Alabama orthopedic practice pays $1.2M to settle billing, self-referral allegations: 5 details

Laura Dyrda -   Print  | Email

Baldwin Bone & Joint in Daphne, Ala., settled a whistleblower lawsuit alleging it violated the False Claims Act and Stark Law.


Five things to know:

1. The whistleblower alleged Baldwin Bone & Joint billed Medicare and Tricare for physical therapy services performed by unauthorized athletic trainers and an exercise physiologist, who are not permitted to bill those federal programs.

2. The practice also faced Stark Law violation allegations because of its direct compensation arrangements with physician owners. The lawsuit alleged the practice paid shareholder physicians directly or indirectly related to the volume of referrals for ancillary services, according to the DOJ.

3. Baldwin Bone & Joint settled the False Claims Act and Stark Law allegations for $1.2 million and the lawsuit was dismissed. The whistleblower, a former employee, received $200,000.

4. The settlement resolves all claims.

5. The practice opened a new location on Aug. 15 in Foley, Ala. It was the practice's fourth location and located near South Baldwin Regional Medical Center, which includes five orthopedic specialists on staff.

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