US Attorney Tessa M. Gorman announced the resolution of a False Claims Act qui tam matter alleging a Tacoma physician billed government insurance programs for medically unnecessary spinal surgeries. CHI Franciscan Health and St. Joseph Medical Center will pay $745,654 to resolve the matter and former Orthopedic Surgeon Kevin Schoenfelder will pay $197,054 to resolve the case. According to the settlement agreement, on May 21, 2018, Dr. Daniel Nehls filed a qui tam lawsuit alleging Dr. Schoenfelder had been performing medically unnecessary spinal surgeries, among other allegations. CHI resolved claims that the hospital billed for Dr. Schoenfelder’s performance of spinal surgery at more spinal levels than necessary and medically unnecessary spinal fusions at Tacoma’s St. Joseph Hospital. Dr. Scheonfelder resolved claims pertaining to his performance of allegedly medically unnecessary spinal surgeries. Between January 1, 2013, and June 30, 2018, these surgeries were billed to government health programs when they were not medically necessary. The surgeries were billed to Medicare, TRICARE, and Veterans Affairs. In resolving 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.
