The United States Department of Justice (DOJ) recently announced it was pursuing allegations of health care fraud against a spine device manufacturer along with its executives.
What were the accusations?
The agency specifically stated the founder and chief executive officer created a separate entity to help disguise the use of illegal bribes to spinal surgeons in exchange for using their products. The accused allegedly used this entity to hire spine surgeons for consultations. The DOJ states this entity was a front used to disguise the illegal kickbacks. The government stated it had evidence to support the accusation the accused provided spinal surgeons with $500 for every cervical procedure and $1,000 for lumbar procedures that used their medical devices.
Based on this information, the government claims the founder violated the Anti-Kickback Statute (AKS). This law makes it illegal to offer payments or other forms of remuneration to encourage referrals or in exchange for using certain products covered by federally funded programs like Medicare.
How did the government gather the evidence to support these allegations?
The claim began as a result of a whistleblower lawsuit. A former employee contacted the government and filed the action on behalf of the DOJ. If successful, this individual will receive a portion of the recovery.
How much will the government get in recovery if the lawsuit is successful?
According to the indictment, the government could recover up to three times the amount of losses as well as additional penalties as applicable. We will provide updates on the progression of this case as they become available.