Dermatology Associates of Central New York has been ordered to pay approximately $811,200 for submitting Medicaid, Medicare, and TRICARE claims that were ordered by unsupervised non-physician practitioners (NPP).
Husband and wife team Amin Fazeli, MD, and Vajdista Broumand, MD, are the owners of Dermatology Associates of Central New York, a practice based in the small village of Fayetteville, about a 15-minute drive from Syracuse. According to the U.S. Attorney General’s office, Dr. Fazeli and Dr. Broumand worked at their practice on a “limited basis” but “employed several NPPs such as physician assistants and nurse practitioners.” Between 2009 and 2015, Dermatology Associates submitted thousands of claims to Medicare, Medicaid, and Tricare for procedures and consultations conducted by NPPs that incorrectly included one of the owners as the supervising physician even though they were not in the office at the time when the claim was written.
Medicaid will only recognize and pay for claims that have been issued by nurse practitioners that are enrolled Medicaid providers. According to Dermatology Associates, their hired billing company was responsible for submitting the ineligible claims. Some of their nurse practitioners at the practice didn’t have the necessary state-issued credentials.
Former employer and nurse practitioner Elaine Cretaro-Williams was the whistleblower in this lawsuit and will receive $138,000 of the settlement. “The irresponsible behavior by Dermatology Associates compromised the integrity of the Medicare, Medicaid, and TRICARE programs, and wasted taxpayer dollars,” said Scott J. Lampert, Special Agent in Charge at the U.S. Department of Health and Human Services, Office of Inspector General’s New York Region (HHS-OIG). “Along with our law enforcement partners, HHS-OIG will continue to ensure that providers that do business with federally funded health care programs do so in an honest fashion.”