For­mer hos­pi­tal CFO, two sur­geons face charges in kick­back scheme

Modern Healthcare - - REGIONAL NEWS - —Michael Sandler

Fed­eral pros­e­cu­tors an­nounced charges last week against a for­mer hos­pi­tal chief fi­nan­cial of­fi­cer, two sur­geons and two other de­fen­dants in a kick­back scheme in­volv­ing nearly $600 mil­lion in fraud­u­lent claims for spinal surg­eries in Southern Cal­i­for­nia.

Ac­cord­ing to the U.S. at­tor­ney’s of­fice for the Cen­tral Dis­trict of Cal­i­for­nia, doc­tors and chi­ro­prac­tors were paid kick­backs to fun­nel pa­tients to Pa­cific Hos­pi­tal in Long Beach, where Joseph Canedo was CFO. Canedo pleaded guilty Sept. 4 to par­tic­i­pat­ing in a con­spir­acy, in­clud­ing kick­backs and mail fraud.

Michael Drobot, the for­mer CEO of Pa­cific Hos­pi­tal, pleaded guilty in 2014 to a role in the scheme and is co­op­er­at­ing with in­ves­ti­ga­tors. Drobot and his col­leagues, ac­cord­ing to the U.S. at­tor­ney’s of­fice, paid doc­tors’ kick­backs of $15,000 for each lum­bar fu­sion surgery and $10,000 for each cer­vi­cal fu­sion surgery and then billed work­ers’ com­pen­sa­tion in­sur­ers and the fed­eral gov­ern­ment for the pro­ce­dures.

Canedo was al­legedly re­spon­si­ble for track­ing the pay­ments to the clin­i­cians and tal­ly­ing the num­ber of pa­tients and pay­ments yielded by their re­fer­rals.

Pros­e­cu­tors also un­sealed con­spir­acy charges against or­tho­pe­dic sur­geon Dr. Philip Sobol and chi­ro­prac­tor Alan Ivar, who both agreed to plead guilty, of­fi­cials said. Ivar said he re­ceived a monthly re­tainer for a decade to send pa­tients to Pa­cific. An­other or­tho­pe­dic sur­geon, Dr. Mitchell Cohen, agreed last week to plead guilty to fil­ing a false tax re­turn.

Paul Richard Ran­dall, de­scribed by pros­e­cu­tors as a health­care mar­keter, also pleaded guilty to charges re­lated to the scheme. He ad­mit­ted to re­cruit­ing doc­tors and chi­ro­prac­tors to re­fer pa­tients to Pa­cific and an­other hos­pi­tal, TriC­ity Med­i­cal Cen­ter in Hawai­ian Gar­dens, Calif. Of­fi­cials said all five de­fen­dants have agreed to co­op­er­ate with the in­ves­ti­ga­tion, which pros­e­cu­tors have dubbed Op­er­a­tion Spinal Cap.

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