Iowa physician accused of filing 89 fraudulent Medicare, Medicaid claims

A plastic surgeon who practiced in Michigan and now works in Iowa is being accused of criminal healthcare fraud and filing false claims, according to the Sioux City Journal.

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Adam Smith, MD, faces the charges in the U.S. District Court for the Western District of Michigan. He is charged with six counts of healthcare fraud and nine counts of making false statements related to healthcare issues, the newspaper reported.

Dr. Smith previously operated Borealis Plastic Surgery in Traverse City, Mich. A grand jury indictment filed Oct. 22 alleges that from 2011 to 2014, while he practiced in Traverse City, Dr. Smith billed cosmetic surgical procedures not covered by Medicare or Medicaid as other medically necessary non-cosmetic surgical procedures, according to the Journal. The newspaper reported Dr. Smith also allegedly falsified patient medical records to make surgeries appear medically necessary.

Dr. Smith now is affiliated with Tri-State Specialists, a multispecialty medical practice on the UnityPoint Health-St. Luke’s campus in Sioux City, Iowa. In addition to the criminal charges, Dr. Smith faces professional incompetency charges before the Iowa Board of Medicine as well as a civil complaint against him in Michigan, alleging he filed 89 fraudulent Medicare and Medicaid claims totaling more than $64,000 while he practiced in the state, according to the Journal.

The newspaper reported there are no scheduled court appearances on the criminal charges, and the civil case was stayed until criminal charges are resolved.

UnityPoint Health declined to comment. 

 

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