Detroit Mesh-Removal Financier: Paid to Send Women Back Into Surgery

The mesh removal plea exposed a paid referral business: the Detroit owner of Surgical Assistance Inc. admitted taking part in a bribery and kickback scheme that sent women for surgery. The Department of Justice’s account of the guilty pleas describes a physician and others paying him for referrals. Women seeking compensation for an implant injury had become a source of income for the people sending them back into surgery.

The recruiter also owned Medical Funding Consultants LLC. The physician owned MedSurg Holdings LLC and was an Orlando, Florida urogynecologist, according to the Department of Justice’s charging announcement. The criminal allegations also described purchasing and reselling women’s medical debts for profit. This was a business built around removing a device already implanted, with money to be made from the referral and the debt.

For someone working in surgical funding, patient recruitment or a physician’s office, the important connection is between the recommendation, the referral and the money. In a medical-device whistleblower matter involving government payments, we also examine how that conduct affected the bill submitted to the government.

Why Mesh Removal Had Settlement Value

Women whose mesh implants were surgically removed were entitled to larger settlements than women whose implants remained in place. The Department of Justice described that incentive in its account of court filings and facts presented at the plea proceeding. The participants sought to profit from the difference.

The prospect of a larger settlement helped make removal a business opportunity. The physician gained a patient, the recruiter received a referral payment, and the financing scheme allegedly made money buying and reselling the patient’s medical debt. A woman seeking compensation for harm from an implant became a source of further business when she agreed to have it removed.

What Women Were Allegedly Told

The May 2019 charging announcement said the indictment alleged false representations about implant risks and the need to travel long distances and incur significant debt for removal surgery. The indictment charged that participants used those representations to entice women across the country into agreeing to the operations.

The alleged pitch reached beyond the condition of the mesh. It concerned where a woman needed to go and what she needed to owe to have it removed. Those are decisions that connect the patient’s health concerns to the surgery and financing businesses.

A recruitment employee may know the language used to describe the implant’s risks. A scheduling employee may know how a patient reached the practice. A funding employee may know how the resulting bill became a debt transaction. Read together, those accounts can show how a medical concern became a referral and then a financial obligation.

The Alleged Trade in Patient Debt

The alleged mesh-removal financing scheme included buying and reselling, for profit, the medical debts women incurred. That added another commercial interest to the procedure. The surgery generated the obligation, and the obligation itself could be traded.

Following a patient only as far as the operating room leaves the debt sale out of the story.

For an insider in Surgical Assistance or Medical Funding Consultants, knowledge of the funding business may connect those transactions to the same women whose referrals generated payments. The useful question is what the business did with the debt after the operation, alongside what it did to bring the patient to the physician.

What Are Some Examples of Kickbacks in Healthcare?

Paying a recruiter to send patients for surgery is a health care kickback example established by these guilty pleas. The physician and others paid the surgical-funding business owner in exchange for referrals of women for transvaginal mesh removal. The Department of Justice’s account of facts presented at the plea proceeding includes women who traveled across the United States for the operations.

The Detroit business owner pleaded guilty on September 14, 2021. The physician pleaded guilty on September 17, 2021. The Department of Justice described both pleas as participation in the bribery and kickback scheme.

The direction of the payment matters. The physician was paying the person who could bring patients to the practice. That makes the recruitment relationship part of the surgery’s economics, alongside the medical bill and the patient’s expected settlement. For someone who handled the referrals or payments, that relationship may be the part of the business they can explain most precisely.

Selling the Implant, Then Selling Its Removal

A California court found that Ethicon understated the risks of pelvic mesh in its marketing. The removal-financing indictment alleged false representations about implant risks used to persuade women to undergo another surgery.

For an insider, the connection is the sales message: who made it, what it promised and whose business benefited from the patient’s decision.

The Records Behind the Referral and the Debt

Referral records, surgical bills, funding agreements and debt-sale records can connect the patient decision to the money. In a matter built around surgery and financing, each answers a different part of the same question: who benefited when a woman agreed to removal?

Patient-contact records may show the risk statements used in recruitment. Referral and scheduling records may connect those contacts to the physician who performed the operation. Funding and debt records may show what happened to the bill, while payment records may connect the referring business to money from the physician. These are the connections we would examine with an insider.

A person inside the funding business may understand the debt transaction without having heard the medical pitch. Someone inside the practice may know the referral arrangement without seeing a later debt sale. Our work is to connect what each person knows to the decisions and payments that made the business run.

For government-paid health care, the 2020 Journal of Forensic and Investigative Accounting review A Forensic Accountant’s Guide to the Most Potent Federal Laws Used Against Healthcare Fraud explains that referral payments can run through cash or other compensation, directly or indirectly. Its discussion concerns services paid for by Medicare, Medicaid or another federal program. The business relationship and the government bill matter together when we assess a potential whistleblower case.

A whistleblower case under the False Claims Act can pay 15% to 30% of what the government recovers. Whether your knowledge supports that kind of case is something our whistleblower experts work through with you.

You Know How the Patients Reached the Practice

If you worked with mesh-removal referrals, surgical funding or patient debt, tell our whistleblower experts how the arrangements worked. We build the case with you around the patient decisions and payments you can explain, bring in medical-device fraud whistleblower lawyers with experience in referral arrangements, and stay beside you throughout the case.