Florida firms accused of upcoding wound repair claims, costing taxpayers.
Forefront Dermatology S.C. and Henghold Surgery Center LLC will pay $847,394 to resolve allegations of defrauding Medicare through false wound repair claims, the Justice Department announced.
The Florida-based dermatology practice and its now-closed ambulatory surgery center, owned by Dr. William B. Henghold, allegedly submitted inflated billing codes for procedures following Mohs surgery, a skin cancer treatment.
By misrepresenting linear repairs as costlier flap repairs, they secured higher Medicare reimbursements, a practice known as upcoding.
The settlement stems from a whistleblower lawsuit filed by former employee Dr. Christopher Wolfe, who will receive $152,531.
The case, investigated by the Justice Department and HHS-OIG, exposes healthcare fraud and ongoing efforts to combat it
“Improper billing depletes resources for millions,” said Assistant Attorney General Brett A. Shumate.
The settlement highlights the False Claims Act’s role in protecting taxpayer-funded programs.
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