BOSTON – Conspiracies and kickbacks roamed the halls of SpineFrontier as bogus consulting fees arose in the form of a fraudulent third-party called IME. At least, this is what the United States Attorney’s Office claims were happening when they filed a complaint about civil health care fraud alleging illegal behavior. The charges are brought against SpineFrontier, specialists in spinal surgery.
SpineFrontier, a partner of Impartial Medical Experts, LLC (IME) and based in Malden, Massachusetts, was involved in the process of spinal implants and devices. When a new accountant, Patricia Katz, enrolled in compliance cases and started noticing that medical devices were hardly recorded, she began to pay attention. This led to Katz’s dismissal, where she responded by taking legal action using the whistleblower protection law. The government was able to intervene in two cases of private whistleblower lawsuits in connection with the case in question. The lawsuits were filed to the False Claims Act under a seal pursuant.
It is now alleged that these kickbacks were made to surgeons as a way of introducing them to the companies’ spinal surgeries. The government maintains that SpineFrontier violated the Anti-Kickback Statute resulting in federal health care programs having to pay millions in alleged false claims. The claims have a negative impact on the economy and shatter the trust the public deserves when it comes to their medical professionals.
The complaint was filed against founder and Chief Executive Officer, Kingsley Chin, Chief Financial Officer, Aditya Humad, as well as Chin’s wife, who played the role of Business Administrator to IME along with other entities controlled by Chin.
Along with the Chins, the U.S. Attorney’s Office settled another five cases of health care fraud claims with individuals who admitted to knowingly obtaining kickbacks from SpineFrontier. This was all done through the fraudulent third-party IME, where the individuals all claimed consulting work, which was never, in fact, performed. These physicians also claimed the Chins, as well as Humad, instructed them to specifically add “consulting” to their hours billed to SpineFrontier. These invoices were made for every surgery done where SpineFrontier’s devices were used.
Dr. F. Paul DeGenova, an Ohio-based orthopedic surgeon that recently admitted he received payments from SpineFrontier for work he did not do. Dr. DeGenova came to an agreement with the government in a settlement costing him $486,985. Dr. Michael Murray, Dr. Joseph Shehadi, Dr. Agha Khan, and Dr. John Atwater together paid a total of $1,070,079 in settlement fees with the government. All five surgeons have been co-operating with the government’s investigation, which was taken into consideration.
United States Attorney Andrew E. Lelling said in a statement that medical device companies paying surgeons for a kickback damages the health care system and whether directly or directly jeopardizes the health and safety of every patient. He went on to claim that they would pursue any organization or individual aggressively who fails to comply with the rules.
Jody Hunt, an Assistant General with the Department of Justice’s Civil Division, was vocal in his statements when he said that the federal health care’s integrity was undermined when kickbacks occur. These, he said, resulted in harmful medical care. His department has promised to pursue any and all unlawful arrangements and that the integrity that comes with medical care is vital to the federal program these beneficiaries receive.
It is alleged that cases such as these cheat both patients and the taxpayers equally. The Special Agent in Charge, Phillip M. Coyne, has vowed that working with partners in law enforcement will continue investigating kickback schemes threatening the federal health care system’s integrity. Though these schemes come in many disguises, Coyne is adamant these investigations will continue.
It is because surgeons hold their patient’s lives in their hands that they have a moral imperative to be as transparent and trustworthy as possible for the sake of the safety of the people they treat. It seems that when hundreds of thousands of dollars are spent in kickbacks, at least five surgeons seemed to be willing to forget about their morals and ethics and instead go for the more valuable and corrupt option. These were sentiments shared by Joseph R. Bonavolonta, a representative in the FBI’s Boston Division. The FBI has promised to aggressively pursue these fraud cases since cases such as these do not just harm the few affected by the scam, but by all taxpayers who are ultimately left with the bill.
In a final statement made by Jeffrey Stachowiak, he added that it was both veterans and non-veterans alike that place their trust in the care of their physicians and that the cornerstone to the United States health care system was the confidence these medical experts bring.
With regard to SpineFrontier’s complaint, it is alleged that the IME kickbacks only operated through a Florida post office box with Dudley, Chin’s wife, as the only employee. The surgeons were told that they could bill SpineFrontier any time of the day and did not set a limit to the bill size. These ‘consulting’ costs were made on a pre-surgical basis with no limit set on the number of times surgeons could have a SpineFrontier product evaluated. This resulted in multiple instances where the same surgeon would submit consulting hours using the same SpineFrontier device repeatedly.
There was no part on SpineFrontier’s side to put any effort into reviewing, cataloging, or even assessing any of the feedback these surgeon-consultants were able to provide. There were often surgeons who were paid ostensibly for their time, even when no feedback was provided on the product. Instances such as these were the red flags officials looking for in their investigations.
It is alleged by the government that SpineFrontier, along with IME, paid surgeons over $8 million in kickbacks. For SpineFrontier, however, the company was able to generate well over $100 million in revenue; most of these profits were made from the kickback-tainted surgeries. This totaled out to be a vast majority of SpineFrontier’s domestic sales. The investigation will take place under the careful eye of the Civil Department of the Department of Justice.
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