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Home/Legal & Regulatory and Reimbursement/U.S. Attorney Sues SpineFrontier Over Alleged Kickback Scheme
Legal & Regulatory and Reimbursement

U.S. Attorney Sues SpineFrontier Over Alleged Kickback Scheme

March 13, 2020 2 min read Premium comments

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U.S. Attorney Sues SpineFrontier Over Alleged Kickback Scheme
Source: Pexels/Pixabay
Secondary#impartialmedicalexpert#healthcarefraud#kickbacks

The United States Attorney’s Office for the District of Massachusetts has filed a civil health care fraud complaint against SpineFrontier, Inc. and Impartial Medical Expert, LLC alleging the companies paid over $8 million in kickbacks through sham consulting fees.

The United States filed its complaint against SpineFrontier, Inc. (SpineFrontier), Impartial Medical Expert, LLC (IME), MC Management Group, Inc., KICVentures LLC, Kingsley Chin, M.D., Aditya Humad, and Vanessa Dudley to recover treble damages, restitution, and civil penalties under the False Claims Act and the Anti-Kickback Statute.

Dr. Chin owns and controls several entities related to the complaint and is the founder and CEO of SpineFrontier. Humad is the chief financial officer of SpineFrontier. Dudley is IME’s business administrator and Dr. Chin’s wife.

The complaint alleges that from March 2013 through December 2018, SpineFrontier, and later IME paid millions of dollars in kickbacks. The kickbacks were in the form of sham “consulting” fees paid to surgeons who did little or no consulting work. The U.S. alleges these “consulting” fees were paid to induce the surgeons to use SpineFrontier’s medical devices during spine surgeries.

Federal law prohibits individuals and entities from paying physicians in exchange for them using their devices in surgeries or other medical procedures paid for by government-funded healthcare programs, such as Medicare, Medicaid, and Tricare.

The U.S. claims, “Through their use of SpineFrontier medical devices in spine surgeries, these ‘consulting’ surgeons generated more than $100 million in revenue for SpineFrontier…the vast majority of SpineFrontier’s total domestic sales of medical devices…”

In conjunction with the complaint, the U.S. Attorney’s Office announced via press release that it has settled civil health care fraud claims against five physicians: F. Paul DeGenova, D.O., an orthopedic spine surgeon in Ohio; Michael Murray, M.D., an orthopedic spine surgeon in New York; Joseph Shehadi, M.D., a neurosurgeon in Ohio; Agha Khan, M.D., a neurosurgeon in Maryland; and John Atwater, M.D., an orthopedic surgeon who has worked in Florida and Illinois.

The physicians each admitted to seeking and obtaining kickbacks from SpineFrontier, via the sham third-party IME, for consulting work he did not perform. The physicians will pay a total of $1.56 million as part of the settlement agreement.

With its filing, the U.S. intervened in two private whistleblower lawsuits related to this complaint. The lawsuits were previously filed under seal pursuant to the False Claims Act.

React:

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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