Healthcare Fraud & Abuse Review 2021

SPECIALTY CARE AND OTHER PROVIDER ENTITIES

DA TE

ENTITY

FCA ALLEGATIONS

AMOUNT

Ambulatory Anesthesia of Atlanta, LLC; 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.; North Fulton Medical Center, Inc.; DCA Diagnostics, L.L.C.; Northside Anesthesiology Consultants, LLC; Northwest Georgia Orthopaedic Surgery Center, LLC; United Surgical Partners International, Inc.; Wellbrook Endoscopy Center, P.C.; Arif A. Aziz, M.D.; Jean Calhoun; Jay A. Cherner, M.D.; David Finkelman, M.D.; Alan M. Fixelle, M.D.; Eugene H. Hirsh, M.D.; A. Steven McIntosh, M.D.; Stanford Plavin, M.D.; M. Thomas Riddick, M.D.; Bruce A. Salzberg, M.D.; Gary S. Simon, M.D.; David N. Socoloff, D.O.

Several outpatient surgery centers, their physician-owners, an administrator and three anesthesia providers agreed to pay more than $28 million to resolve FCA allegations that they billed for services tainted by kickbacks, in violation of the AKS. The anesthesia providers allegedly made payments for drugs, supplies, equipment and labor, and provided free staffing for a number of the surgery centers to induce the surgery centers to name them the exclusive anesthesia providers for the centers. 114

11/9/2021

$28 million

Medical practice agreed to pay $500,000 to resolve FCA allegations that it billed Medicare and Medicaid for medically unnecessary cardiac catheterization procedures performed by one of its formerly employed physicians. 115 The hospital where the physician performed the procedures entered into a separate settlement regarding these allegations. A pain clinic and associated ambulatory surgery center agreed to pay more than $836,000 to resolve FCA allegations that they overbilled Medicare, Medicaid and TRICARE for more units or levels of various injections and procedures than were actually administered. 116

Quincy Medical Group

$500,000

11/29/2021

Integrated Pain Associates, PLLC; Central Texas Day Surgery Center, LLC

12/21/2021

$836,702

114 https://www.justice.gov/usao-ndga/pr/anesthesia-providers-and-outpatient-surgery-centers-pay-more-28-million-resolve. 115 https://www.justice.gov/usao-cdil/pr/federal-and-state-authorities-reach-settlement-quincy-medical-group-over-medicare-and. 116 https://www.justice.gov/usao-wdtx/pr/pain-clinic-and-ambulatory-surgery-center-agree-pay-836k-resolve-allegations.

NOTABLE SETTLEMENTS BASS, BERRY & SIMS | 68

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