United States Attorney Maria Chapa Lopez announces Friday that the Estate of Dr. Patrick T. Hunter has paid the United States $1.75 million to resolve allegations that Dr. Hunter violated the False Claims Act by submitting claims for kidney stone procedures that were not medically justified and for engaging in an illegal kickback arrangement.
Dr. Hunter passed away in March 2019.
The settlement relates to Dr. Hunter’s submission of claims for extracorporeal shock wave lithotripsy, a procedure used to break up kidney stones.
According to the settlement agreement, between January 2010 and April of 2016, Dr. Hunter performed lithotripsy procedures on Medicare and TRICARE patients that were medically unnecessary because the procedures were not medically indicated or because there were no kidney stones in those patients.
The settlement agreement also resolves allegations that Dr. Hunter engaged in an illegal kickback arrangement with the Orlando Center for Outpatient Surgery, LP, where he performed the lithotripsy procedures.
Dr. Hunter and the Orlando Center allegedly entered into an illegal kickback arrangement where Dr. Hunter agreed to perform his lithotripsy procedures at the Orlando Center in exchange for payments from the Orlando Center, in violation of the Anti-Kickback Statute.
These procedures were then billed to and paid by Medicare and TRICARE in violation of the False Claims Act.
“Physicians that perform illegal and baseless procedures violate the sanctity of the doctor-patient relationship,” said U.S. Attorney Chapa Lopez. “The U.S. Attorney’s Office remains committed to pursuing providers who perform unnecessary procedures and engage in illegal kickback agreements that violate the law.”
“Health care fraud impacts both Medicare beneficiaries and taxpayers alike. Fraud schemes are especially insidious when unscrupulous medical professionals try to enrich themselves by performing unnecessary procedures and engaging in kickback arrangements with others in the health care community,” said Special Agent in Charge Omar Pérez Aybar of the U.S. Department of Health and Human Services Office of Inspector General (HHS-OIG). “With our law enforcement partners, our agency will continue to investigate individuals who commit health care fraud.”
The settlement resulted from a lawsuit originally filed in the United States District Court for the Middle District of Florida by Scott Thompson. Mr. Thompson sued under the qui tam, or whistleblower, provisions of the False Claims Act permitting a private citizen to sue on behalf of the United States for false claims and to share in the recovery.
The Act also allows the United States to intervene and prosecute the action. Mr. Thompson will receive $385,000 of the proceeds from the settlement with Dr. Hunter’s Estate.
The United States’ intervention in this matter illustrates its emphasis on combating health care fraud.
One of the most powerful tools in this effort is the False Claims Act. Tips and complaints from all sources about potential fraud, waste, abuse, and mismanagement, can be reported to the Department of Health and Human Services, at 800-HHS-TIPS (800-447-8477).
This settlement resulted from a coordinated effort by the U.S. Attorney’s Office for the Middle District of Florida, the HHS Office of Inspector General, and the Defense Health Agency. Assistant United States Attorneys Jeremy R. Bloor and Sean Keefe led the investigation.
The case is captioned United States ex rel. Thompson v. Surgical Care Affiliates et al., Case No. 6:16-cv-2189-Orl-22KRS.
The settlement resolves the United States’ claims against Dr. Hunter’s Estate in that case.
The case remains pending against the other defendants. The claims resolved by the settlement are allegations only, and there has been no determination of liability.