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A plastic surgeon in Beverly Hills, along with his son, medical practices and billing company, have agreed to pay $23.9 million to resolve allegations that they violated the False Claims Act by submitting or causing the submission of false claims to both Medicare and Medicaid.

The settlement resolves allegations that Dr. Joel Aronowitz; Daniel Aronowitz; Joel A. Aronowitz, M.D., a medical corporation; Tower Multi-Specialty Medical Group; Tower Wound Care Center of Santa Monica, Inc.; Tower Outpatient Surgery Center, Inc.; and Tower Medical Billing Solutions falsified the place of service for skin grafts and billed multiple times for single-use skin substitute products.

The United States contends that the settling parties manipulated the place of service code on claims for skin grafts to fraudulently maximize reimbursement from Medicare and Medicaid. The United States further contends that Dr. Aronowitz failed to properly dispose of unused portions of single-use skin graft materials and, instead, used them in later procedures involving other Medicare and Medicaid beneficiaries, resulting in thousands of instances of double billing.

In connection with the settlement, the United States Department of Health and Human Services, Office of Inspector General (HHS OIG), negotiated the voluntary exclusion of Dr. Aronowitz and Tower Multi-Specialty Medical Group from Medicare, Medicaid, and all other federal health care programs for a period of 15 years. Daniel Aronowitz will be excluded for three years.

Medicaid is funded jointly by the states and the federal government. The state of California paid for a portion of the Medicaid claims at issue and will receive a total of approximately $497,619 from the settlement.

The civil settlement includes the resolution of claims brought under the qui tam, or whistleblower, provisions of the False Claims Act by parties that worked for Dr. Aronowitz and his associated medical practices and businesses: TDP, a billing company; Dr. Jason Morris, a podiatrist; and Harold Bautista, a billing department employee.

Under the qui tam provisions, a private party can file an action on behalf of the government and receive a portion of any recovery. The civil lawsuits, all of which were filed in federal court in Los Angeles, are captioned: United States ex rel. TDP RCM Servs., LLC v. Aronowitz, et al., United States ex rel. Morris, et al. v. Tower Wound Care Ctr. of Santa Monica, Inc., et al., and United States ex rel. Bautista et al. v. Tower Outpatient Surgery Center, Inc., et al.. The amount to be recovered by the private parties has not been determined.

The resolution obtained in this matter was the result of a coordinated effort between the United States Attorney’s Office in Los Angeles and the United States Justice Department’s Civil Division, Commercial Litigation Branch, Fraud Section. HHS OIG assisted in the investigation.

The matter was handled by Assistant United States Attorney Aaron Ezroj of the Civil Fraud Section and Trial Attorney Lyle Gruby of the Justice Department’s Civil Division. The exclusions of the individuals and entity were negotiated by Senior Counsel Patrice Drew for HHS OIG.

The investigation and resolution of this matter illustrates the government’s emphasis on combating healthcare fraud. One of the most powerful tools in this effort is the False Claims Act. Tips and complaints from all sources about potential fraud, waste, abuse and mismanagement can be reported to the Department of Health and Human Services at 800-HHS-TIPS (800-447-8477).

The claims resolved by the settlement are allegations only and there has been no determination of liability.