The U.S. Department of Justice is suing Dr. Patrick Hunter; the Orlando Center for Outpatient Surgery, where he performed the procedures; and an affiliated company called Surgical Care Affiliates for violation of anti-kickback laws, filing false and fraudulent claims with federal government programs including Medicare, and for violation of whistleblower protection, according to the lawsuit.
What are the Details of the Suit
The suit, was unsealed after three years of investigation by the government, was brought by Scott Thompson, the former director of compliance at Illinois-based Surgical Care Affiliates. They hired the staff and managed the billing at Orlando Center for Outpatient Surgery.
The U.S. Justice Department has decided to take the lead in pursuing the case on behalf of Thompson. The department will file its own lawsuit within the next 90 days and potentially narrow down the allegations.
Dr. Hunter passed away earlier this year, and it is unclear whether the Justice Department will continue the case against his estate.
The government’s involvement in the case is noteworthy because the Justice Department declines to intervene in about 80% of whistleblower lawsuits. Meanwhile, about 90% of the cases in which the government intervenes get a positive outcome, either by winning a trial or reaching a settlement.
The lawsuit’s allegations stem from procedures and activities between 2010 and 2016.
What Did Dr. Hunter Do
Dr. Hunter performed many procedures, according to the lawsuit. In 2012, out of more than 1,400 doctors who ordered lithotripsy nationwide, Hunter ranked on top, ordering twice as many procedures as the next highest ordering physicians, the suit claims, although it did not say how many procedure he ordered.
Meanwhile, Orlando Center for Outpatient Surgery, where Hunter was on medical staff, ranked third in the nation and first in Florida for ordering the Lithotripsy, according to the lawsuit.
Hunter was also performing a large volume of ultrasounds at his own practice, The Florida Urology Group, compared to the patient volume he was referring to other diagnostic facilities. Medicare data showed that in 2012, out of more than 1,230 urologists who ordered ultrasounds in their own office, Hunter ranked sixth.
Florida Urology Group, where Hunter had a practice, is not part of the lawsuit and is run by a different physician today. Hunter went on leave of absence at his practice starting in May 2016 and eventually retired.
How Much Was He Billing
Hunter billed Medicare and others each time he performed a lithotripsy procedure for an average of $2,300 per procedure, the lawsuit claims. Orlando Center for Outpatient Surgery also billed Medicare and other federal payers, including Tricare, for facility charges, which gradually rose from $6,500 to $8,000.
Although the lawsuit doesn’t specify how much money is sought in damages, the government is entitled to three times the total damages, in addition to a civil penalty that’s between $5,000 and $10,000 for each false claim.
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