A Florida dermatologist has agreed to pay $18 million to settle numerous false claims for Medicare he allegedly billed the government. According to the whistleblower lawsuit, he had allegedly billed Medicare for radiation therapy services that were not needed.

Prosecutors called this alleged scheme impressive in both “scope and magnitude.”

According to a consent judgment in Florida federal court, the man and his clinic had until Feb. 24, 2017 to pay the $18 million to resolve the false claims for Medicare. The defendant Gary L. Marder and his clinic, Allergy, Dermatology & Skin Cancer Center Inc., have to pay over $41 million if they fail to pay the $18 million by the deadline.

In addition, codefendant Dr. Robert I. Kendall will have to pay the government $250,000 to resolve his portion of the alleged false claims for Medicare.

Overview of Whistleblower Medicare Settlement

This whistleblower lawsuit was filed by Florida resident Dr. Theodore Schiff in 2013, and was joined by the U.S. Department of Justice (DOJ) in 2014.

Schiff alleges that Marder and other defendants had wrongfully billed Medicare for biopsies and radiation therapy that were not needed, were performed too close together, or were performed without proper supervision, like by an unlicensed professional.

The DOJ took particular notice in these claims due to the severity of the alleged false claims for Medicare; the “outright fraud of the scope and magnitude seen in this case is rarely seen, especially when supported by such irrefutable evidence.”

Kendall had landed in hot water for taking part in the alleged false claims for Medicare, by submitting the faulty claims for services that were reportedly “tainted by kickbacks” as indicated by his business relation with Marder.

The government had won summary judgment in September 2016, which included allegations of Marder submitting false claims for services that were either not conducted or were improperly done by an unlicensed professional. In addition, Marder had also falsely billed for medical physicist services beginning in 2011.

While the parties have not yet decided how much of the settlement will go to Schiff, whistleblowers are typically rewarded between 15 to 30% of whatever settlement is recovered. Schiff is grateful that his claims were taken seriously, and hopes that “more health care providers will take the time and effort to report fraud and abuse.”

Marder and his codefendants are also reportedly content with this conclusion, with their lawyers stating their clients are happy to put this matter behind them.

The Whistleblower Lawsuit is U.S. et al. ex rel. Schiff v. Marder et al., Case No. 1:13-cv-24503, in the U.S. District Court for the Southern District of Florida.