Illinois Doc Charged With Medicare Fraud

Oct. 19--A west suburban dermatologist has been accused of defrauding Medicare and private insurance companies for millions of dollars over several years, according to federal authorities.

Robert Kolbusz of Oak Brook, who runs the Center for Dermatology & Skin Cancer Ltd. in Lombard, was indicted In U.S. District Court on Oct. 3 on four counts of wire fraud and three counts of mail fraud. He is accused of submitting false claims for hundreds of patients, FBI officials said in a release. The indictment was part of a crackdown on dozens of similar fraud cases throughout the country.

"These cases ought to be taken as a warning that dishonest medical providers ought to think twice before cheating Medicare and private insurers," said Gary S. Shapiro, acting United States Attorney for the Northern District of Illinois.

The FBI alleges that Kolbusz, 55, falsely diagnosed patients with sun-induced skin lesions that can become cancerous and subsequently billed Medicare, Blue Cross Blue Shield of Illinois, Aetna and Humana for ineffective treatments.

Between 2003 and 2010, the FBI alleges Kolbusz also falsified patients' records to support medically unnecessary procedures, including the removal of more than 1,000 lesions from patients, officials said. Records from the Illinois Department of Professional Regulation indicate that no disciplinary action has ever been taken against Kolbusz, whose physician license dates back to April 1985. The clinic website states that Kolbusz received his medical degree from Loyola University'sStritch School of Medicine in Maywood in 1983.

Patients were being seen at Kolbusz' office at 2500 S. Highland Ave. on a recent morning. A receptionist said that Kolbusz was present in the office but was unavailable to answer questions because he was treating patients.

FBI Special Agent Joan Hyde said that Kolbusz was not arrested and that the FBI has no authority to affect the status of his license or his dermatology practice.

IDPR spokeswoman Susan Hofer said she could not comment on Kolbusz' case. Typically, she said, it's unlikely the agency would take action until there was a conviction or unless officials had their own information that a physician was violating state-established professional standards.

"Being indicted does not mean that he's done anything wrong," Hofer said.

Officials with the Centers for Medicare & Medicaid Services would not comment on whether Kolbusz could continue billing Medicare while the charges are pending. However, anti-fraud provisions under the Affordable Care Act do empower CMS to halt Medicare payments to providers "during the investigation of a credible allegation of fraud." Previously, the government would continue to pay out then try to recoup funds from fraudulent or erroneous claims.

An arraignment date has not been set.

Kolbusz was one of 91 doctors, nurses and other medical professionals in seven cities charged this week with Medicare fraud schemes amounting to nearly $430 million in false billing, according to the FBI. The cases were investigated by federal, state and local authorities with the joint Department of Justice and HHS Medicare Fraud Strike Force.

Attorney General Eric Holder said the charges "reveal an alarming and unacceptable trend of individuals attempting to exploit federal health care programs to steal billions in taxpayer dollars for personal gain. Such activities not only siphon precious taxpayer resources, drive up health care costs, and jeopardize the strength of the Medicare program -- they also disproportionately victimize the most vulnerable members of society, including elderly, disabled, and impoverished Americans."

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