Doctor accused of falsely diagnosing cancersBy MIKE SAEWITZ
SARASOTA -- A Sarasota dermatologist who was indicted last month on charges of falsely diagnosing patients sometimes diagnosed skin cancer even before looking at biopsy slides, his employees told federal investigators.
Every biopsy Dr. Michael A. Rosin took was diagnosed as cancerous, they said. He even once performed skin cancer surgery after reviewing a slide that contained a piece of chewing gum, placed there by a laboratory technician who had lost the skin specimen, according to court records obtained Thursday.
He performed more than 120 surgeries on one patient over 20 years.
Rosin, 54, told his employees he had a daily surgery quota. He told his office manager he had seven children and needed to make $10,000 a day, investigative reports show.
Investigators believe he made more than $3 million in three years by falsely billing Medicare. They said he may have made much more because the scheme dates back to at least the early 1990s.
Court documents detail what FBI agents say was a long-standing scam in which Rosin falsely diagnosed cancer in dozens of elderly patients at his Hillview Street office, then performed surgery to collect Medicare reimbursements.
Rosin "falsely diagnosed the great majority of his patients" with the type of skin cancer that would "yield the maximum cost-effective Medicare reimbursement," a lawyer for Rosin's former office manager wrote in one of the documents.
Rosin was indicted last month on 25 counts of health-care fraud, as well as 25 counts of making false statements in health-care matters. He faces up to five years in prison on each false statement charge, and up to 10 years in prison on each charge of health-care fraud.
He was released on $100,000 bail after turning himself in to authorities last month, and has forfeited his $1.4 million Bay Shore Road home to the federal government. His office is still open, according to an answering machine message.
Rosin's Fort Lauderdale attorney, Theresa Van Vliet, said her client has pleaded not guilty to all of the charges.
"This case is going to be vigorously fought in court in Tampa," said Van Vliet, who specializes in white-collar criminal defense law. "These documents present one side of the story. In this case, there is most assuredly another side of that story. Dr. Rosin looks forward to his day in court."
The FBI began investigating Rosin after his office manager and billing clerk talked to special agents on April 12, 2004.
Rosin was arrested a few days later at Tampa International Airport after trying to board an airplane with a loaded gun, authorities say. He said he had the gun because he often carries large sums of money.
A few days later agents raided his office, collecting boxes of patient files.
His office manager, Carolyn Ferrara, said at the time that she was "shocked" and had never noticed anything unusual in the office. Investigative reports now show that Ferrara had been talking to FBI agents before the raid.
Over the next few months, special agents interviewed laboratory technicians who had worked for Rosin.
One technician told an agent she questioned why all of the biopsies were diagnosed as cancerous.
Rosin said the results were "always positive for cancer because he only biopsied an area if he believed it was cancer," the FBI agent wrote in a seizure warrant affidavit.
Rosin also said the rate was high because his patients had previously had skin cancer and it was "not uncommon for the skin cancer to recur," the agent wrote.
But the employees were still suspicious. They told investigators about losing skin samples and replacing them with chewing gum, a piece of plastic foam, and even a raised skin bump off the leg of Rosin's office manager. The diagnoses still came back as cancer, the employees reported.
Agents who seized log books from Rosin's office last year said a majority of his recorded diagnoses came back positive for basal cell carcinoma, the most common form of skin cancer, which is often caused by chronic exposure to sunlight.
Rosin was one of the few dermatologists in the area specializing in Mohs micrographic surgery, a technique to get rid of skin cancer by removing layers of skin. Medicare reimbursed Rosin for each layer he cut, and he always cut four layers during a surgery, agents said.
The FBI had several medical experts review Rosin's patient files. One expert, Dr. Pearon Gordon Lang Jr., reported that Rosin found cancer in nearly two dozen slides that were of such poor quality that a diagnosis could not have been made.
Lang, a dermatologist for 30 years and a university professor, said Rosin also found cancer in 19 slides that were of poor quality but showed no signs of cancer.
Nine slides had nothing that could be identified as human tissue, and six files simply had no slides at all.
"Dr. Lang remarked that it would be nearly impossible for any dermatology practice to have such a high rate of positive basal cell carcinoma," the FBI agent wrote. "He felt that there should be a much wider range of diagnoses, including negative diagnoses."
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