GREENBELT, Md., Oct. 29, 2019 /PRNewswire/ -- A
whistleblower case alleging kickbacks and unnecessary spine
surgeries has been settled by Sanford Health in South Dakota for $20.25
million. The False Claims Act settlement is believed to be
one of the largest in the district.
Two Sanford surgeons filed the complaint under seal in
August 2016 under the whistleblower
process (qui tam) in the False Claims Act. It alleged that
the lucrative Sanford neurosurgeon, Dr. Asfora, was selling medical
devices to Sanford for surgeries he performed, resulting in an
unlawful economic incentive for him to use, and overuse, the
devices on unwitting patients. The complaint alleged that this
kickback scheme resulted in multi-level, medically unnecessary
spinal fusion surgeries to scores of Medicare and Medicaid
patients.
The complaint recounted the numerous efforts made over many
years by the physician whistleblowers and others to implore Sanford
to take appropriate actions to stop the alleged unlawful kickbacks
and the resulting unnecessary spinal surgeries. As alleged, Sanford
repeatedly failed to take corrective measures, and the physicians
had no choice but to bring their grave concerns to the federal
government "as a last resort" by filing the whistleblower complaint
and fully cooperating with the Government's investigation.
Their efforts have now successfully met their goal of protecting
patients from these unnecessary and harmful surgeries. The case
received widespread local and national attention after the
Government intervened and the court unsealed the record in
June 2019. In July, the hospital
announced that it was suspending the purchase of devices sold by
Dr. Asfora's device companies. It has since announced the
termination of Dr. Asfora from the hospital system.
The Department of Justice announced today that Sanford settled
its share of the litigation for $20.25
million. In addition, the government entered into a
Corporate Integrity Agreement (CIA) with Sanford, requiring that
"Sanford maintain a compliance program, implement a risk assessment
program, and hire an Independent Review Organization to review
Medicare and Medicaid claims at Sanford Medical Center." Moreover,
the CIA also requires compliance-related certifications from the
board of directors and key executives at Sanford, increasing
individual accountability. The case against Dr. Asfora and his
company, Medical Designs, continues to be prosecuted.
JGL's Veronica Nannis and
Jay Holland are honored to represent
the physician relators. They are also thankful for the assistance
of local counsel, Robert Anderson,
and for the comprehensive investigation performed by the
experienced government attorneys dedicated to this case,
particularly DOJ Trial Attorney Chris
Terranova and Assistant U.S. Attorney Meghan Roche from the U.S. Attorney's Office in
Sioux Falls. "The government's
commitment to investigating and wholeheartedly pursuing this case
underscores its keen desire to protect patients, root out fraud and
protect taxpayer dollars," said Holland.
Greenbelt, Maryland based
Joseph, Greenwald & Laake filed the lawsuit in August 2016. The case caption is US ex rel
Bechtold v. Sanford Health, et al., Case 4:16-cv-04115-LLP
(S.D.).
Jay Holland is a
partner at Joseph, Greenwald & Laake, and is Chair of the
Firm's Labor, Employment and Qui Tam practice. He is an employment
and a whistleblower attorney with a nationwide qui tam practice.
His False Claims Act cases have resulted in recoveries of over $600
million for the United States. His recent publications include
articles for The National Law Journal, Trial Magazine, D.C. Trial
Lawyer, and the Maryland State Bar Association Employment Law
Deskbook. He can be reached
at jholland@jgllaw.com
|
Veronica Nannis is
a partner at Joseph, Greenwald & Laake, and is the Chair of the
Firm's Civil Litigation Department. She is a whistleblower and a
class action attorney focusing on fraud cases. A Super Lawyer's
Rising Star in DC and Maryland for the last several years, she was
also awarded the Maryland Association for Justice's Trial Lawyer of
the Year Award in 2011 with the team from Joseph, Greenwald &
Laake. Recent publications include those for Law 360 and The Daily
Record. She can be reached at vnannis@jgllaw.com
|
Contact: Joseph Greenwald &
Laake, P.A.
Veronica Nannis;
vnannis@jgllaw.com
Jay Holland; jholland@jgllaw.com
Phone: 301-220-2200
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SOURCE Joseph, Greenwald & Laake