Friday, April 27, 2012

"Helping Hospitals Cut Cost for Spinal Implants"

On Thursday, April 26th, the Marin County Independent Journal reported that the Santa Clara County District Attorney's Office had filed criminal and fraud charges against the CEO and Medical Director for a company known as Implantium.  The charges in question stem from the DA's charge that Implantium has been over billing Santa Clara County and the taxpayers of San Jose for the cost of spinal implants for government employees, allowing the company and its officers to profit tens of thousands of dollars while public agencies were forced to compensate by "jacking up" workers' comp premiums.

The parties in question are Trudy Maurer, CEO, and Tigran Shahsuvarya, the company's Medical Director.  Mauer is to be arraigned on May 1, 2012, while Shahsuvarya is to be arraigned on April 30th at the Santa Clara Superior Court.  If convicted, both could face up to 13 years in prison and a monetary penalty of $50,000 per count.

So who is Implantium?  Besides being the company whose tag line is, "Helping Hospitals Cut Cost for Spinal Implants," based on their website www.implantium.homestead.com, Implantium acts as a third party billing intermediary that enters into arrangements with hospitals to defer the cost for using spinal implants on workers' compensation patients.  As a third party billing company, Implantium assumes the carrying cost for these implants since the average reimbursement time in the State of Ca-li-for-nia is 170 days. What the State Workers' Compensation Board and the Federal Government are learning is that these shell companies or pyramids involve lawyers, surgeons and various frontmen and or women that have mastered the art of usury when it comes to medical devices and workers' comp claims.  

If Implantium is acting as a third party billing company without actually handling the product there must be some financial incentive to use products from Implantium, and or the 45 various companies that Implantium supposedly works with, besides deferring the carrying cost.  Could it be that someone higher up in the food chain is being compensated?  Who are the lawyers, investment bankers, and surgeons involved with Implantium? Legally, Implantium must be working with a lawyer or lawyers and surgeons, who are funneling the patients or advising Implantium on how to run this alleged operation.  Many of our readers know this scam, since TSB is sure that there are many whom have been approached about acting as an intermediary to carry the cost of the product for months. Maybe its time that the Prosecutor in this case start serving some subpoena's to the hospitals and surgeons involved.

By California law, Implantium is allowed to profit up to $250 per device, but Trudy Maurer is accused of altering invoices for as much as tens of thousands of dollars.  This story sounds familiar with what was recently reported in the Wall Street Journal regarding the shenanigans that have been taking place in the local Long Beach, California area.  The invoices in question go as far back as 2008.  God help Trudy and Tigran if they are found guilty, TSB would hate to think how many patients were involved.  If not for a San Jose City Attorney who was performing an audit and took notice of the claims the alleged gravy train could have just kept going on.  So TSB must ask the question, will the California State Board of Workers' Compensation and its Governor Jerry Brown take notice of some of the nefarious dealings going on in the Golden State or, will it be business as usual?

This is a golden opportunity for the State of California to evaluate many so-called business models that have surface, all for the love of the Almighty Dollar. But how many of these scams exist on a national level?  How many of you have been approached by someone asking you to front such an operation?  How many of you have lost money as a distributor getting involved in these deals?  Maybe the Prosecutor should squeeze all the parties involved in this case so they sing like canaries.  They just may find out how deeply rooted this scam really goes. TSB wants to know what our readers think?  Do we start in the East Bay? 

As I drive to Mill Valley, TSB has Tony Bennett on the the iPhone singing his heart out,

"I left my heart in San Francisco, High on the Hill it calls to me
To be where little cable cars climb halfway to the stars
The morning fog may chill the air, I don't care

Who knows if convicted, Implantium can work on a new tag line for their website.

Kudos goes out to our source in the Bay Area.

62 comments:

  1. This does not come as a surprise! Perhaps now the FED's will have a trail to the other corrupt doc's in the bay area.

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  2. Implantium is going down, but web site still up for now


    Off topic from:
    Ortho-Spine Opportunities Network

    "..4 people have joined the group, including Stephen Lubischer who has joined.." ?

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    1. Huh?? Perhaps old Dirk is not happy with the results. The turn and burn in the industry continues.

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    2. Looks like Michael Plunkett is new VP of Sales--guess Les is hard to work for.

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    3. This industry is F'd up! When will some of the leadership in this industry understand that 2007 does not exist anymore, we're not going back, companies are growing at single digits and people need to stop smoking whatever it is creating these expectations. As for Les and Dirk, they wouldn't have a clue even if it came up and bit them in the ass.

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    4. Well the market has a clue--and that's why ATEC is 2.24--funny thing is if they knew how much of their sales are attributable to PODs the price would probably be below a buck!

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    5. So you know how much is thru POD's and they don't? Wow! You must be the smartest coverage rep out there!

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    6. Horrible company with horrible people.

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  3. It was only time until this early POD scam was highlighted. Interestingly, sitting across from Trudy Maurer's desk in the same office is none other that Dr. Kenneth Light founder of The Spine Network of California. Light and Maurer, several years ago recruited the "who's who" of spine surgeons in California to form a collective that would control spine surgery in the state.
    Sales presentations were respectfully heard by Light but at the end you were told to work with Trudy Maurer as she "negotiated" the price you could sell it to HER.
    Google The Spine Network of California and Dr. Ken Light will appear. The tag line list Trudy Maurer as the CEO. Give them credit as they have created a marketing machine. It's too bad she/they got greedy.

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  4. There are 20 of these dirtbag companies operating in Southern California. The charge work comp $5,000 per screw and $20,000 for a cage. They also bill as manufactures which they are not.

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    1. The only way to eradicate this cancer is by performing a whipple, start naming names.

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  5. It already has been quite a few years since I shied away from working with the Spine Network. i.e. Ms. Maurer and her Guiding Light. Revisiting the website makes two things clear: plastic surgery does change your appearance and the network has shrunk, not grown. You got to love Trudy's video on that website announcing the patient advocacy service. I vote for Dolly Parton playing the movie part....

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  6. SO as everyone is aware The VP of Xspineless is getting phased out! Will the company be more profitable with the tools that are left to run the show? Will Dr K have to go back to performing surgeries since according to him is the father of modern spine surgery. Will the brothers that run the show figure out that with out Plastic Joe sales go away

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    1. They will probably increase their bottom line once Plasticine man is gone, if he isn't already.

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    2. Heard he had a sweet deal--but don't worry about them- Danny boy will pick up the flag ;-)

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    3. Danny boy please! He is hanging on by a thread over an alleged sexual harasment issue. RUmor out of AZ is screw is backing out of cervical plate...

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  7. If there any truth to these charges, there is a distinction in providing excellent medical care for your patients and ripping off workers' comp insurance, even the patients need to understand this. This is what is driving up the cost of healthcare in this country and we all pay for it when people cheat, lie or steal. If proven, everyone should walk the gang plank.

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    1. 9:36, its 110% true! Trust me on this one. Spine Network has been "operating" this scam for years. I knew one day this shit would catch up to her and her side kick, Tigran.

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  8. After viewing the spine network website I didn't know spine surgeons had an agent working for them

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  9. Trudy love the outfit when will you be doing a video playing the piano in the background? As the late Fernando Llama once said: Dallin' you look mahvelous.

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  10. Ken Light should be joining Trudy and her side kick in prison

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    1. Agree completely, how is that he is not named?

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    2. Oh, he wil be named. She will sing like a bird to protect herself.

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  11. What about the crooks in souther CA. Medical Acquisitions or I think they go by MAC. We are really talking about some real shady characters here.

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    1. That's strange, MAC doesn't acquire WC accounts nor does it bill worker's compensation.

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  12. Hopefully someone will be looking into Ken Light's practices. He is the worst, he should be RED FLAGGED. The only reason why he has high volume of surgeries is because he does 5-7 surgeries on each patients.

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    1. What do you mean..."5-7 surgeries on each patient"? He is supposed to do my Double Disk Replacement in C4/C5! Can I even trust his opinion now! UCSF Spine Center experience was a joke...long story...including not being FDA approved to do more than a Single Disk Replacement. Anyone out there know of other REPUTABLE Surgeon's who can handle this. Looks more and more like I may have to go International:(

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  13. Trudy karma is a bitch. Remember all the little people that you step on along the way, forget about karma, payback will be a bitch.

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    1. I waited for this Karma a long time!

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  14. Hopefully this be another event to shed light (no pun intended) on the widespread corruption in this industry, and carry consequences severe enough for surgeons to begin wondering if they should consider changing their business models. There are many involved with this scheme and others like it in this area. You all know who they are. Anyone care to toss out some names?

    Maybe honest dealings with legitimate vendors/representatives will again be of value to hospitals and state/federal governments.

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  15. Unfortunately this world is full of greedy, narcissistic, and deceitful people who will manipulate and literally ruin others for profit. A good rule of thumb is to stay away from any company whose sole function is to do billing for worker’s compensation. They are either keeping an outrageous percentage for doing the billing or asserting fraudulent charges to make a profit. Since the whole Premier Medical Management Systems scandal unfolded it appears that the authorities are watching out for these crooks too. I hope they bust them all. Farewell opportunists!

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  16. SeaSpine is the joke of So. Cal as much as Lanx is the Jester of Colorado!
    Any doc using these companies has only one thing in mind!

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  17. Extra Extra Globus goes public in need of cash to support massive lawsuits.

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    1. 6:33pm, you're probably just making-up some BS because you hate the Globus rep in your area, but on the real, what's up with all of the Globus reps looking to jump ship the second Globus makes its IPO? Literally 1 day after Globus announced that it will go public soon, the top Globus rep in my area came to me and said that he wanted to come work for us. Of course he wanted to wait until after the IPO because he has a shit-ton of shares that won't fully vest if he leaves before...or at least that's what he said.

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    2. Lawsuits are true, most Globust reps are ASC's from Synthes barely wet behind their ears.
      That stock is so diluted with a majority of revenues coming from consultant surgeons.

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  18. TSB wrote an inaccuracy based on the facts and charges in this case as reported in various news outlets:

    "By California law, Implantium is allowed to profit up to $250 per device, but Trudy Maurer is accused of altering implants for as much as tens of thousands of dollars."

    The charges are for altering invoices, not implants. Huge difference.

    Schmucks-yes, but they are innocent until proven guilty. God bless America and all the ships at sea.

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  19. California Love - "Diego to the Bay."

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  20. As per 7:05's observation, TSB stands corrected as per our edition to this post. As for alluding that they are guilty, TSB never accused them of being guilty, we'll leave that up to the court of public opinion and a jury of their peers. As some wise sage once said; "it takes less energy to be professional and nice to people rather than stepping on people and crushing them. So remember, the same people you stepped on, on your way up, will be the same people that crush you on your way down." Power does dilute one's sense of reality.

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  21. What's the difference between what Trudy is advertising vs. PDP, Access Mediquip, et al? Is this an assault on that whole part of the industry, or was Trudy up to something that the others are not? Are they staying within the approved bounds of the $250 per device? Seems like a slim margin relative to the risk of not getting reimbursed for the extra 140 days....

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    1. $250 x10 devices minimum for a single level screw construct (4 screws, 4 set screws, 2 rods) is not a bad margin. Anybody know if they buy legitimate implants or is there a POD wrapped up in this deal and they are buying Spinal USA? If thats the case, $2500 is more than she pays for the implants.

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    2. they were at one time using Spine Tech, now Zimmer Spine. Hench where they talk about the BAK cage on their website.

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  22. How is old Spinal USA doing? Heard some "interesting" details... BTW - their prices are A LOT higher than the ones listed above.

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  23. Implantium doesn't care what company the surgeon uses. When there is a case scheduled, if the surgeon 'owner' wants to get his % (kickback?) he lets Implantium know that there is a case coming. The rep gets a call from Tigrin, telling him to fax the charge sheet to him, rather than submit it to materials management. If you give Tigrin any pushback, he gets pissy. They bill for the implants instead of the hospital. So they take the huge mark-up, plus their little $250/device slice. I am sure that they are creative in their accounting, so that after salaries, distributions (kickbacks,) entertainment, overhead, etc., they usually stay within their $250 limit. My guess is that Trudy is being hit for the ridiculous mark-up, which may open the doors for the feds to go after hospitals for their ridiculous mark-up. The justice department will probably stop short of going after the hospitals, though, since they are just as sleazy as Trudy.

    There are a few companies that have told Trudy to stick-it, mainly Medtronic, for which I respect them, but most companies don't care, as long as they get paid. In fact, in most cases, Implantium has no problem paying list. Access Mediquip is a similar scam, but they try to get reps to get them in with docs, rather than kicking back to the doc directly. Their hook is that they offer reps better pricing than they get at most hospitals. Their 'salespeople' seem super slimey...super slimey.

    Trudy, I hope you and Tigrin, and all of your docs go down for this. You are all filth. Mark Howard, Jeff Coe, Paul Nottingham, are you guys still letting Trudy use you to rape the system, or have you also been raped by her? You are all good guys, and good surgeons, so I hope you managed to dissociate with her when it became obvious this scam was dirty. If you can show how your affiliation with Implantium and Spine Network have saved anyone, anywhere a single dime, I would be shocked.

    It has been a long time since I had to deal with any of this, and reading this has conjured-up some horrible memories. Glad to see Trudy go down, she is a pompous hag, and Tigrin is a pushy weasel.

    This whole industry is just pathetic.

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    1. Are Coe et al complicit? Seems like they are, but you state hopefully not here. Just wanting some clarification. Thanks.

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    2. 11:19, dude you hit it right on the head. While with Spine Tech I used to have to deal with the same shit form them both. Remember the annual mtg she used to have in Vegas? What a joke that was. Lets not forget about the surgeons up in Reno also that made $$ off this scam as well!!!

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  24. Has anyone heard of John Hoffman and his "implant companies?"

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  25. I don't know if any of the doc's are complicit. Not sure if they are still involved with Trudy, or how the business was/is structured. I don't want to accuse anyone since I am uncertain of the details, but I am pretty sure these guys have worked through/with Trudy in the past. Knowing Trudy, and having dealt with her in the past, I could see her burning the doc's that put her in business.

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  26. I billed with a similar company, STRATEGIC INSURANCE...after jumping over a few hurdles they paid up...list price.

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  27. Interesting that Coe disclosures stock ownership in Implantium and is on the Board of Directors in NASS disclosures.

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  28. Anybody know the outcome of the arraignments?

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  29. An arraignment is simply the time when you show up in court (usually with representation) and have the judge read your charges to you. 9.9 time out of 10 you give the plea of "Not Guilty" even if you plan to admit guilt at a later point. It is the first official step in bringing the case to the defendant and starting the legal process.

    The lawyers will then posture with the judge over the charges in order to see what actually sticks and is frivelous.

    Then we start to get the fireworks when the lawyers square off and start asking for records and documents and emails and texts and everything behind about 20 feet of your keister hole.

    Then it will get even better as each side will get to depose each other which is simply an expensive debate which allows for a lot of finger pointing, spitting, anger management failure and poor clothing choices.

    If they don't come to a settlement during this fight, it will be offered to mediation or potentially arbitration, where everyone involved gets finger banged financially and goes home with a gaping wound in the hind quarters smoking a Marlboro red.

    If that does not work out, then it is off to court they go...lucky for us, that would all be public info.

    In the end, only lawyers wins here.

    To my knowledge, this is still America and I believe, as we all should, that a defendant is innocent until proven guilty. So to all of you prior emailers before me who felt that fingering a group or person just because you did not like them, please keep in mind that this is not 1930's Germany. I get that you don't like some of these folks, but if you were a real sales person, you would be out selling and making money not whining on the Spine Blogger about your losses and failures and unimportant opinions...GET BACK TO WORK.

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    1. With all due respect, your post seems to mix criminal and civil procedure up. In CA there are no depositions in criminal matters. Mediation and arbitration are used in civil matters, not criminal matters. There are settlement conferences in criminal courts. But generally the broad strokes of the post are correct.

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  30. For a guy who just made a 7 paragraph post to tell other people to get back to work is hilarious.

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  31. I'll second that. Hey, doc your degree is in medicine and not the law. You sound like the idiots that rant about slander on this blog, BTW it's not slander it would be libel, if it was that. As for calling out the people on this blog, look at who is calling the kettle black, now go back to work and implant some more hardware so you can continue to scam the system.

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  32. Schadenfreude....is pleasure derived from the misfortunes of others.

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  33. Actually its called Maurerfreude

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  34. I am now retired and no longer in the industry. I don't have to work any more. And I was never a doctor...Call my kettle black, but it is full of $$$

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  35. Dr Kenneth Light insisted that "Implantium" Spinal Implants be used on his patients, and refused to use Hospital supplied Spinal Implants! Sounds like a "Conflict of Interest " to me!!!Especially since he is the Principal of "Implantium"!

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  36. Anyone know how Light has been able to avoid being charged?!?! It seems as if he orchestrated this whole thing from the get go being the Principal!
    He consults with 30-50 patients on each Office Day according to a reliable source! One would think he doesn't need the money to the degree of risking his entire career and reputation?????

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    1. My friends and acquaintances tell me Light spends 30+/- minutes on the first visit and a few have spent upwards of an hour with him. Followup ortho visits are typically 5-8 minutes unless there are complications. So a doc working a 10 hour day can easily see 30-50 patient visits.

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  37. Who does UCSF use for their implant source? I've heard that they'll suggest alternate surgeries over Multiple Disk, even if the patient is a candidate. It supposedly is rooted in "politics" with their implant source? Even though the FDA hasn't approved Multiple Disk in the US, it's ultimately up to the Surgeon to make the call...that's why Light can do Multiples. So UCSF...what's really up with YOUR politics? It's inexcusable that UCSF would tell someone they have to have Fusion, which carry many long term and permanent complications vs doing a Multiple on a qualified patient! Any insight out there?

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