Kevin Schoenfelder, Medicare Fraud, Washington 2018

Seattle – In a shocking case of medical malfeasance, a Tacoma spine surgeon has been caught billing government insurance programs for medically unnecessary spinal surgeries. U.S. Attorney Tessa M. Gorman announced the resolution of a False Claims Act qui tam matter alleging Kevin Schoenfelder, a former Orthopedic Surgeon, billed for procedures that put patients at risk of medical complications.

According to the settlement agreement, Dr. Schoenfelder, who retired in 2018 and surrendered his physician license in 2019, performed medically unnecessary spinal surgeries, among other allegations, between January 1, 2013, and June 30, 2018. These surgeries were billed to Medicare, TRICARE, and Veterans Affairs.

CHI Franciscan Health and St. Joseph Medical Center will pay $745,654 to resolve the matter, while Dr. Schoenfelder will pay $197,054 to resolve the case. Neither the doctor nor the hospital and CHI Franciscan are admitting wrongdoing. Each is paying the government health programs the amount that was improperly billed and additional penalties.

Dr. Daniel Nehls, who filed the qui tam lawsuit, will receive 22% of the payments to the government health programs. The settlement resolved a lawsuit filed under the qui tam provisions of the False Claims Act, which permit private parties known as relators to file suit on behalf of the government for false claims and to share in any recovery.

The resolution of this case was handled by Assistant United States Attorneys Kayla Stahman and Nickolas Bohl. The case highlights the importance of protecting taxpayer-funded healthcare and ensuring that patients receive quality care without putting them at risk of medical complications.

The settlement sends a message to doctors that patient safety and the integrity of our healthcare programs, including the Department of Defense's TRICARE program, are paramount. Health care providers who perform medically unnecessary procedures compromise the integrity of Federal health care programs and expose their patients to potential harm.

Source: https://www.justice.gov/usao-wdwa/pr/doj-resolves-allegations-tacoma-spine-surgeon-billed-unnecessary-surgeries