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Home/Legal & Regulatory and Reimbursement/Texas Ortho Surgeon to Pay $300K to Settle Kickback Allegations
Legal & Regulatory and Reimbursement

Texas Ortho Surgeon to Pay $300K to Settle Kickback Allegations

December 16, 2019 1 min read Premium comments

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Texas Ortho Surgeon to Pay $300K to Settle Kickback Allegations
Pixabay and RJA1988
#falseclaimsactSecondary#kickbacks

A Friendswood, Texas-based orthopedic surgeon has agreed to pay $300,000 to settle kickback allegations under the False Claims Act.

On November 26, 2019, Ian Reynolds, M.D., an orthopedic surgeon of Friendswood, Texas, agreed to pay the United States Federal Government $300,000. This settlement agreement resolves all False Claims Act allegations against Dr. Reynolds.

The U.S. Attorney’s Office for the Northern District of Oklahoma had claimed that Dr. Reynolds accepted illegal kickback payments from OK Compounding, LLC between April 2013 and September 2015.

It is illegal to pay or receive “kickbacks” in conjunction with federal health care insurance. Under the False Claims Act, there can be an actionable claim where a provider submits a claim for government payment and that claim is tainted by a kickback violation.

Some of Dr. Reynolds’ patients were federally insured by Medicare, TRICARE, the Veterans Health Administration and the Federal Employees Compensation Act Program (FECA). Because the patients were covered under federal health insurance programs, the kickbacks violated the False Claims Act.

Dr. Reynolds is one of many physicians and healthcare providers being implicated in an illegal kickback scheme involving OK Compounding. This is the twelfth kickback settlement involving OK Compounding since November 2018.

These settlements are a collaborative effort to recoup the costs to the U.S. government resulting from the illegal kickbacks. This matter was the result of an investigation by the Defense Criminal Investigative Service, IRS–Criminal Investigation Division, Department of Labor–Office of Inspector General (OIG), U.S. Postal Service–OIG, FBI, Department of Veterans Affairs–OIG and the Department of Health and Human Services–OIG.

The settlement agreement was not a determination of liability. The claims resolved were civil allegations only.

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Discussion

14
DS
Dr. Sarah MitchellOrthopedic Surgeon · Mayo Clinic

This is a fascinating development. In my practice we've seen similar outcomes with the revised protocol. The key differentiator seems to be patient selection criteria. Has anyone else noticed the correlation with BMI thresholds?

8
JT
James Thornton, MDSpine Fellow · HSS

Great point. I'd push back slightly on the conclusion, the sample size in the cited study is too small to draw population-level inferences. That said, the directional signal is compelling and worth a larger RCT.

5
RP
R. PatelSports Medicine · Stanford

We implemented a similar approach last year. Early results are promising but we're still gathering 12-month follow-up data. Happy to share our protocol if anyone is interested.

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