California physician, practice to pay $11.4M fraud settlement: 5 details

Sacramento, Calif.-based Lags Spine & Sports Center along with its owner and medical director will pay millions of dollars to resolve false claims allegations, according to a Justice Department news release.

Five details:

1. Francis Lagattuta, MD, the owner and medical director of Lags Medical, was accused of performing medically unnecessary skin biopsies from 2016 to 2021 and medically unnecessary spinal cord stimulator implants from 2018 to 2021.

2. Dr. Lagattuta admitted to creating an "artificial intelligence team" of non-provider staff who had to order at least 150 skin biopsies per week without the consent of the patients' providers at Lags Medical, and each biopsy had to state the patient had small fiber neuropathy symptoms, which wasn't generally consistent with the patients' actual symptoms. Patients were told their opioid medication would be reduced if they refused the skin biopsy, according to the release.

3. The report also revealed Dr. Lagattuta paid a psychiatrist to tell Medicare and Medicaid that psychological evaluations were performed on patients before receiving spinal cord stimulators and the patients didn't have pre-existing psychological or active substance abuse disorder. The in-person evaluations never occurred and there were indications many patients did have potential psychological or substance abuse disorders.

4. Lags Medical and Dr. Lagattuta also allegedly performed medically unnecessary definitive urine drug testing. Blanket drug testing for patients was ordered every four months using The code G0483. Medicare does not cover blanket urine drug testing orders.

5. Dr. Lagattuta and his practice agreed to pay $11.4 million to resolve the allegations. Dr. Lagattuta also agreed to five years of voluntary exclusion from federal healthcare programs.

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