Florida Organization Maintains False Claims Suit Against Anesthesiology Companies and Others

Monday, August 29, 2016
By Miles O. Indest, J.D./M.B.A.; Law Clerk, The Health Law Firm

The Florida Society of Anesthesiologists (FSA) is unwavering as a qui tam relator, maintaining that more than 50 physicians, anesthesiology companies, and ambulatory surgical centers (ASCs) engaged in illegal kickback schemes. The suit involves claims under the False Claims Act, the Anti-Kickback Statute, and the Florida Medicaid False Claims Act.


Companies Abused Their Power and Patients, FSA Alleges.

On August 2, 2016, the FSA filed its third amended qui tam complaint, reinforcing its allegations that medical providers used kickbacks to encourage ASCs to exclusively use certain anesthesiologists. The anesthesiologists also allegedly increased their use of anesthesia to increase their reimbursement claims to government programs, promoting a scheme in which anesthesia was overused on patients to their detriment.

According to the complaint, the defendants “abused their position as specialist/surgeon/ASC owners with a captive patient base to demand from independent anesthesia providers kickbacks for anesthesia referrals.” They later gave kickbacks to other surgeons and ASC owners for their anesthesia referrals.

Ultimately, because the defendants billed government programs for services “tainted by kickbacks,” FSA claims that they violated the False Claims Act. FSA is seeking approximately $5,500 to $11,000 in civil penalties per false claim, in addition to treble damages and other costs.


Defendants Seek to Dismiss “Business Dispute” Involving Empty Allegations.

The defendants have sought dismissal of the suit, arguing that the FSA has failed to sufficiently state its claims or meet the high pleading requirements for fraud claims. One motion to dismiss states that False Claims Act relators “must do more than merely allege a private scheme the relator must provide ‘some indicia of reliability,’” which FSA failed to do.

Notably, the defendants characterize FSA’s complaint as a “shotgun pleading” that improperly hurls accusations without underlying support. They even conclude that the suit is merely a “business dispute between competitors” brought by individuals upset about trends in the anesthesiology industry.

To read the FSA’s qui tam complaint, click here.

The case is U.S. et al. ex rel. Florida Anesthesiologists v. Choudhry et al., case number 8:13-cv-02603 (M.D. Fla. 2013).


Contact Health Law Attorneys Experienced with Health Care Fraud and Qui Tam or Whistleblower Cases.

The Health Law Firm’s attorneys routinely represent physicians, dentists, orthodontists, medical groups, clinics, pharmacies, assisted living facilities (AFLs), home health care agencies, nursing homes, group homes and other healthcare providers in Medicaid and Medicare investigations, audits and recovery actions.

Attorneys with The Health Law Firm also represent health care professionals and others who may desire to file a qui tam, False Claims Act or whistleblower suit. We work with physicians, nurses and other professionals to investigate, document and file such cases. We have developed relationships with recognized experts in health care accounting, health care financing, utilization review, medical review, filling, coding and other services that assist us in such matters. We have represented number of doctors and other licensed health professionals as relators in bringing qui tam or whistleblower cases. Our attorneys are also available to defend physicians, medical groups and health care providers in qui tam or whistleblower cases.

To contact The Health Law Firm, please call (407) 331-6620 or visit our website at www.TheHealthLawFirm.com.


About the Author: Miles Indest, J.D./M.B.A., graduated in May 2016 from Tulane University Law School and the Freeman School of Business. He has served three years as a member of Tulane Law Review and served one year as the Writing Skills Chair of Tulane Moot Court.


Sources:

Nathan Hale. “Medical Providers Say Anesthesia Kickback Suit Fails.” Law360. (June 15, 2016). Web.

Dani Kass. “FCA Suit Alleges Anesthesia Kickback Schemes in Florida.” Law360. (March 28, 2016). Web.


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8/29/2016

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