DOJ cracks down on kickbacks: 4 cases involving spine surgery

Alan Condon -   Print  |

The U.S. Department of Justice continues to crack down on unlawful kickback arrangements in healthcare, with four big stories catching the attention of Becker's readers since January:

1. A spine surgeon and co-owner of Baton Rouge-based Louisiana Spine & Sports was sentenced to 18 months in prison and ordered to pay $336,000 for his role in a kickback scheme in April. The surgeon admitted to sending urine specimens from his patients to a drug-testing lab in exchange for a percentage of the reimbursement Medicare and other payers paid to the lab.

2. In March, three spine surgeons and a pain management physician were among those sentenced for roles in a $40 million kickback scheme at the now-defunct Forest Park Medical Center in Dallas. The physicians were found guilty of bribery and both paying and accepting kickbacks to steer surgeries to the hospital. They referred patients to Forest Park in exchange for money to advertise their practices, which helped some of their practices grow significantly, according to prosecutors.

3. A Texas spine surgeon received a 10-year prison sentence in February for conspiring with his wife and a physical therapist at his practice to defraud Medicare, Medicaid and Tricare in a $10 million scheme. Payers were billed for services the clinic never performed and patients were required to attend sham appointments to get prescriptions for controlled substances. Furthermore, the surgeon and his wife accidentally burned down their house after burning medical records in an attempt to destroy evidence of the fraud, according to the DOJ.

4. A former pain management specialist was given a full pardon by former President Donald Trump in January after he was sentenced to 15 months in prison for his role in an illegal kickback scheme. The physician concealed more than $30 million in illegal kickbacks to physicians who directed spine surgeries to Pacific Hospital in Long Beach, Calif., which he had owned, according to the DOJ. The scheme spanned several years and led to over $900 million in fraudulent bills, mostly submitted to California's workers' compensation system.

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