Becker's ASC Review

35 ORTHOPEDICS 8 DOJ investigations into illegal kickbacks in orthopedics in 2019 By Alan Condon Here are eight Department of Justice investigations into fraud in orthopedics this year: 1. Daniel Capen, MD, was sentenced to 30 months in prison aer pleading guilty to conspiracy and receiving kickbacks at the now defunct Pacific Hospital of Long Beach (Calif.). 2. Life Spine and two executives agreed to pay about $5.99 million to resolve the federal government's allegations that they violated the False Claims Act. e lawsuit was brought by a private whistleblower before the government intervened. 3. e DOJ filed is arguing that former Sioux Falls, S.D.-based Sanford Health neurosurgeon Wilson Asfora, MD, profited from performing "aggressive, unnecessary surgeries" and implanting devices from a company he had ownership in. Sanford terminated Dr. Asfora's employ- ment in September and agreed to settle the whistleblower lawsuit for more than $20 million. 4. Prosecutors are arguing that Michael Rimlawi, MD, should not be granted a new trial aer he was convicted for his role in a $40 million kickback scheme at the now- defunct Forest Park Medical Center in Dallas. 5. e DOJ charged three Oklahoma-based physicians, including an orthopedic surgeon, with violating the anti- kickback statute for their role in a scheme dating back to November 2012. e physicians are accused of accepting bribes to prescribe compounding drugs from OK Com- pounding in Skiatook, Okla., One Stop Rx in Tulsa and NBJ Pharmacy and Airport McKay Pharmacy in Houston. 6. Orlando, Fla.-based Conway Lakes Health & Rehabilita- tion Center and orthopedic surgeon Kenneth Krumins, MD, agreed to pay $1.5 million to settle anti-kickback violation allegations. 7. e DOJ charged 24 individuals — including three licensed medical professionals — in connection with an alleged kickback scheme involving durable medical equip- ment braces. e individuals were accused of advertis- ing telemedicine services to Medicare beneficiaries that would allow them to obtain DME braces; the call centers involved allegedly paid kickbacks to the telemedicine companies, which paid kickbacks to physicians to write the prescriptions. e scheme created more than $1.2 bil- lion in losses for Medicare. 8. Brandon Claflin, DO, paid $84,666 to settle allegations he accepted illega n NuVasive names former Mallinckrodt exec CFO By Laura Dyrda N uVasive named Matthew Harbaugh executive vice presi- dent and CFO, succeeding Raj Asarpota, who is leaving the company. Mr. Harbaugh will be responsible for all financial aspects of NuVasive, including its financial planning and analysis, tax and treasury. He will be part of the company's global executive team and report to CEO J. Christopher Barry. Prior to joining NuVasive, Mr. Harbaugh was president of the spe- cialty generics business at Mallinckrodt plc. He also spent five years as the company's CFO. Beyond Mallinckrodt, Mr. Harbaugh spent time in financial management roles at Covidien, including CFO. Mr. Harbaugh took over the CFO role on Jan. 2. Mr. Asarpota plans to stay with NuVasive in an advisory role through May; he will then provide ongoing consulting services through September. n Orthopedic clinic faces renewed lawsuit over 2016 cyberattack By Angie Stewart T he Supreme Court of Georgia revived a lawsuit accusing Ath- ens (Ga.) Orthopedic Clinic of negligence for a 2016 patient data breach, according to court documents filed Dec. 23. The court unanimously reversed an appeals court's decision to dismiss the suit — which was filed by Athens Orthopedic Clinic pa- tients affected by a June 2016 cyberattack — ruling that the "injury the plaintiffs allege that they have suffered is legally cognizable." Hackers from a group called thedarkoverlord reportedly stole credentials from a third-party vendor to infiltrate Athens Or- thopedic Clinic's EHR, HealthITSecurity reported. The names, addresses, Social Security numbers, birthdays, phone numbers and medical information of at least 200,000 current and former patients were potentially compromised. When the clinic refused to pay a ransom, the group reportedly sold patient data on the dark web, putting individuals at higher risk of identity fraud. Athens Orthopedic Clinic patients have since been battling criminal attempts to obtain their credit cards, tax returns and checks, steal their identities, and open accounts in their names, according to the lawsuit. After reporting the breach, Athens Orthopedic Clinic notified patients that it didn't have insurance to cover credit monitoring and identity theft restoration services. The patients later sued Athens Orthopedic Clinic for negligence, breach of implied contract and "unjust enrichment." They're seeking damages for the cost of credit monitoring and identity theft protection services, as well as a judgment that the clinic must better secure patient data. n

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