Fort Myers doctor to pay $1.7 M for medical fraud

A Fort Myers doctor will be paying $1.7 million to resolve allegations of fraud, according to the Department of Justice.

Dr. Jonathan Daitch, M.D. has agreed to a civil settlement that will pay $1.718 million to the United States to resolve allegations that he violated the False Claims Act by receiving illegal kickbacks associated with the provision of anesthesia services and by causing the submission of medically unnecessary urine tests.

Dr. Daitch was a practicing interventional pain management specialist and one of two principal owners of Advanced Pain Management Specialists, P.A. in Fort Myers. The other principal owner, Dr. Michael Frey, previously pleaded guilty to two counts of conspiracy to receive healthcare kickbacks and has agreed to a civil settlement with the United States for $2.8 million, the DOJ said.

From 2013 through 2016, Dr. Daitch submitted false claims to Medicare and Tricare by ordering Urine Drug Testing (“UDT”) in circumstances where such testing was not reasonable or medically necessary. Definitive UDT testing was financially lucrative for Dr. Daitch because the testing was performed at Advanced Pain’s own in-house laboratory and was billed for by the practice, the DOJ said.

The civil settlement also resolves kickback allegations associated with anesthesia services provided by Anesthesia Partners of SWFL, LLC. Anesthesia Partners was owned by Dr. Daitch and his partner Dr. Frey and provided anesthesia services exclusively for the procedures performed by the Advanced Pain physicians.

Anesthesia Partners contracted with Certified Registered Nurse Anesthetists (“CRNAs”) to provide the anesthesia services. These CRNAs were paid a contracted rate. Anesthesia Partners then billed Medicare and Tricare directly for the anesthesia services they provided. This arrangement resulted in improper remuneration to Dr. Daitch as one of the owners Anesthesia Partners. The United States contends that Dr. Daitch’s ownership interest in Anesthesia Partners, and the remuneration he received through this ownership interest, influenced him to refer his patients for anesthesia services to Anesthesia Partners.

On July 9, 2018, the Centers for Medicare & Medicaid Services (“CMS”) suspended all Medicare payments to Anesthesia Partners. As part of this settlement, the United States will retain the funds withheld as a result of the suspension.

“The investigation of this healthcare company, which has resulted in three guilty pleas and more than $4.5 million returned to the taxpayers, is a great example of our commitment to enforce our nation’s health care laws,” said United States Attorney Chapa Lopez.

In addition to the civil settlement, Dr. Daitch, Advanced Pain, and Park Center for Procedures (“Park Center”—an ambulatory surgical center also owned by Drs. Daitch and Frey, which provides services to patients of Advanced Pain) have entered into a five-year Corporate Integrity Agreement with the Office of Inspector General of the United States Department of Health and Human Services. The Corporate Integrity Agreement, among other obligations, requires Dr. Daitch, Advanced Pain, and Park Center to hire an independent review organization to monitor both claims and financial arrangements. That information, along with other information, will then be reported annually to OIG, according to the DOJ.

“OIG will continue to aggressively investigate physicians disregarding their Hippocratic Oath in order to enrich themselves through illegal kickback arrangements and the ordering of unnecessary medical services,” said Shimon R. Richmond, Special Agent in Charge for the Office of Inspector General of the U.S. Department of Health and Human Services.

The investigation was handled by Assistant U.S. Attorney Kyle S. Cohen, with assistance from DCIS and the Department of Health and Human Services Office of Inspector General.

Tips 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). The claims resolved by the settlement are allegations only, and there has been no determination of liability.