Wednesday, January 18, 2017

Neurosurgeon Sentenced for Health Care Fraud Involving Spinal Implant Devices. Admitted Hiding Financial Interest in Implant Company From California Hospitals

Spinal implant billing by hospitals has been an area of intense investigation and scrutiny for the past five years. Physicians who performed spinal surgeries at hospitals have been investigated to see whether they have ownership or other financial arrangement with companies selling implants to the hospitals. 

A recent case involving a neurosurgeon who used to practice in California where his plea agreement included admissions that he had an interest in an implant company that sold implants to California hospitals where he performed surgeries and that he his his financial interest from the hospitals. 

On January 8, 2017,  Detroit-area neurosurgeon Aria O. Sabit M.D., who previously practiced in Ventura, California, was sentenced to 235 months in prison after he pleaded guilty to four counts of health care fraud, one count of conspiracy to commit health care fraud and one count of unlawful distribution of a controlled substance. 

Before moving to moving to Michigan, Dr.  Sabit practiced in Ventura, California. Dr. Sabit admitted in his plea that in approximately February 2010, while he was on the staff of a California hospital, he became involved with Apex Medical Technologies LLC (Apex), which was owned by another neurosurgeon and three non-physicians. Dr. Sabit is also is a defendant in two civil False Claims Act cases brought by the Justice Department in the Central District of California and these cases are pending.  

In exchange for the opportunity to invest in Apex and share in its profits, Dr. Sabit admitted he agreed to convince his hospital to buy spinal implant devices from Apex and to use a substantial number Apex spinal implant devices in his surgical procedures. Dr. Sabit further admitted that he and Apex’s co-owners concealed Dr. Sabit’s involvement in Apex from the hospitals and surgical centers.

In connection with his guilty plea, Dr. Sabit admitted that the financial incentives provided to him by Apex and his co-conspirators caused him to use more spinal implant devices than were medically necessary to treat his patients in order to generate more sales revenue for Apex, which resulted in serious bodily injury to his patients. Dr. Sabit also admitted that, on a few occasions, the money he made from using Apex spinal implant devices motivated him either to refer patients for unnecessary spine surgeries or for more complex procedures that they did not need.

The allegations regarding Apex were not what caused Dr. Sabit to receive such a long sentence. The key portions of the plea and sentence were based on his activities in owning and operating the Michigan Brain and Spine Physicians Group. In connection with his guilty plea, Dr. Sabit admitted that he derived significant profits by convincing patients to undergo spinal fusion surgeries with “instrumentation” (medical devices designed to stabilize and strengthen the spine) that he never performed and billed public and private healthcare benefit programs for those fraudulent services. 

Dr. Sabit further admitted that, in some instances, he operated on patients and dictated in his operative reports – which he knew would later be used to support fraudulent insurance claims – that he had performed spinal fusion with instrumentation, when he had not. Specifically, Dr. Sabit admitted he fraudulently billed public and private health care programs for instrumentation when, in fact, he used cortical bone dowels made of tissue. Dr. Sabit further admitted he failed to render services in relation to lumbar and thoracic fusion surgeries, including in certain instances, billing for implants that were not provided.

The alleged health care fraud included his admissions that he caused harm to patients by performing unnecessary invasive spinal surgeries in his Michigan practice. The amount of losses to Medicare, Medicaid and various private insurance companies was agreed in the plea to be $2.8 million.

Due to the long statute of limitation, we can expect more cases based on surgeries and implants from 2010 to 2013. These cases take a long time to investigate and where conspiracy is charged the statute runs from the last date of the procedure or billing.

Posted by Tracy Green, Esq.
Green and Associates, Attorneys at Law
Phone: 213-233-2260


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