Our law firm has a fairly unique practice…we represent patients in medical malpractice cases against health care providers and whistleblower cases on behalf of honest folks who report cases of financial and billing fraud. I recently learned of a case which deals with both issues: a whistleblower on illegal kickbacks for unnecessary back surgeries.
South Dakota neurosurgeon Wilson Asfora, MD, and his two medical device distribution companies, agreed to pay $4.4 million to settle federal allegations around kickbacks and unnecessary procedures, according to the U.S. Department of Justice. The settlement resolves False Claims Act allegations related to illegal payments to Asfora for the use of certain medical devices, in violation of the Anti-Kickback Statute, as well as claims for medically unnecessary surgeries.
Medpage Today reported the Department of Justice filed a complaint against the defendants in 2019, following a suit brought by a pair of whistleblowers. It alleged that two companies owned by Asfora paid him profit distributions in exchange for his use of their devices in his spine surgeries. The suit also alleged that Asfora solicited and received kickbacks from another medical device manufacturer in exchange for using its infusion pumps. The pumps are implantable devices used to deliver medication to patients.
Asfora and his two companies will be excluded from participating in Medicare, Medicaid, and other federal healthcare programs for 6 years under the terms of the settlement agreement. Even better, the two whistleblowers who brought the original suit will receive $880,000 of the settlement proceeds.
My Take: Two very honest healthcare workers or administrative staff employees saw a doctor taking advantage of his patients by recommending and performing unnecessary back surgery and taking illegal kickbacks from the manufacturers of the medical devices he implanted during those unnecessary surgeries.
Sometimes the good guys do win!