Forefront Dermatology and a now-closed ambulatory surgery center (ASC) have agreed to pay nearly $850,000 to resolve allegations they improperly billed Medicare for wound repair procedures, according to the U.S. Department of Justice (DOJ).
The $847,394 settlement addresses claims that Forefront Dermatology S.C. and Henghold Surgery Center LLC violated the False Claims Act (FCA) by upcoding wound repair services tied to Mohs micrographic surgeries – an advanced technique used to treat skin cancer.
The government alleged that the Florida-based providers submitted falsely coded claims that exaggerated the complexity of wound repairs. Specifically, linear repairs were billed as flap repairs, and small flap repairs were billed as large flap repairs, inflating Medicare reimbursements.
Forefront operates the dermatology practice doing business as Henghold Dermatology. Henghold Surgery Center, which closed in 2023, was wholly owned by Dr. William B. Henghold, according to the DOJ.
“Improperly billing Medicare depletes valuable government resources that provide necessary medical care to millions of Americans,” Assistant Attorney General Brett A. Shumate of the Justice Department’s Civil Division said in a statement. “We will hold accountable health care providers who enrich themselves by defrauding federal health care programs.”
The settlement resolves claims brought by whistleblower Dr. Christopher Wolfe, a former Forefront employee, under the qui tam provisions of FCA.
Wolfe will receive $152,531 from the settlement.
The case – United States ex rel. Wolfe v. Henghold et al., No. 3:23-cv-21624 – was filed in the U.S. District Court for the Northern District of Florida. It was investigated by the DOJ’s Civil Division, the U.S. Attorney’s Office for the Northern District of Florida, and the U.S. Department of Health and Human Services Office of Inspector General (HHS-OIG).
“Schemes that cause Medicare to pay for costlier services than were actually performed waste taxpayer funding, threatening the integrity of this federal health care program,” HHS-OIG Deputy Inspector General for Investigations Christian J. Schrank said in a statement. “Working together with our law enforcement partners, HHS-OIG will continue to investigate allegations of improper billing schemes to protect taxpayer-funded health care programs and the people served by them.”
The DOJ emphasized that the claims resolved are allegations only and that there has been no determination of liability.
