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Lap-Band Surgery Centers Accused of Insurance Fraud

Please note, The Senators (Ret.) Firm, LLP is no longer accepting Lap Band claims. If you feel that you may have a potential case, we urge you to locate another law firm adequately suited to handle your claim.

Lap-Band surgery centers affiliated with the 1-800-GET-THIN advertising campaign have received a significant amount of criticism in recent months. The corresponding firms have allegedly used fraudulent advertising practices to market their products. However, recent weeks have witnessed an entirely new set of accusations leveled at the participating companies. Compounding their already ambiguous situation even further, are claims that suggest the surgical centers participated in insurance fraud.

Due to the recent allegations brought against the Lap-Band surgery centers, the California Department of Insurance, in association with Aetna Inc., has begun to investigate current business practices of the accused firms. Aetna, a leader in the insurance industry, acknowledged that they are currently cooperating with the department’s law enforcement branch so that they may make appropriate arrests and pursue criminal charges, to “investigate alleged fraud against their members by the 1-800-GET-THIN … surgery centers.”

However, representatives from the accused surgery centers were surprised by the current allegations and firmly believe that they have not broken any laws. “1-800-GET-THIN has never engaged in any type of insurance fraud and has not been contacted by the Department of Insurance,” the marketing firm’s president, Robert Silverman, said in an email. Further substantiating their defense, are attorneys who reminded officials that their clients’ “ medical facilities have been repeatedly inspected and reviewed and no wrongdoing has ever been found.”

Contradictory to the negligence exhibited by the accused firms, are the opinions of the California Department of Insurance. The California Department of Insurance, along with Aetna, have reason to believe that the firms are inflating the prices of surgical procedures to receive larger monetary gains. According to Lap-Band developers, surgical procedures for such a device usually cost approximately $12,000 to $20,000. However, a subsequent Lap-Band lawsuit acknowledged that the surgery centers may have inflated costs. According to court documents, one patient claims to have been charged, in upwards of, $179,000.

The Department of Insurance has deployed a team of investigators who are currently looking into the alleged insurance fraud. If the investigation finds criminal activity, the agency will ask prosecutors to consider filing criminal charges.

The recent insurance fraud accusations leveled against the surgical centers have compounded an already ambiguous situation. Amidst the insurance fraud investigation, are several civil cases that allege that workers at the surgery centers encouraged patients to have “medically unnecessary” surgeries and billed insurers for procedures that were not performed. According to the same lawsuit, the surgery centers allegedly operated in consistently unsanitary conditions. Court documents mention situations in which equipment did not receive the proper sterilization.

However, the most significant allegations still remain. The same lawsuit acknowledging the unsanitary conditions and unnecessary surgeries suggests that the same companies covered up circumstances behind the death of a patient. According to the lawsuit, medical staff forgot to turn on the oxygen before Rojeski’s surgery and a tube that was supposed to fill her bloodstream with medication became dislodged during surgery, causing the solution to pool on the floor.

Due to the influx of adverse reports leveled at 1-800-GET-THIN and corresponding surgical centers, the U.S. Food and Drug Administration (FDA) intervened. Last month, the FDA issued a warning letter to 1-800-GET-THIN that accused the firm of failing to adequately disclose risks of the surgery. Subsequently, three members of Congress are calling for hearings on the advertising campaign and the safety and effectiveness of the Lap-Band device.

Do I Have a Lap-Band Lawsuit?

The trial lawyers at The Senators (Ret.) Firm, LLP have decades of experience navigating through complex legislative and regulatory issues and litigating high stakes cases all over the nation. Our law firm focuses on the representation of plaintiffs in Lap-Band lawsuits. We are currently accepting new cases in all 50 states.

If you or a loved one has been injured by a Lap-Band medical device or procedure, you may be entitled to financial compensation. For a free case review, please click the link below or call toll free 24 hrs/day 1-800-773-0849.

Categories: Product Liability
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