Surgeon Whistleblower Moves the Ball on Tuomey Regional

by Kurt Schulzke on March 3, 2008

Sumter, South Carolina orthopedic surgeon Michael Drakeford’s qui tam suit — originally filed in 2005 against Tuomey Regional Medical Center — is moving forward, according to recent reports by The and Modern Healthcare Online. Dr. Drakeford was the original plaintiff. However, as is typical in whistleblower cases, the U.S. Justice Department has “intervened” as lead plaintiff. The DOJ’s intervention greatly increases the likelihood of a payment by Tuomey through settlement or trial. This is good news for Drakeford who as the qui tam plaintiff stands to win between 15 and 25 percent of any recovery from Tuomey.

Drakeford is a former President of the South Carolina Orthopaedic Association. If his allegations prove true, they offer another illustration of the savvy-guy syndrome involving bright, highly-trained people who try to make money in ways that violate the law. Sometimes they violate out of ignorance. Often they do it relying on the advice or examples of “savvy guys” who have gone before.

The reports that — according to Drakeford and the Justice Department — Tuomey colluded with local doctors to bill millions more than legally permitted for medical services. Specifically, Drakeford’s complaint alleges — among other things — that:

  • in 2001, a group of Sumter doctors got the State’s permission to build a clinic for low-risk, outpatient surgery in competition with Tuomey;
  • Tuomey then began to enter into agreements with Sumter-area doctors pursuant to which Tuomey would pay the docs if they did their patients’ surgeries at Tuomey instead of at the docs’ clinic; and
  • Tuomey recruited Drakeford who (wisely) sought legal counsel and was told “don’t sign” because of Stark law issues.
  • Tuomey and Drakeford then jointly approached a second attorney who verbally opined that the contracts were “problematic”.

In the first court hearing on the matter, Assistant U.S. Attorney Norman Acker alleged that “Every time there was a referral, the hospital got money and the doctor got money.” Nineteen Sumter doctors allegedly signed contracts with Tuomey. Tuomey’s lawyers, however, insist that Tuomey has not violated any laws.

More details on this story are available at The and Modern Healthcare Online.

ht: Alan Rumph