Dermatologist John Y. Chung, M.D., and his practice, Skin Cancer & Cosmetic Dermatology Center, P.C. (“SCCDC”), which operates 13 dermatology clinics in southeast Tennessee and north Georgia (including one on Medical Drive off Old Highway 20 in Cartersville), have agreed to pay $6.6 million to resolve allegations that they violated the False Claims Act by knowingly submitting false claims to federal healthcare programs for Mohs Micrographic Surgeries and other dermatological procedures.
This settlement resolves allegations that Dr. Chung and SCCDC knowingly submitted false claims for payment to Medicare, Medicaid, and other government payors for Mohs procedures billed as if both the surgery and pathology portions of the processes were performed by Dr. Chung when, in fact, different individuals completed at least one part. The settlement further resolves allegations that SCCDC regularly billed Medicare for multiple procedures performed on the same patient on the same day in a manner that improperly circumvented Medicare’s “multiple procedure reduction rule.” The alleged misconduct occurred from 2010 through 2020.
As part of the settlement, Chung and SCCDC entered an Integrity Agreement (I.A.) with the U.S. Department of Health and Human Services – Office of Inspector General (HHS-OIG), which promotes its future compliance with the statutes, regulations, program requirements, and written directives of Medicare and all other federal health care programs. The IA focuses on the practice’s obligation to bill and properly submit reimbursement claims to government payors accurately.
This investigation resulted from a coordinated effort between HHS-OIG (Nashville Field Office), the Federal Bureau of Investigation (Knoxville), the Tennessee Bureau of Investigation, Defense Criminal Investigative Service, Tennessee Valley Authority – OIG, U.S. Department of Veterans Affairs – OIG, the U.S. Attorney’s Office for the Eastern District of Tennessee, the Tennessee Attorney General’s Office, and the Georgia Attorney General’s Office. The investigation came from a lawsuit filed under the qui tam, or whistleblower, provisions of the False Claims Act, which permits private parties to sue on behalf of the government for false claims and to receive a share of any recovery. The qui tam case is captioned United States, State of Tennessee, and State of Georgia ex rel. Chambers v. Skin Cancer and Cosmetic Dermatology Ctr. and Chung, No. 1:20-CV-177 (E.D. Tenn.). The relator’s share of the recovery will be $1.32 million.
Assistant U.S. Attorneys Jeremy Dykes and Alexa Ortiz Hadley represented the United States. Senior Assistant Attorney General Tony Hullender represented the State of Tennessee, and Assistant Attorney General Sara Vann represented the State of Georgia.
The claims settled by this agreement are allegations only, and there has been no determination of liability.