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White collar crimes: Dermatologist settles insurance fraud claim

| Nov 19, 2016 | White Collar Crimes |

When people in Michigan or elsewhere are in trouble with the law, they may turn out to be their own worst enemies. It is only natural to try to talk one’s way out of trouble when accused of a crime, but it may be more appropriate to let a legal representative handle the defense. Navigating the defense of white collar crimes, such as insurance fraud, is complicated and may need a professional to determine the most suitable strategy.

A dermatologist in another state has recently agreed to settle a civil lawsuit that arose from a whistle blower’s claim several years ago. The dermatologist allegedly defrauded Tricare and Medicare of millions of dollars by diagnosing any skin condition as cancer and performing biopsies and radiation treatments unnecessarily. Allegations say that these services were often billed to the insurance programs while they were never performed or were done by unqualified assistants.

Court papers indicate that the dermatologist claimed more than $49 million from the two insurance programs between 2008 and 2014. It also states that 8,000 claims totaling $2.7 million was billed to Medicare for procedures done on 265 days on which the doctor was, reportedly, not in the country. These are only some of the allegations against the defendant.

The settlement was reached on the eve of the trial, and the claims remain allegations because liability has not been determined. Michigan residents may be interested to know that a settlement agreement does not constitute the admittance of any wrongdoing. In some white collar crimes, an experienced criminal defense attorney may advise a client to agree to a settlement because that might be the best possible outcome.

Source: mypalmbeachpost.com, “Palm Beach doctor settles massive Medicare fraud lawsuit”, Jane Musgrave, Nov. 15, 2016