8 DOJ investigations into illegal kickbacks in orthopedics in 2019


Here are eight Department of Justice investigations into fraud in orthopedics this year:

1. Daniel Capen, MD, was sentenced to 30 months in prison after pleading guilty to conspiracy and receiving kickbacks at the now defunct Pacific Hospital of Long Beach, Calif.

2. Life Spine and two executives agreed to pay about $5.99 million to resolve the federal government's allegations that they violated the False Claims Act. The lawsuit was brought by a private whistleblower before the government intervened.

3. The DOJ is arguing that former Sioux Falls, S.D.-based Sanford Health neurosurgeon Wilson Asfora, MD, profited from performing "aggressive, unnecessary surgeries" and implanting devices from a company he had ownership in. Sanford terminated Dr. Asfora’s employment in September and agreed to settle the whistleblower lawsuit for more than $20 million.

4. Prosecutors are arguing that Michael Rimlawi, MD, should not be granted a new trial after he was convicted for his role in a $40 million kickback scheme at the now-defunct Forest Park Medical Center in Dallas.

5. The DOJ charged three Oklahoma-based physicians, including an orthopedic surgeon, with violating the anti-kickback statute for their role in a scheme dating back to November 2012. The physicians are accused of accepting bribes to prescribe compounding drugs from OK Compounding in Skiatook, Okla., One Stop Rx in Tulsa and NBJ Pharmacy and Airport McKay Pharmacy in Houston.

6. Orlando, Fla.-based Conway Lakes Health & Rehabilitation Center and orthopedic surgeon Kenneth Krumins, MD, agreed to pay $1.5 million to settle anti-kickback violation allegations.

7. The DOJ charged 24 individuals — including three licensed medical professionals — in connection with an alleged kickback scheme involving durable medical equipment braces. The individuals were accused of advertising telemedicine services to Medicare beneficiaries that would allow them to obtain DME braces; the call centers involved allegedly paid kickbacks to the telemedicine companies, which paid kickbacks to physicians to write the prescriptions. The scheme created more than $1.2 billion in losses for Medicare.

8. Brandon Claflin, DO, paid $84,666 to settle allegations he accepted illegal kickbacks from OK Compounding in exchange for writing prescriptions.

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