Dermatologist and Practice Settle for $6.6 Million over Alleged False Claims in Procedures Billing

U.S. Attorney Francis M. Hamilton III announced today that dermatologist John Y. Chung, MD, and his practice Skin Cancer Cosmetic Dermatology Center SCCDC, which operates 13 clinics in Southeast Tennessee and North Georgia, have agreed to pay $6.6 million to resolve allegations that they violated the False Clms Act by submitting false clms for payment on behalf of Mohs micrographic surgeries and other dermatological procedures.

The settlement is based on clms that Dr. Chung and SCCCD were knowingly billing Medicare, Medicd, and other government healthcare programs for Mohs procedures in which one or more parts were actually performed by individuals other than himself. The charges alleged that Dr. Chung billed as if both the surgical and pathologic portions of these procedures were carried out by him when he might have been assisted by others.

The settlement also addresses allegations that SCCCD frequently submitted cl Medicare for multiple procedures administered to the same patient on the same day, which improperly avoided the Multiple Procedure Reduction MPR rule. The investigation covered the period from 2010 through 2020.

“Healthcare providers must adhere to strict ethical and legal standards when submitting clms for reimbursement. This agreement is evidence of our commitment to upholding those principles,” stated U.S. Attorney Francis M. Hamilton III. “By entering into this settlement, Dr. Chung and SCCCD have acknowledged their responsibility in ensuring accurate billing practices.”

As part of the agreement, Dr. Chung and SCCCD entered into an Integrity Agreement with the Department of Health and Services - Office of Inspector General HHS-OIG, committing to adhere to all federal healthcare program regulations and directives moving forward.

This investigation was a collaborative effort involving HHS-OIG Nashville Field Office, Federal Bureau of Investigation FBI - Knoxville, Tennessee Bureau of Investigation, Defense Criminal Investigative Service, Tennessee Valley Authority's Office of Inspector General TVA-OIG, the Tennessee Attorney General’s Office, and the Georgia Attorney General’s Office.

The case was prompted by a False Clms Act lawsuit filed under the qui tam provision, which allows private parties to act on behalf of the government in cases involving false clms. The relator in this case, who has agreed to share $1.32 million from the settlement proceeds, is entitled to 25 of the recovery.

Assistant U.S. Attorneys Jeremy Dykes and Alexa Ortiz Hadley represented the United States in negotiating the settlement agreement with Dr. Chung and SCCCD, while Senior Assistant Attorney General Tony Huller was responsible for the Tennessee state government's position. Sara Vann of the Georgia Attorney General’s Office handled matters on behalf of Georgia.

that this is a summary of the case; the full detls have not been reviewed or verified by an attorney.

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