And $488 million to the whistleblowers who alerted the Department of Justice to those false claims.
The Department of Justice has just released data for the fiscal year ending September 30, 2022, revealing that settlements and judgments under the False Claims Act exceeded $2.2 billion.
It wasn’t just a big year for the government. It was also a big year for the whistleblowers who originally brought actions. During the same fiscal year, the government paid out over $488 million to whistleblowers.
Last year, the government and whistleblowers were involved in 351 settlements and judgments. According to the Department of Justice press release, that is “the second-highest number of settlements and judgments in a single year.” Many of the settlements and judgements involved the orthopedics industry.
OTW has been following False Claims Act actions closely. Below are some of the settlements and judgments we have covered from the past fiscal year.
Last year, health care and hospital system Providence Health & Services Washington, said the Department of Justice “agreed to pay $22,690,458 to resolve allegations that it fraudulently billed Medicare, Medicaid, and other federal health care programs for medically unnecessary neurosurgery procedures.” The settlement was the “largest-ever health care fraud settlement in the Eastern District of Washington.” For more information, see “Lawsuit Alleges Neurosurgeons Performed Unnecessary Procedures.”
Naples, Florida-based Arthrex Inc. agreed to pay $16 million to settle allegations that it paid kickbacks to an orthopedic surgeon to use its products. For OTW’s coverage, see “Arthrex Pays $16M to Settle Kickback Allegations.”
A number of clinics and doctors have faced accusations that their anesthesia arrangements run afoul of the anti-kickback rules. Last year, the Department of Justice entered into a $7.2 million settlement with Georgia-based Care Plus Management, LLC and its creators Paul D. Weir and John R. Morgan, M.D. The whistleblower in the matter received more than $1.3 million from the settlement.
Another anesthesia-related settlement for over $28 million involved three anesthesia providers, numerous Georgia outpatient surgery centers and their physician-owners, and an administrator. For OTW’s coverage of the kickback settlements involving anesthesia arrangements, see “Don’t Get Sued by DOJ Over Anesthesia Arrangements!”
Oklahoma-based orthopedic surgeon Mark Stephen Wilson, M.D. agreed to pay the United States $342,750 to resolve False Claims Act allegations. For additional information, see “Ortho Surgeon Pays $342,750 to Settle Kickback Allegations.”
The largest teaching hospital of Harvard Medical School, Massachusetts General Hospital, agreed to pay $14.6 million to resolve False Claims Acts allegations. For OTW’s coverage, see “Mass General Hospital Pays $14.6M to Settle Surgery Claims.”
Over the years, OTW has been following a kickback scheme involving a number of orthopedic surgeons. Last year, an accountant involved in California’s notorious “Spinal Cap” kickback scheme was sentenced and ordered to pay a fine of $8,000 and forfeit $500,000 in proceeds from the scheme. For OTW’s coverage of the sentencing, see “Accountant Sentenced in Spine Surgery Kickback Scheme.”
