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Home/Legal & Regulatory and Reimbursement/Mitias Orthopaedics Owes $1.87M to Settle False Claims Allegations
Legal & Regulatory and Reimbursement

Mitias Orthopaedics Owes $1.87M to Settle False Claims Allegations

January 25, 2023 1 min read Premium comments

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Mitias Orthopaedics Owes $1.87M to Settle False Claims Allegations
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False Claims Act allegations against Mitias Orthopaedics, PLLC, its owner Hanna “Johnny” Mitias, M.D., and a subsidiary Champion Orthopedics (collectively “Mitias”) have been resolved for $1,870,714.83.

The settlement resolves allegations that Mitias submitted false claims to the Medicare and Medicaid programs. The U.S. prosecutors in this case had alleged that Mitias submitted claims to the programs for brand name viscosupplementation agents for knee injections. However, according to the complaint, Mitias administered a compounded viscosupplementation agent that was much less expensive and, when the company submitted for reimbursement, was paid at the rate assigned to more expensive products.

According to United States Attorney Clay Joyner, “Taxpayers deserve to receive the products and services billed to their federal health insurance programs. The viability of Medicare and Medicaid is threatened by each wasted dollar. Our people come before profits.”

Joyner also commented, “This settlement is an example of how whistleblowers and the government can work together to recoup and deter overbilling practices.”

The original complaint was filed in 2015 by a medical device sales representative under the whistleblower provisions of the False Claims Act. The provisions allow private individuals to file a lawsuit on behalf of the government for false claims. If the government intervenes in the lawsuit and the lawsuit is successfully settled or the government prevails at trial, the whistleblower is entitled to a share of the recovery.

How did the whistleblower obtain the information behind the allegations in the original complaint? By doing his job as a salesperson for one of the brand name products and meeting with Mitias.

The whistleblower claimed that he learned a lot about the Mitias practice during the meeting. The whistleblower claimed that they were told about a number of false claims made by Mitias. The allegations come from information that was purportedly provided by the clinical staff during the meeting with the whistleblower.

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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