3 recent payer battles involving spine surgeons


In the last two weeks, three payer battles have garnered attention in the spine and orthopedic community. 

Here are three court cases Becker's has covered since July 27:

1. A Missouri neurosurgeon was convicted of submitting false claims to CMS and was fined nearly $5.5 million by a Missouri Court of Appeals. 

2. A Texas spine surgeon was sued by an insurer who alleged that he performed medically unnecessary procedures in an attempt to inflate personal injury claims. Insurer State Farm alleges the surgeon owes more than $1.1 million in damages. 

3. A New York neurosurgeon was accused of bribing physicians for more patient referrals and performing medically unnecessary procedures to file claims. He allegedly gave more than $547,000 in gifts intended to bribe physicians and received more than $1 million in illegal paid claims.

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