PENSACOLA, Fla. — Two Florida dermatology providers have agreed to pay nearly $850,000 to resolve allegations they caused the submission of falsely coded Medicare claims for wound repair procedures, said the U.S. Department of Justice (DOJ).
Forefront Dermatology S.C., doing business as Henghold Dermatology, and Henghold Surgery Center LLC will pay $847,394 under the civil settlement. Henghold Surgery Center, which closed in 2023, is wholly owned by William B. Henghold, M.D. Both the practice and the surgery center performed wound repair procedures following Mohs micrographic surgery, a method of skin cancer removal.
Henghold Dermatology operates locations in Pensacola and Gulf Breeze, according to its website.
According to the DOJ, Henghold Dermatology and Henghold Surgery Center caused the submission of false claims to Medicare by using inaccurate billing codes that resulted in higher payments than what would have been paid for the procedures actually performed, a practice known as “upcoding.”
Officials said the providers falsely coded linear repairs as flap repairs and coded smaller flap repairs as larger flap repairs.
“Improperly billing Medicare depletes valuable government resources that provide necessary medical care to millions of Americans,” said Assistant Attorney General Brett A. Shumate of the Justice Department’s Civil Division.
“We will hold accountable health care providers who enrich themselves by defrauding federal health care programs.”
The settlement also resolves claims brought under the qui tam, or whistleblower, provisions of the False Claims Act by Christopher Wolfe, M.D., a former Forefront employee. Under those provisions, a private party can file an action on behalf of the United States and receive a share of any recovery.
Dr. Wolfe will receive $152,531 in connection with the settlement.
The resolution was the result of a coordinated effort by the Justice Department’s Civil Division, Commercial Litigation Branch, Fraud Section, and the U.S. Attorney’s Office for the Northern District of Florida, with assistance from HHS-OIG.
The matter was investigated by Trial Attorney Colin Shannon and Assistant U.S. Attorneys John Spaccarotella, Mary Ann Couch, and Marie Moyle for the Northern District of Florida.
Officials noted that the claims resolved by the settlement are allegations only, and there has been no determination of liability.
