Surgeon pleads guilty to $3M insurance fraud — 5 takeaways

Cosmetic surgeon David M. Morrow, MD, pled guilty to charges of defrauding health insurance companies, according to Palm Desert Patch.

Here are five takeaways:

1. Dr. Morrow pled guilty to billing payers for tummy tucks, nose jobs and breast enlargement, claiming the procedures were medically necessary.

2. The U.S. Attorney's Office alleges the surgeon submitted bills for more than $3.4 million. Dr. Morrow admitted to failing to report more than $100,000 of income on a tax return and more than $1.5 million on his 2009 tax return.

3. Several of the victimized payers include Anthem Blue Cross, Blue Cross/Blue Shield of California, Blue Cross/Blue Shield of Massachusetts, Regional Employer/Employee Partnership for Benefits and Cigna.

4. Dr. Morrow and others billed one payer more than $150,000 for a single procedure.

5. Dr. Morrow faces a maximum sentence of 20 years in federal prison for his guilty plea to one count of conspiracy to commit mail fraud and three years for filing the false tax return. On September 23, the United States District Judge Josephine L. Staton is scheduled to sentence Dr. Morrow.

More articles on coding & billing:
4 new strategies that could make Medicare function more like the private sector
Aetna, Virtua introduce ACO in South Jersey — 5 things to know
CMS releases update for ICD-10 transition complications: 5 insights

Copyright © 2024 Becker's Healthcare. All Rights Reserved. Privacy Policy. Cookie Policy. Linking and Reprinting Policy.

 

Featured Webinars

Featured Whitepapers

Featured Podcast