Alex Kacik October 28, 2019 06:19 PM
Sanford Health will pay the federal
government $20.25 million to settle allegations that one of its neurosurgeons
received kickbacks for using implantable devices distributed by his
physician-owned distributorship, the Justice Department announced Monday
afternoon.
Colleagues of Dr. Wilson Asfora
allegedly warned the Sioux Falls, S.D.-based not-for-profit health system that
he was performing medically unnecessary procedures involving the devices in which he had a
substantial financial interest. Despite these repeated warnings, the
DOJ alleged, Sanford continued to employ him, allowed him to profit from the
devices he used in surgeries and continued to submit fraudulent claims.
"More than six years ago the
Department of Health and Human Services Office of the Inspector General warned
in a fraud alert that (physician-owned distributorships) were inherently
suspect under the Anti-Kickback Statute. Unfortunately, these distributors
remain questionable," Curt Muller, special agent in charge of HHS' Office
of Inspector General, said in prepared remarks. "Patients in government
healthcare programs rightly expect that surgeries are medically indicated, not
performed to increase provider profits."
Sanford said in a statement that it
denies any liability or wrongdoing, and that it chose to settle because the
amount is far less than the unnecessary costs and operational disruption that
would have persisted for multiple years.
"We continue to stand behind
the medical care that Dr. Wilson Asfora, who was a Sanford physician from 2007
to 2019, provided to his patients," the health system said. "We
remain committed to our providers doing what is best for their patients and
supporting them in bringing innovative interventions and treatments to patients
and communities."
Along with the civil settlement,
Sanford agreed to maintain a compliance program, implement a risk-assessment
program and hire an independent review organization to oversee Medicare and
Medicaid claims at Sanford Medical Center. The agreement also requires
compliance-related certifications from the center's board and key executives.
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