Feds force $3.2 million payment in local medical kickback case


A Coweta County medical office has agreed to pay its portion of a $3.2 million civil settlement, according to the U.S. Attorney.

Georgia Bone and Joint (GBJ) on Ga. Highway 34, Southern Bone and Joint a/k/a Summit Orthopaedic Surgery Center (Summit Surgery Center), Southern Crescent Anesthesiology, PC (SCA), Sentry Anesthesia Management, LLC (Sentry), and David LaGuardia (LaGuardia) agreed to pay $3.2 million to settle allegations that LaGuardia, Sentry and SCA provided a free medical director to Summit Surgery Center in order to induce it to choose to perform more procedures at the surgery center rather than in the GBJ office; and that GBJ and LaGuardia caused the submission of false claims to Medicare for prescription drugs purchased outside of the United States and not approved by the U.S. Food and Drug Administration (FDA), said the U.S. Attorney for the Northern District of Georgia on March 29.

“Kickbacks should never play a role in medical decision-making,” said U.S. Attorney Byung J. “BJay” Pak. “It is critical to our healthcare system that patients seeking healthcare know that their providers’ recommendations are based on what is in the patient’s best interests and not influenced by illegal kickbacks or arrangements.”

Derrick L. Jackson, Special Agent in Charge for the Office of Inspector General of the U.S. Department of Health and Human Services, said decisions on where and how patients’ medical procedures are performed should never be made based on thinly-veiled bribes, as was alleged in this matter. Such alleged schemes will be aggressively investigated and prosecuted.”

“Abuses of the healthcare system destroy the basic trust between providers and patients, between taxpayers and government,” said David J. LeValley, Special Agent in Charge of FBI Atlanta. “The FBI and its federal partners make it a priority to make sure funds are not hijacked by those willing to misuse taxpayer dollars, thereby violating individuals who count on our healthcare programs for their medical needs.”

Pak said the civil settlement resolves a lawsuit filed in the U.S. District Court for the Northern District of Georgia by Sharon Kopko, former practice administrator, under whistleblower provisions of the False Claims Act.

“This settlement sends a clear message to all healthcare providers that fraudulent activities intended to defraud federal benefit programs are a federal crime that carries serious consequences and will not be tolerated,” said U.S. Postal Service, Office of Inspector General Special Agent in Charge Imari Niles. “The USPS-OIG, along with our law enforcement partners, will continue to aggressively investigate those who engage in fraudulent activities intended to defraud federal benefit programs and the Postal Service.”

Pak said the claims resolved by the settlement are allegations only, and there has been no determination of liability.

This case was investigated by the U.S. Attorney’s Office for the Northern District of Georgia, the U.S. Department of Health and Human Services Office of Inspector General, the FBI and the U.S. Postal Service Office of Inspector General.