APRIL 19, 2022. What if the surgeon from whom you were about to receive care chose the anesthesia provider for your surgery not based on quality or value, but because the surgeon and anesthesia provider are in a financial arrangement that benefits them—and not you? A whistleblower reported just that situation in Georgia. The United States Department of Justice recently settled a case against the owners of an anesthesia services company and 18 related entities for an unlawful kickback arrangement with surgery centers, as well as submitting false claims to federal and state healthcare programs. Under the terms of the settlement, the anesthesia services companies will pay $7.2 million. The whistleblower was a C-suite executive of the company, Care Plus Management LLC (Care Plus), and they will receive $3.1 million of the government’s recovery.
According to the allegations, the fraud scheme involved a symbiotic—or parasitic—relationship between Care Plus and outpatient surgery centers in Georgia, Florida, Texas, Alabama, and South Carolina. Care Plus approached surgeon/owners of ambulatory surgery centers (ASCs), particularly in gastroenterology, podiatry, and vascular surgery specialties. The anesthesia service provider paid kickbacks to surgeons for choosing Care Plus’ and affiliates’ services through revenue sharing for patient referrals and also by paying the surgeons subsidies for anesthesia drugs and supplies. Anesthesia services companies financially benefit from a...
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https://www.natlawreview.com/article/going-under-whistleblower-receives-over-...