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Anesthesia providers, outpatient surgery centers agree to pay back $28 million amid ‘kickback and False Claim Act’ allegations

Three anesthesia providers and several outpatient surgery centers in Georgia, including some with ties to Forsyth County, have agreed to pay back more than $28 million amid “allegations that they entered into kickback arrangements by paying and receiving payments for medications, supplies, equipment and labor as well as free staffing in exchange for the referral of patients,” the U.S. Department of Justice and Acting U.S. Attorney Kurt R. Erskine announced recently in a news release.

“A physician’s health care decisions should be based solely on what is in the patient’s best interest, not what increases the physician’s bottom line,” Erskine said in the release. “There are significant consequences for healthcare providers who put their own financial well-being ahead of the well-being of their patients.”

Per the release, the government alleges that between 2005 and 2015, Ambulatory Anesthesia of Atlanta, LLC and Northside Anesthesiology Consultants, LLC “made payments for drugs, supplies, equipment and labor, and provided free staffing to a number of Georgia outpatient surgery centers in order to induce the centers to select AAA and NAC to be their exclusive anesthesia providers.”

“Anesthesia providers typically depend on hospitals and outpatient surgery centers for their income,” the release said. “If an anesthesia provider can secure an exclusive contract for anesthesia services with a center, it is guaranteed a steady stream of patient referrals during the term of the contract.  As a result, anesthesia providers compete aggressively for these contracts.”

The doctors and businesses who entered into the settlement agreement with the government are:

  • Ambulatory Anesthesia of Atlanta, LLC (“AAA”);
  • Arif A. Aziz, M.D.;
  • Jean Calhoun;
  • Jay A. Cherner, M.D;.
  • David Finkelman, M.D.;
  • Alan M. Fixelle, M.D.;
  • DCA Diagnostics, L.L.C.;
  • The Endoscopy Center, LLC (Savannah);
  • Endoscopy Consultants, LLC;
  • Gastrointestinal Specialists of Georgia, P.C.;
  • Georgia Endoscopy Center, LLC;
  • G.I. Diagnostics Endoscopy Center, L.L.C.;
  • Eugene H. Hirsh, M.D.;
  • Steven McIntosh, M.D.;
  • North Fulton Medical Center Inc.;
  • Northside Anesthesiology Consultants, LLC (“NAC”);
  • Northwest Georgia Orthopaedic Surgery Center, LLC;
  • Stanford Plavin, M.D.;
  • M. Thomas Riddick, M.D.;
  • Bruce A. Salzberg, M.D.;
  • Gary S. Simon, M.D.;
  • David N. Socoloff, D.O.;
  • United Surgical Partners International Inc.;
  • Wellbrook Endoscopy Center, P.C.

“Medical providers who pay out or take kickback payments for referrals are taking advantage of patients and taxpayer funded healthcare programs,” said Special Agent in Charge of FBI Atlanta Chris Hacker. “The FBI is proud of the role it played in this settlement and will continue to provide investigative assets and resources to ensure no one takes advantage of a fair system and undermines the public’s trust.”

The settlement is the result of a lawsuit filed by whistleblowers, who received $4.7 million in the settlement.

“Paying or receiving kickbacks to secure taxpayer-funded healthcare payments – as alleged in this case – is illegal and corrupts the federal health care system,” said Derrick L. Jackson, Special Agent in Charge for the Office of Inspector General of the U.S. Department of Health and Human Services.  “We will continue to work diligently with our State and Federal law enforcement partners to protect government health programs and those they serve.”

The 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 and the Georgia Medicaid Fraud Control Unit.

Since the settlement was only for allegations, no liability has been determined.