• 'The numbers don't lie': Endoscopy to become more prominent among next generation of spine surgeons
  • Minnesota orthopedic group hit with $111M negligence verdict
  • Orthopedic patient's death highlights potential dangers of prior authorization
  • Spine surgeon killed in Oklahoma hospital shooting
  • Neurosurgeon accepted $3.3M in illegal payments to perform spine surgeries at hospital
  • Spine surgeon gets jail time for abusing patient during hospital visit
  • Providence to pay $22.7M to settle unnecessary spine surgery allegations
  • Texas spine surgeon defending himself from 'Dr. Death 2.0' allegations
  • 'They're on really thin ice': Why 1 insurer has drawn spine surgeons' ire
  • Orthopedic surgeon must face suit in patient's death
  • Spine surgeon 1 of 9 physician billionaires on Forbes' 2022 list
  • Connecticut hospital to appeal $12.5M verdict to family of patient who died after orthopedic surgery
  • 4 spine technologies that promised more than they delivered
  • Orthopedic surgeon's health system exit steeped in controversy
  • Terminated orthopedic surgeon contracts with another New York hospital
  • Texas spine surgeon sued by State Farm over 'unnecessary' procedures
  • 22 hospitals ranked top 25 orthopedic hospitals 3+ years in a row
  • Orthopedic surgeon convicted of battery at hospital
  • UArizona neurosurgery chair dies after motorcycle collision
  • America's largest independent practices by number of spine surgeons
  • Could Medtronic's spine business be the next medtech spinoff?
  • 41 'rising stars' in orthopedics
  • Idaho orthopedic surgeon arrested for alleged misconduct at practice
  • Neurosurgeon's startup hits $1.2B valuation
  • Orthopedic surgeon indicted in $10M telemedicine fraud scheme
  • Orthopedic surgeon salaries in the 5 best, worst states for healthcare
  • New Jersey hospital must pay neurosurgeons $24.3M, appeals court rules
  • Good news, bad news for orthopedic surgeons: 6 observations
  • Why private equity is bettering orthopedics, 3 physician leaders say
  • Florida hospital patients say they were injured during surgeries. Now a physician faces 350 lawsuits.
  • Texas spine surgeon's $11M verdict being appealed
  • A Rutgers physician accused of 'ghost surgeries' will return — but with fewer responsibilities
  • Top orthopedic hospital in every state: US News
  • Rothman Orthopaedics to become national brand, but no 'aspirations to go beyond US'
  • Sports medicine physician fired amid misconduct allegations involving patients
  • Orthopedic surgeon asking for misconduct charges to be dropped
  • Unnecessary spine cases spur class action lawsuit
  • Colorado Supreme Court rejects hospital's bid to enforce $229K spine surgery bill
  • Jury finds neurosurgeon largely responsible for paralysis, awards $15.5M in damages
  • Dr. Jon Yoon performs NHL's 4th disc replacement in 7 months
  • 'The numbers don't lie': Endoscopy to become more prominent among next generation of spine surgeons
  • Neurosurgeon accepted $3.3M in illegal payments to perform spine surgeries at hospital
  • Carson Daly has 2nd spine procedure in 3 months
  • Spine surgeon steps down as CEO of biologics company
  • 2 professional athletes undergo spine surgery in a week
  • DOJ alleges system paid 'excessive' salaries to keep specialist referrals in network

    DOJ alleges system paid 'excessive' salaries to keep specialist referrals in network

    Angie Stewart -  

    The Department of Justice filed a lawsuit alleging that Indianapolis-based Community Health Network illegally paid specialists "excessive" salaries in an "aggressive," "defensive" strategy to keep referrals within the system.

    From 2008 to at least 2017, CHN allegedly employed hundreds of physicians, including ones specializing in orthopedic surgery and neurosurgery, by compensating them well above fair market value using calculations based on referral and utilization patterns.

    CHN then billed Medicare for inpatient and outpatient services provided by those physicians, in violation of Stark Law, according to court documents. As a result, CHN "received millions of dollars in Medicare reimbursement to which it was not entitled," the DOJ alleges.

    Prosecutors allege CHN leaders received "clear guidance" from a valuation firm that said the physicians' salaries were outside the range of fair market value and needed further justification to be in compliance with Stark Law, which prohibits physicians from referring Medicare patients for care at a facility the physician has an improper financial relationship with.

    CHN allegedly provided the firm with falsely deflated compensation figures for four neurosurgeons recruited and employed from 2008-10. The system also failed to disclose that it was guaranteeing compensation to three of those surgeons, the DOJ alleges.

    In one instance, CHN allegedly guaranteed one neurosurgeon a base salary of $650,000 for the first year of employment and $675,000 for the second year, but told the valuation firm that the figures were $420,320 and $463,052, respectively.

    Another surgeon — whom the system believed could capture one-third of the volume of neurosurgery and spine cases in four Indiana counties — was guaranteed a $921,600 salary based on 12,000 work relative value units, but the wRVUs were later significantly reduced to reflect lower productivity estimates.

    The government is seeking damages caused by improper payments, plus interest, costs and expenses. The lawsuit stems from a whistleblower complaint filed under the False Claims Act by Thomas Fischer, who served as CHN's CFO from 2005 to 2013.

    More articles on spine and orthopedics:
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    Ex-Olympic sports medicine chief sues, claims he was fired for reporting sexual abuse
    Dr. Tom Price, former US Secretary of Health and Human Services, joins Sanuwave Health board of directors 

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