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United States files complaint alleging Iowa surgeon caused submission of false claims to Medicare

The complaint alleges that from approximately August 2014 to August 2019, a plastic surgeon practicing in Iowa during that time submitted or caused to be submitted false claims for healthcare services to government payors, including Medicare.

CEDAR RAPIDS – Adam B. Smith, M.D., also known as “Adam Bryant,” has been sued by the United States for two counts of violating the False Claims Act, 31 U.S.C. §3729 et seq. The claims are contained in a Civil Complaint filed by both the United States and the State of Iowa on May 9, 2023, in the United States District Court for the Northern District of Iowa.

The complaint alleges that from approximately August 2014 to August 2019, Smith, a plastic surgeon practicing in Sioux City during that time, submitted or caused to be submitted false claims for healthcare services to government payors, including Medicare. The complaint alleges Smith did so by: (1) billing government payors for services he claimed were medically necessary surgical procedures, but that were in actuality medically unnecessary cosmetic surgeries, which are not payable by government payors; (2) billing for services in excess of those actually rendered (“upcoding”) to increase reimbursement, or even billing for surgical procedures he didn’t perform at all; and (3) overstating the complexity of office visits with patients in order to obtain greater reimbursement from government payors.

Under the federal False Claims Act, the United States is entitled to a judgment equal to three times the cost to the United States for any false claims. In addition, the United States is entitled to per-claim penalties, currently set by law at between $13,508 and $27,018. The United States alleged Smith caused the submission of over one thousand false claims.

The United States previously entered into a settlement agreement for $612,501.44 with Smith’s employer during his time practicing in Sioux City, Tri-State Specialists, LLP, in December 2021.

As with any civil case, a complaint is merely an allegation and a defendant is presumed not liable until shown otherwise by a preponderance of the evidence.

This civil matter arose from an action brought under the whistleblower provisions of the False Claims Act. Pursuant to that Act, the whistleblower will share in any recovery obtained by the United States.

The case is being handled by Assistant United States Attorneys Melissa A. Carrington and Matthew K. Gillespie and was investigated by the United States Department of Health and Human Services, Office of Inspector General, and Department of Defense, Defense Criminal Investigative Service.

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