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Case dismissed: Modesto-area doctor repays $173,700 to insurers in billing fraud case

The Modesto Bee logoThe Modesto Bee 10/4/2021 Ken Carlson, The Modesto Bee

Oct. 4—Federal charges against a Turlock physician have been dismissed after the doctor complied with a deferred prosecution agreement in the health care billing fraud case.

Dr. Basil Hantash was charged in May 2017 with eight counts of health care billing fraud. The dermatologist is president and medical director of Advanced Skin Institute on Geer Road in Turlock.

The Department of Justice prosecuted the case in the U.S. District Court in Fresno.

Judge Dale Drozd approved a deferred prosecution agreement in September 2019 obligating Hantash to stop seeking reimbursements from insurance companies for procedures using a dermalinfusion device, unless the practice received prior approval from insurance providers.

Hantash agreed to return insurance company payments received for those procedures between January 2011 and April 2016. According to terms of the agreement, Advanced Skin Institute reimbursed $92,234 to Anthem Blue Cross and $81,515 to Blue Shield of California.

The federal case was dismissed Sept. 27.

Hantash expressed the opinion last week the criminal indictment was not justified. "This was a civil dispute and contractually should have gone to arbitration," the physician said by email.

The indictment alleged that ASI submitted claims to insurance companies seeking payments for acne surgeries when staff had performed only cosmetic procedures known as chemical peels.

The case also involved billings for using a suction instrument to treat damaged skin for patients with acne. Insurance companies may refuse to reimburse dermatology practices for cosmetic treatments. Dermatologists are reimbursed for medically necessary acne surgeries using a surgical blade.

Federal authorities seized $687,583 in funds from an Advanced Skin Institute account in 2017. The court agreement called for returning $513,804 to Hantash's practice after reimbursements of $173,749 to the insurance companies.

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