Podiatrist pleads guilty to billing Medicare $1.5 million for clipping toenails
In case you were wondering, clipping toenails cannot be reimbursed under Medicare. But a 55-year-old Ocala podiatrist had been doing it for so long, he racked up more than $1.5 million in claims.
On Monday, Michael Rotstein pleaded guilty to one count of health care fraud and could face a maximum of 10 years in prison, according to the Middle District of Florida Acting U.S. Attorney W. Stephen Muldrow. Rotstein also must pay back $1,504,952.67.
In the plea agreement, Rotstein said he billed Medicare and TRICARE for “removal of skin and muscle greater than 20 square centimeters” and “drainage of fluid-filled sac” and ended up being one of the highest billers in the country for it. But he was actually just trimming his patients’ toenails.
“Clipping of toe nails is not a reimbursable service under Medicare or TRICARE,” the plea agreement read.
He submitted claims to Medicare and TRICARE under false diagnosis codes, and altered his patients’ files to say that he performed the billable services.
The case was investigated by the Officer of the Inspector General in the Department of Health and Human Services. Assistant U.S. Attorney Jason Mehta prosecuted.
Hannah Morse: 941-745-7055, @mannahhorse
This story was originally published July 12, 2017 at 9:28 AM with the headline "Podiatrist pleads guilty to billing Medicare $1.5 million for clipping toenails."