad, but fee-for-service is the root of this. If you pay people for every little thing they do, they’ll find ways to “do” more little things. And here we are, reaping the results.
Could not agree more with you.
A little while back I was in the lounge and a few clinical docs were moaning about how reimbursements are declining for their specialties and complaining how they aren’t getting paid enough for the work they do. Listening to the conversation, an uneducated observer might feel sorry for them, but I know that every last one of them is client billing for pathology services. So they complain, yet here they are making tens of thousands of dollars or more for work they aren’t doing.
And to make it worse, one of the guys said, “Yeah, there are cost saving things I can do in GI…” But then he trailed off. So without saying it, he is admitting he is doing things that aren’t necessary just to make money.
And then they wonder why reimbursement is dropping.
Disgusting.
Thanks for the comment.
Any comments from Dr. Wasserman’s parents?
Not yet…
dermatologists should not be allowed to read slides in their office it is a self-referral of laboratory work. it causes overutilization of services and corruption as is proven very beautifully by this case. this is an example of fee splitting as well and why dermatologists should not be allowed to bill for services they did not perform like the TC in this case not just on the governmental insurers but on commercial insurers as it is a “pull-through” for medicare work where they sacrifice the commercial monies in return for the medicare TC. my question is the following why doesnt the government stop that. when are the licenses of the providers that do this kind of stuff going to be revoked. when is the ancillary office exception to the stark law going to be shut so that clinicians will stop self referring labwork including the reading of slides in their office. Mohs is not labwork. Mohs is a bastardizarion of the frozen section procedure. licensed HTs are not required for it therefore it is not labwork. it is very easy to shut the loophole now. isolate Mohs out and stop all clinicians in GU,GI, derm, oncology and even podiatry from having their own in-house anatomic pathology labs. there is a huge flaw in the system here that has been going on for decades. now the lives of the doctors are being destroyed as they round them all up. so A do you still think it should be okay for derms to do pathology slide reading in their offices? derms can do dermatology and derms can do pathology but not both. they have to choose one specialty or the other. they should not be practicing both at the same time on the same patients. I dont give a darn how much training in our area they claim to have. until you understand the corruption with the dermatologists and their strong lobby, you will not understand why the loophole has not been shut. the whole time you have been attacking the urologists and you have not been giving the derms equal time. the government does not know what to do with the derms because they have made such a great case for why pathology is part of their specialty but that is irrelevant. they should not be doing labwork such as anatomic pathology in their offices. Bostwick is going to lose his case. but why pick on one thing? he is fee splitting his tail off most likely with the urologists. write a book A “Labwork culture of corruption.” Please dont give me garbage that this is “capitalism.” or dont tell me “whats wrong with making money.” or what a “great business man” that pathologist is. that lab helped corrupt that dermatologist and the lab fine was way too low. they are just as culpable as the dermatologist. they were doing this from 1997 forward. its incredible. this is more about self referral than it is about fee for service.