Outpatient Surgery Magazine - Subscribers

Secrets to Speedier Room Turnover - November 2013 - Outpatient Surgery Magazine

Outpatient Surgery Magazine, providing current information on Surgical Services, Surgical Facility Administration, Outpatient Surgery News and Trends, OR Excellence and more.

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Page 30 of 156

OSE_1311_part1_Layout 1 11/6/13 8:57 AM Page 31 LEGAL UPDATE their investments than Meridian was, and that only physicians who referred Medicare patients were permitted to become owners. (See "Former Business Manager Sues ASC, Corporate Partner Over Alleged Kickbacks" at tinyurl.com/kdkrpvg). In the civil action, Mr. Simmons alleges that Treasure Coast and Meridian defrauded Medicare of an estimated $100 million. Mr. Simmons contends in court records that the defendants' distributions to physician-owners were intended as improper compensation for referrals. As such, they ran afoul of the federal Anti-Kickback Statute. Because the referrals included many Medicare payments, the distributions also violated the federal False Claims Act, the suit alleges. In the lawsuit, which federal prosecutors have declined to join, Mr. Simmons is seeking a jury trial, financial restitution and (in accordance with federal whistleblower law) a share of any recovered funds. Meridian and Treasure Coast counter that Mr. Simmons's allegations are false. Their physician-owner distributions, they argue, are issued strictly in accordance with equity percentages. They also point out that Mr. Simmons was terminated as business office manager for allegedly misappropriating funds. Right side of the line Whatever its eventual outcome, the case shows the scrutiny and risk that surgical centers face even when entering into common arrangements that are generally viewed as commercially reasonable, and not fraught with fraud and abuse. Simmons v. Meridian revolves around business valuation principles, and as such has the potential to bring more regulatory attention to, and to adversely impact, how ASC transactions are handled. Whistleblower lawsuits often trigger Medicare fraud enforcement. N O V E M B E R 2013 | O U T PAT I E N T S U R G E R Y M A G A Z I N E O N L I N E 3 1

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