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Cosmetic surgeon accused of health care fraud in Michigan

On Behalf of | Nov 4, 2019 | Federal Crimes |

A cosmetic surgeon is facing allegations of wrongdoing on a number of fronts, including in U.S. District Court in Michigan’s Western District. A grand jury indictment charges Dr. Adam Smith with six counts of health care fraud and nine counts of making false statements relating to health care matters.

Smith practiced in Traverse City until 2014, when he moved to Sioux City, Iowa. He currently faces incompetence charges before that state’s medical board.

According to the indictment, while in Michigan from 2011 to 2014, Smith billed plastic surgery procedures not covered by Medicare or Medicaid as medically necessary, covered non-cosmetic surgical procedures. In court documents, he’s accused of falsifying patient records to make it appear that the cosmetic surgeries were medically necessary, mislabeling some of the procedures as wound repairs.

Late last year, federal attorneys in Michigan filed a civil complaint that accused him of filing 89 fraudulent Medicaid and Medicare claims for more than $64,000. He faces up to five years behind bars on the charges that he made false statements to investigators about a health care benefit program.

According to a news report, his Traverse City patient charts were reviewed at a hospital where he had staff privileges. Reviewers raised concerns that the surgeon engaged in fraud, citing problematic documentation and billing coding.

Two former Michigan patients filed medical malpractice suits in 2015. Smith agreed to confidential settlements of the claims out of court.

A federal court can impose harsh penalties on those convicted of health care fraud, including up to 10 years in federal prison and a fine of up to $250,000.