The United States Attorney’s Office for the District of Massachusetts announced on March 5, 2020 that it has settled civil health care fraud claims against five physicians, each of whom admitted to seeking and obtaining kickbacks from SpineFrontier, a provider of devices in spinal surgeries, via the sham third-party Impartial Medical Experts, LLC (IME), whose Business Administrator is the wife of the founder and CEO of SpineFrontier, for consulting work that each of the five physicians did not perform. Further, each physician admitted that they were specifically instructed to bill “consulting” hours to SpineFrontier for each and every surgery in which he used a SpineFrontier device, regardless of whether he spent any time actually consulting.
The U.S. government alleges that SpineFrontier and the other defendants paid, and conspired to pay, kickbacks in the form of sham consulting fees via IME, which operates only with a Florida post office box and whose sole employee is SpineFrontier’s CEO’s wife. The lawsuit alleges that the defendants made the payments to surgeons to induce them to use SpineFrontier’s devices in spinal surgeries. The U.S. government contends that the defendants violated the Anti-Kickback Statute, and as a result caused federal health care programs to pay millions of dollars in false claims.
The U.S. government contends that the defendants told surgeons that they could bill SpineFrontier and IME for “consulting” on a per-surgical case basis, regardless of the time, if any, the surgeons spent consulting. SpineFrontier and IME allegedly set no limit on the number of times a surgeon could purportedly evaluate a SpineFrontier device, leading to numerous instances in which SpineFrontier paid the same physician for submitting consulting hours on the same SpineFrontier device over and over again.
The U.S. government alleges that SpineFrontier and IME paid more than $8 million in kickbacks to surgeons, which generated more than $100 million in revenue, with the vast majority of SpineFrontier’s total domestic sales revenues coming from kickback-tainted surgeries. The five surgeons agreed to pay the U.S. government between $105,149 and $486,985 to settle the claims.
In connection with the filing of its complaint, the U.S. government intervened in two private whistleblower lawsuits that had been filed under seal pursuant to the False Claims Act. The cases are United States ex rel. Birchall v. SpineFrontier, Inc. et al., No. 15-cv-12877 and United States ex rel. Miller & Bennett v. SpineFrontier, Inc. et al., No. 15-cv-12908.
If you have information regarding false claims having been submitted to Medicare, Medicaid, TRICARE, other federal health care programs, or to other federal agencies/programs, and the information is not publically known and no actions have been taken by the government with regard to recovering the false claims, you should promptly consult with a False Claims Act attorney (also known as qui tam attorneys) in your U.S. state who may investigate the basis of your False Claims Act allegations and who may also assist you in bringing a qui tam lawsuit on behalf of the United States, if appropriate, for which you may be entitled to receive a portion of the recovery received by the U.S. government.
Click here to visit our website or call us toll-free in the United States at 800-295-3959 to be connected with qui tam lawyers (False Claims Act lawyers) in your U.S. state who may assist you with a False Claims Act lawsuit.
Turn to us when you don’t know where to turn.