Anesthesia providers and outpatient surgery centers pay more than $28 million to resolve kickback and False Claims Act allegations
ATLANTA (STL.News) Three anesthesia providers and several Georgia outpatient surgery centers, as well as their physician-owners and an administrator, agreed to pay more than $28 million to resolve allegations that they entered into kickback arrangements by paying and receiving payments for medications, supplies, equipment and labor as well as free staffing in exchange for the referral of patients.
“A physician’s health care decisions should be based solely on what is in the patient’s best interest, not what increases the physician’s bottom line,” said Acting U.S. Attorney Kurt R. Erskine. “There are significant consequences for healthcare providers who put their own financial well-being ahead of the well-being of their patients.”
“Paying or receiving kickbacks to secure taxpayer-funded healthcare payments – as alleged in this case – is illegal and corrupts the federal health care system,” said Derrick L. Jackson, Special Agent in Charge for the Office of Inspector General of the U.S. Department of Health and Human Services. “We will continue to work diligently with our State and Federal law enforcement partners to protect government health programs and those they serve.”
“Medical providers who pay out or take kickback payments for referrals are taking advantage of patients and taxpayer funded healthcare programs,” said Chris Hacker, Special Agent in Charge of FBI Atlanta. “The FBI is proud of the role it played in this settlement and will continue to provide investigative assets and resources to ensure no one takes advantage of a fair system and undermines the public’s trust.”
Anesthesia providers typically depend on hospitals and outpatient surgery centers for their income. If an anesthesia provider can secure an exclusive contract for anesthesia services with a center, it is guaranteed a steady stream of patient referrals during the term of the contract. As a result, anesthesia providers compete aggressively for these contracts.
The Government alleges that between 2005 and 2015, Ambulatory Anesthesia of Atlanta, LLC (f/k/a Ambulatory Anesthesia of Atlanta, PC) (“AAA”) and Northside Anesthesiology Consultants, LLC (“NAC”) made payments for drugs, supplies, equipment and labor, and provided free staffing to a number of Georgia outpatient surgery centers in order to induce the centers to select AAA and NAC to be their exclusive anesthesia providers. The Government alleges that these arrangements were negotiated by Stanford Plavin, M.D. on behalf of AAA and NAC. The Government alleges that these arrangements violated the Anti-Kickback Statute, 42 U.S.C. § 1320a-7b(b), and caused the submission of false claims in violation of the False Claims Act, 31 U.S.C. § 3729, et seq.
The following individuals and entities have entered into settlement agreements with the Government (listed in alphabetical order):
• Ambulatory Anesthesia of Atlanta, LLC (“AAA”)
• Arif A. Aziz, M.D.
• Jean Calhoun
• Jay A. Cherner, M.D.
• David Finkelman, M.D.
• Alan M. Fixelle, M.D.
• DCA Diagnostics, L.L.C.
• The Endoscopy Center, LLC (Savannah)
• Endoscopy Consultants, LLC
• Gastrointestinal Specialists of Georgia, P.C.
• Georgia Endoscopy Center, LLC
• G.I. Diagnostics Endoscopy Center, L.L.C.
• Eugene H. Hirsh, M.D.
• A. Steven McIntosh, M.D.
• North Fulton Medical Center, Inc.
• Northside Anesthesiology Consultants, LLC (“NAC”)
• Northwest Georgia Orthopaedic Surgery Center, LLC
• Stanford Plavin, M.D.
• M. Thomas Riddick, M.D.
• Bruce A. Salzberg, M.D.
• Gary S. Simon, M.D.
• David N. Socoloff, D.O.
• United Surgical Partners International, Inc.
• Wellbrook Endoscopy Center, P.C.
This settlement resolves a lawsuit originally filed in the U.S. District Court for the Northern District of Georgia by Kathleen Hartney-Velazco, M.D., Jan Kersey and Capitol Anesthesiology, P.C. (the Relators) under the qui tam or whistleblower provisions of the False Claims Act. United States ex rel. Capitol Anesthesiology, P.C., et al. v. Stanford Plavin, M.D., et al., No. 1:11-cv-2513-SCJ. Under the False Claims Act, private citizens may bring suit for false claims on behalf of the United States and share in any recovery obtained by the government. The Relators have received over $4,700,000.00 from the settlement.
The claims resolved by the settlement are allegations only, and there has been no determination of liability.
This case was investigated by the U.S. Attorney’s Office for the Northern District of Georgia, the U.S. Department of Health and Human Services Office of Inspector General and the Georgia Medicaid Fraud Control Unit.
The civil settlement was reached by Assistant U.S. Attorney Neeli Ben-David and Georgia Assistant Attorney-General Sara Vann.