The Justice Department announced a settlement with a Tacoma spine surgeon and several healthcare entities over allegations of billing for unnecessary surgeries. According to the DOJ's Office, CHI Franciscan Health and St. Joseph Medical Center will cough up $745,654, while former Orthopedic Surgeon Kevin Schoenfelder is set to pay $197,054 to settle the false claims action.
U.S. Attorney Tessa M. Gorman expressed concern, stating, "Unnecessary surgeries put patients at risk of medical complications," and highlighted the added issue, of taxpayer-funded healthcare exploitation. The allegations were initially brought forward in a qui tam lawsuit by Dr. Daniel Nehls on May 21, 2018, accusing Dr. Schoenfelder of performing surplus spinal surgeries. Billings to Medicare, TRICARE, and Veterans Affairs between January 1, 2013 and June 30, 2018, were deemed nonessential.
Dr. Schoenfelder, who had since retired and relinquished his medical license, did not admit any wrongdoing as part of the settlement. Despite this, both the medical professional and the implicated healthcare providers agreed to pay back the amounts improperly billed to the government health programs, along with additional penalties.
As the whistleblower, Dr. Nehls stands to receive 22% of the return to government healthcare programs. "This outcome demonstrates that HHS-OIG along with our law enforcement partners will relentlessly pursue those who abuse taxpayer-supported health care programs," said Special Agent in Charge Steven J. Ryan of the Department of Health and Human Services Office of Inspector General.
The settlement, moreover, serves as a stark warning to healthcare providers. "Subjecting veterans to unnecessary medical procedures at the expense of the taxpayer will not be tolerated," Acting Special Agent in Charge Gregory S. Phelan of the VA Office of Inspector General's Northwest Field Office added in his statement, vowing continued vigilance to maintain the integrity of VA programs.
Concurring with this stance, Special Agent in Charge Bryan D. Denny of the DCIS Western Field Office emphasized the primacy of patient safety and healthcare integrity. This case, filed under the False Claims Act's whistleblower provisions, was resolved under the guidance of Assistant United States Attorneys Kayla Stahman and Nickolas Bohl.
