26 January 2023. The United States Department of Justice settled a qui tam False Claims Act case against medical device manufacturer DePuy Synthes, Inc. (DePuy). Under the terms of the settlement, the Johnson & Johnson subsidiary paid $9.75 million. A former sales representative for the medical device company blew the whistle on the company’s alleged practice of paying kickbacks, in the form of free implants and instruments, to an orthopedic surgeon to use in surgeries for people overseas in order to induce them to use the same company’s devices in Medicare and Medicaid patients in the U.S.
Per the allegations, DePuy provided free products, enumerated in the settlement agreement as “cages, rods, screws, plates, and a modular access and retraction system,” to a Massachusetts-based orthopedic surgeon. The surgeon then used these free products to perform at least 20 spine-related surgeries in six Middle Eastern countries, over a period of approximately five years. The surgeon also used DePuy products in spinal surgeries performed on Medicare and Medicaid patients in the U.S., for which they billed the government-funded healthcare programs. Certain sales representatives were key to funneling the surgical products to the surgeon. According to the DOJ, the medical device company gave the surgeon over $100,000 in surgical products as improper inducements to use the same brand of devices in surgeries on Medicare and Medicaid beneficiaries.
Medical patients have a right to medical care that is free from undue influence by corporations. In this case, the medical device company gave a surgeon specialized spinal implants and surgical tools for their free use, to incentivize the surgeon to use that same company’s devices in surgeries which are billed to Medicaid and Medicare. “Unlawful kickbacks can severely distort medical judgment as well as the market for medical devices,” stated the U.S. Attorney for the District of Massachusetts. “The millions of patients that depend on our health care system deserve untainted medical decisions.” The Anti-Kickback Statute is a law that makes it illegal for medical professionals to accept anything of monetary value in exchange for federally funded healthcare program business.
The Commonwealth of Massachusetts has a False Claims Act. In this case, the medical device manufacturer is paying approximately $7.23 million to the federal government and $2.52 million to Massachusetts for false claims made to the Commonwealth’s Medicaid program. For reporting Medicare and Medicaid fraud, out of the government’s recovery, the relator will receive a $1,374,460.36 million reward from the United States, $478,039.64 from the Commonwealth of Massachusetts, and $209,968.50 for attorneys’ fees from the medical device manufacturer. If you suspect your employer or a company you work with is defrauding government-funded programs such as Medicare or Medicaid, don’t delay. Contact the whistleblower attorneys at Tycko & Zavareei LLP.
Eva Gunasekera and Renée Brooker are former officials of the United States Department of Justice and prosecuted whistleblower cases under the False Claims Act. Eva was the Senior Counsel for Health Care Fraud. Renée served as Assistant Director at the United States Department of Justice, the office that supervises False Claims Act cases in all 94 United States District Courts. Eva and Renée now represent whistleblowers. For a free consultation, you can contact Eva Gunasekera at [email protected] or contact Renée at [email protected] (tel.: 202-417-3664). Visit Tycko & Zavareei LLP’s website for whistleblowers to learn more at https://www.fraudfighters.net/.