TG- What happened?

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Anonymous said:
With all of the nonsense that occurs in my region, it would seem the DOJ would benefit most by actually going after Donjoy. Paying off staff members is not an Orthofix-specific problem. DJO, at least on this side of the big river, is known to be crooked.
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Let's get to the real problem. Execs at top orchestrated the scam a long time ago...1994. Biomet the worst. If the roots are pulled up, that is where it starts. The fraud has too many tenacles to be one silver bullet. They will all fall in time....big time....it's too big now...paying fines with public money and sending VP's to jail is a travesty of justice.
 


















Anonymous said:
Let's get to the real problem. Execs at top orchestrated the scam a long time ago...1994. Biomet the worst. If the roots are pulled up, that is where it starts. The fraud has too many tenacles to be one silver bullet. They will all fall in time....big time....it's too big now...paying fines with public money and sending VP's to jail is a travesty of justice.
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Agree. "It will all come out in the Wash".....Grandma
 




































U.S. Attorney’s Office - January 23, 2013

Thomas P. Guerrieri, 52, was sentenced by U.S. District Judge Rya W. Zobel to eight months in prison and ordered to pay a fine of $20,000 and to forfeit $30,000. In April 2012, Guerrieri pleaded guilty to paying kickbacks.

Guerrieri, the former vice president of Sales of Orthofix Inc., admitted that he paid kickbacks to two separate health care professionals, in violation of the Medicare AntiKickback Law.

Guerrieri authorized kickbacks in two separate transactions in order to induce bone growth stimulator orders from two of Orthofix’s highest-prescribing physicians. First, Guerrieri facilitated a bogus “consulting” agreement with a surgeon in New York. The surgeon was paid tens of thousands of dollars but provided little or no consulting services in return. This surgeon failed to document his services in time sheets provided to the company, even though he was paid every month. During a meeting in August 2007, the surgeon, Guerrieri, and another Orthofix employee hatched a scheme to create and backdate time sheets going back to 2006, making it appear as though the surgeon filled out these forms contemporaneously and performed legitimate consulting services. In addition, Guerrieri obtained a letter from the company’s general counsel indicating that the surgeon was compliant under his consulting agreement, which was not true.

Second, Guerrieri authorized kickbacks to pay a physician’s assistant in Rhode Island, Michael Cobb, for each bone growth stimulator he ordered. Cobb was responsible for ordering bone growth stimulators for the surgeon who employed him. For years, Orthofix paid Cobb $50-$100 for each stimulator that he ordered. In September 2008, Orthofix issued a policy expressly prohibiting any payments to anyone who works for a surgeon that prescribes Orthofix products. Guerrieri was concerned that Orthofix would lose business if it could no longer pay Cobb. Thus, Guerrieri executed a scheme where Cobb continued to be paid for each order, but the payments were made by an Orthofix vendor, making it more difficult to trace the paper trail back to Orthofix. In July 2012, Cobb was sentenced to six months in prison and six months home confinement for accepting these kickbacks in addition to forfeiture of $40,000 and a $4,000 fine.

Guerrieri also obstructed justice in connection with the government’s investigation. In the midst of the investigation, Guerrieri instructed the sales force that, if they were asked by government investigators if they manipulated Medicare Certificates of Medical Necessity (CMNs), they should lie and state that they had not done so. Manipulation of CMNs was the conduct at issue in the recent Orthofix conviction, as described below.

In addition to the Guerrieri sentence, the Orthofix investigation has, to date, resulted in a number of felony charges against employees and contractors of Orthofix, including the following:

In December 2012, Orthofix was convicted of obstruction of a federal audit and ordered to pay $42 million in criminal fines and civil payments and was sentenced to probation for five years;

In January 2013, Derrick Field, a former Orthofix territory manager, was sentenced to five months of home confinement as part of a two-year probation sentence;
In December 2011, Mitchell Salzman pleaded guilty while he was a regional manager for Orthofix;

In May 2012, Michael McKay pleaded guilty to health care fraud while he was a territory manager for Orthofix; and

In September 2012, Brian Racey pleaded guilty to health care fraud while he was a territory manager for Orthofix.
 






Anonymous said:
Understand TG was supposed to be sentenced in Boston yesterday. Anyone hear what the outcome was?
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Another Orthofix Defendant Sentenced for Committing Medicare Fraud



JANUARY 24, 2013


BOSTON – A former Orthofix territory manager was sentenced yesterday for defrauding Medicare by forging patient medical records.

Michael J. McKay, 32, was sentenced by U.S. District Court Judge Denise J. Casper to one year of probation, with the first three months to be served in home confinement, and ordered to forfeit $10,000 and pay a fine of $3,000. In May 2012, McKay pleaded guilty to healthcare fraud.

Between 2008 and 2009 McKay was a territory manager for Orthofix, a company that manufactured and distributed bone growth stimulator medical devices that were intended to assist patients with bone fractures that did not heal properly. Medicare and many private insurance carriers have specific guidelines describing when it will pay for bone growth stimulators. When McKay received orders for patients that did not satisfy these guidelines, McKay frequently falsified the patients’ medical records to make it appear as though the order met Medicare’s rules so that Medicare would pay for a claim that otherwise would not be covered. Between 2008 and 2010, federal insurance carriers paid more than $70,000 for bone growth stimulators for claims where McKay falsified medical records. McKay altered physician’s chart notes, changing the dates of patient visits, describing patient visits that did not occur, and inserting false diagnoses. McKay also forged prescriptions and Medicare Certificates of Medical Necessity within the orders. Orthofix fired McKay after it discovered his fraud. Even after he was fired, however, McKay continued to submit orders for stimulators by submitting them to a colleague, Derrick Field, who split the commissions with Field. Even after he was fired, McKay continued to forge chart notes, prescriptions and CMNs in the orders he submitted to Field. On January 9, 2013, Field was sentenced to five months home confinement, two years of probation, and $44,000 in fines and forfeiture.

In addition to the McKay sentence, the Orthofix investigation has to date resulted in a number of felony charges against employees and contractors of Orthofix, including the following:
•In December 2012, Orthofix was convicted of obstruction of a federal audit, and ordered to pay $42 million in criminal fines and civil payments, and was sentenced to probation for five years;
•On January 22, 2013, Tom Guerrieri, the former vice president of sales for Orthofix, was sentenced to eight months in prison and ordered to pay $50,000 in fines and forfeiture for paying kickbacks;
•In July 2012, Michael Cobb, a physician’s assistant, was sentenced to six months in prison, six months home confinement, and ordered to forfeit $10,000 and pay a $3,000 fine for accepting kickbacks from Orthofix;
•In December 2011, Mitchell Salzman pleaded guilty while he was a regional manager for Orthofix and is scheduled to be sentenced on Jan. 31, 2013; and
•In September 2012, Brian Racey pleaded guilty to health care while he was a territory manager for Orthofix and is scheduled to be sentenced on Feb. 20, 2013 in the U.S. District Court for the Eastern District of Pennsylvania.

This case was investigated by the U.S. Department of Health and Human Services, Office of Inspector General, Office of Investigations; the Federal Bureau of Investigation Boston Field Division; and the Department of Defense, Defense Criminal Investigative Service – Boston Resident Agency. It was being prosecuted by Assistant U.S. Attorneys David Schumacher and Jeremy Sternberg of Ortiz's Health Care Fraud Unit.
 




































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