Becker's ASC Review

46 ORTHOPEDICS DOJ alleges system paid 'excessive' salaries to keep specialist referrals in network By Angie Stewart T he Department of Justice filed a lawsuit alleging that Indianapolis- based Community Health Network illegally paid specialists "excessive" salaries in an "aggressive," "defensive" strategy to keep referrals within the system. From 2008 to at least 2017, CHN allegedly employed hundreds of physicians, including ones specializing in orthopedic surgery and neurosurgery, by compensating them well above fair market value using calculations based on referral and utilization patterns. CHN then billed Medicare for inpatient and outpatient services provided by those physi- cians, in violation of Stark Law, according to court documents. As a result, CHN "received millions of dollars in Medicare reimbursement to which it was not entitled," the DOJ alleges. Prosecutors allege CHN leaders received "clear guidance" from a valuation firm that said the physicians' salaries were outside the range of fair market value and needed further justification to be in compliance with Stark Law, which prohibits physicians from referring Medicare patients for care at a facil- ity the physician has an improper financial relationship with. CHN allegedly provided the firm with falsely deflated compensation figures for four neurosurgeons recruited and employed from 2008-10. e system also failed to disclose that it was guaranteeing compensation to three of those surgeons, the DOJ alleges. In one instance, CHN allegedly guaranteed one neurosurgeon a base salary of $650,000 for the first year of employment and $675,000 for the second year, but told the valuation firm that the figures were $420,320 and $463,052, respectively. Another surgeon — whom the system believed could capture one-third of the volume of neurosurgery and spine cases in four Indiana counties — was guaranteed a $921,600 salary based on 12,000 work relative value units, but the wRVUs were later significantly reduced to reflect lower productivity estimates. The government is seeking damages caused by improper payments, plus inter- est, costs and expenses. The lawsuit stems from a whistleblower complaint filed under the False Claims Act by Thomas Fischer, who served as CHN's CFO from 2005 to 2013. n Texas surgery center acquires surgical robot for total knee replacements By Rachel Popa I NOV8 Surgical, an orthopedic practice and ASC in Houston, acquired the TSolution One robotic system from THINK Surgical. The TSolution One robotic system was recently cleared by the FDA and includes both a 3D presurgical planning workstation and the active robot. The workstation allows the surgeon to create a surgical plan in a virtual environment. In the operating room, the robot helps the sur- geon by preparing the joint implant according to the surgeon's plan. "We are proud to collaborate with Dr. Stefan Kreuzer and his team at INOV8 Surgical to offer patients the TSolution one total knee applica- tion," said John Hahn, CEO of THINK Surgical. "Our active robot technology is advancing the field of orthopedic surgery by helping surgeons perform total knee replacement procedures with more accuracy and precision. The system also offers an open implant library, which allows surgeons to select the implant that is best suited for their patient from an array of options." n Murder trial begins for neurosurgeon accused of over- prescribing opioids, could serve life in prison By Alan Condon S anta Rosa, Calif.-based neurosurgeon Thomas Keller, MD, faces a potential prison term of 60 years to life for allegedly causing four patient deaths by overprescribing opioids from 2011 to 2017, The Press Democrat reports. The trial began Jan. 29 and accuses Dr. Keller of second-degree murder of four Sonoma County, Calif., residents. It's expected to close in mid-March. On the first day of testimony, prosecutors told the court how a female patient died after overdosing on oxycodone, two days after Dr. Keller prescribed her 120 pills in 2014. Dr. Keller is also charged with four felony counts of providing pre- scriptions without legitimate medical purposes linked to four other patients and one count of elder abuse. He was arrested in August and remains in Sonoma County Jail, with bail set at $12 million. Dr. Keller previously served a six-month prison term after he was found guilty of engaging in sexual misconduct with several patients in 1989, according to The Press Democrat. His medical license was revoked after his conviction but reinstated in 1994. n

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