Apr 09 2018

Uncompensated Medical Directorship Leads to $3.2 Million False Claims Act Settlement

You may have seen their websites: Anesthesia “practice management companies” that advertise “no stipends!” to obtain facility contracts.

Or, you may have seen the RPFs, usually drafted by “consultants” or “management companies”  (and others specializing in perhaps unknowingly committing federal crimes) who promise the surgeon-owners of ASCs that they’ll get anesthesia groups to provide a plethora of coverage and directorship services for free.

Oops. Nothing just became $3.2 million. Plus legal fees. Plus the continued risk of being criminally prosecuted.

Yes, the type of stupid compliance mistake underlying these idiots’ thinking just led to a $3.2 million civil settlement of a False Claims Act (i.e., whistleblower) suit brought against (among others) an orthopedic surgery practice, Georgia Bone & Joint (“GBJ”) and its related surgery center, Southern Bone & Joint a/k/a Summit Orthopaedic Surgery Center (“Summit Surgery Center”), as well as against CRNA David LaGuardia (“LaGuardia”) and anesthesia entities Southern Crescent Anesthesiology, PC (“SCA”) and Sentry Anesthesia Management, LLC (“Sentry”).

The suit was initially brought by Sharon Kopko, the former practice/facility administrator for both GBJ and Summit Surgery Center.  Upon investigation by the U.S. Department of Health & Human Services Office of Inspector General, the FBI, and the U.S. Postal Service Office of Inspector General, the federal government took up the prosecution of the case.

From the settlement announcement of the U.S. Attorney for the Northern District of Georgia, the allegations against the defendants apparently grew from those originally contained in Ms. Kopko’s complaint to include  that LaGuardia, Sentry, and SCA provided a free medical director to Summit Surgery Center  in order to induce it to choose to perform more procedures at the surgery center rather than in the GBJ office.

In the words of the U.S. Attorney, “Kickbacks should never play a role in medical decision-making. It is critical to our health care system that patients seeking health care know that their providers’ recommendations are based on what is in the patient’s best interests and not influenced by illegal kickbacks or arrangements.”

Stay tuned. It’s yet to be seen who’ll now be criminally prosecuted.

Comment or contact me if you’d like to discuss this post.

Mark F. Weiss

www.advisorylawgroup.com

 

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