Southeast Orthopedic Specialists reach $4.5M settlement with government

Southeast Orthopedic Specialists agreed to pay the government more than $4.5 million in a settlement over accusations that they over-billed Medicare.

The settlement document said the government accused the practice of going so far as to push patients into therapies they didn't need.

The practice has several locations throughout Northeast Florida.

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“They’ve done excellent work for me,” said Southeast Orthopedic Specialists patient Donald Hart. “They haven’t had any fraudulent billing with us. As a matter of fact, they recently refunded some of mine.”

In the settlement, the federal government accused Southeast Orthopedic Specialists of billing federal healthcare programs for services that were not medically necessary, including unnecessary ultrasound-guided injections and unnecessarily exceeding the Medicare cap on physical therapy.

“Our knee-jerk is (to) trust that professionals are doing the proper things and they are also making proper billings,” said Action News Jax Law and Safety Expert Dale Carson.

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Carson said it’s likely that patients won’t get reimbursed for any of their expenses.

“In a circumstance like this, if there were co-pays, things of that nature, then perhaps they would have some claim, but it would be so small as to not merit trying to prove it in court,” said Carson.

A statement from the practice’s CEO Donnie Romine said in part:

"At Southeast Orthopedic Specialists, our first priority is the well-being of our patients. As a matter of sound business practices we initiated an audit with an independent consulting organization that revealed historical technical coding questions that were corrected, and in cooperation with the federal authorities we reached a settlement without delay… All staff at Southeast Orthopedic Specialists thank our patients for their support as we continue our commitment to providing the highest quality orthopedic care to the entire First Coast community."

A spokesperson noted that “there was no determination of liability in the matter.”

The settlement said the accusations include billing from Jan. 1, 2010 through Sept. 29, 2016.

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