A false Medicare claims lawsuit has been settled without the accused doctor admitting liability.

Dr. Norman A. Brooks, an Encino, Calif. dermatologist and owner of the Skin Cancer Medical Center, paid nearly $2.7 million to the federal government to settle allegations made by a whistleblower. A former employee had reported that Dr. Brooks submitted bills to Medicare for surgeries that were not needed because he could make substantial profits.

The U.S. Attorney’s Office said the physician paid the settlement on April 10^th, resolving allegations brought forth by former employee Janet Burke.

Burke alleged that the doctor submitted false skin cancer diagnoses in order to perform Mohs surgeries. The intricate procedure is mainly reserved for removing skin cancers of the face. Several stages of surgery allow the doctor to remove one layer of tissue at a time that is examined under a microscope.

Layers of skin are removed until all of the cancer cells are gone.

Mohs surgeries translate to higher Medicare reimbursements than other procedures simply because more time and complex evaluations are required.

False Medicare Claims Lawsuit Rewards Whistleblower

As part of the settlement, whistleblower Burke will receive $482,500. Without her bravely coming forward with the false Medicare claims lawsuit, Dr. Brooks could have continued to allegedly scam the system.

The false Medicare claims lawsuitwas made possible under qui tam (Latin for “in the name of the king”) provisions of the False Claims Act. The law allows private persons to file lawsuits on behalf of the federal government and eventually to obtain a portion of any recovered monies.

Rounding out the settlement, Dr. Brooks agreed to a three-year Integrity Agreement with the U.S. Department of Health and Human Services that will force him to create and maintain a compliance program. He and his employees will undergo required trainings and review their procedures for all claims submitted for Medicare and Medicaid reimbursement.

Details of the false Medicare claims lawsuit settlement came to light after U.S. District Judge Philip S. Gutierrez unsealed and dismissed the complaint.

Who Is a Whistleblower?

A whistleblower is any person who offers information regarding wrongdoing to the authorities. The questionable acts are illegal and can be hidden under layers of minutia.

More than 55 federal laws protect or reward whistleblowers, and 44 states plus Washington D.C. provide varying degrees of legal protection.

The oldest whistleblower law is the False Claims Act that dates back to the Civil war when it was designed to protect whistleblowers from defense contractors’ overpriced goods. This law made the news in the 1980s when defense department purchases of $400 screwdrivers and $600 toilet seats were brought to light by whistleblowers.

This act encompasses any person or entity that defrauds the government. Eighty percent of the cases heard involve health care. Military defense, energy, construction and mortgage fraud are other industries that have a notable number of claims.