Doctors Allege Sanford Made Millions on Medicare/Medicaid Fraud with Implanting Unnecessary Bone

[TexasTowelie]

Doctors Allege Sanford Made Millions on Medicare/Medicaid Fraud with Implanting Unnecessary Bone Screws


Three years ago, Dr. C. Dustin Bechtold and Dr. Bryan Wellman sued Sanford neurosurgeon Wilson Asfora and Sanford Health in the U.S. District Court of South Dakota for defrauding the federal government and us, the taxpayers. The court almost immediately sealed the case to keep individual health information confidential.

On Thursday, after United States Department of Justice notified the court that the feds are intervening and going after Dr. Asfora and Sanford as well, the court unsealed a redacted version of the original 2016 complaint.

(PDF Document at link)

The complaint is big—111 pages. Here’s my summary of the main points of concern.

Drs. Bechtold and Wellman allege that Dr. Asfora, Sanford Health, Sanford Clinic, and Asfora’s medical device company Medical Designs, LLC committed “violations of the Federal False Claims Act, 31 U.S.C. §§3729–3733 et. seq. and the Federal Anti-Kickback Statute related to causing improper payments from Medicare, Medicaid, and other federally and state-funded government healthcare programs. The 2016 complaint says Dr. Asfora committed a variety of naughties:

1. submitting false claims for services;
2. implanting his devices in patients who didn’t need them, just to make a buck;
3. fraudulently and improperly billing and coding;
4. telling lies (the formal term is “misrepresentations”) to the FDA and others;
5. falsifying medical records;
6. systematically violating the Federal Anti-Kickback Statute; and
7. defrauding Uncle Sam;

…and Sanford Health and Sanford Clinic management “were aware of, permitted, actively encouraged, and financially benefitted from” all of Asfora’s fraud.

-snip-

The complaint alleges that Asfora stated that “he makes $3.5 million a year off his various implants.”

Read more: http://dakotafreepress.com/2019/06/30/doctors-allege-sanford-made-millions-on-medicare-medicaid-fraud-with-implanting-unnecessary-bone-screws/