DOJ recovers $2.2B under False Claims Act — 2 orthopedic cases at center of FY 2020

Orthopedic
Alan Condon -

The Department of Justice collected more than $2.2 billion from civil cases involving fraud and false claims against government programs in the fiscal year ending Sept. 30, 2020.

More than $1.8 billion of the $2.2 billion related to healthcare fraud, including medical device manufacturers, managed care providers, hospitals and physicians, according to a Jan. 15 news release.

Two significant recoveries from last year were cases against a Massachusetts-based spine device company and an orthopedic surgical hospital in Oklahoma.

In July, Oklahoma Center for Orthopaedic and Multi-Specialty Surgery in Oklahoma City, agreed to resolve allegations that it made improper payments in exchange for patient referrals over a 12-year period.

The specialty hospital, along with its part-owner and management company, Oklahoma City-based Southwest Orthopaedic Specialists, and two SOS physicians, reached a $77.2 million settlement to settle whistleblower claims that their relationships were improper.

The DOJ filed a complaint against device company SpineFrontier and its CEO in March, alleging that kickbacks were paid to spine surgeons in the form of sham consulting fees to prompt use of its surgical devices. 

Six surgeons agreed to pay over $3.25 million to settle allegations that they received illegal kickbacks from SpineFrontier and a third-party entity that was owned by the company's CEO.

Recoveries since 1986, when Congress strengthened the civil False Claims Act, total more than $64 billion, according to the news release.

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