Orthopedic Surgeon Files Lawsuit Citing Forced Referrals

06 Feb, 2020 F.J. Thomas


Orlando, FL (WorkersCompensation.com) – A Florida-based orthopedic surgeon has filed a lawsuit against Orlando Health and three of its affiliates citing alleged violations of the Stark Law, according to a report from the Orlando Sentinel. The Stark Law prohibits physicians from referring patients to receive designated health services payable by Medicare or Medicaid from facilities with which the physician or an immediate family member has a financial relationship.

Ayman Daouk, MD filed the complaint against Orlando Health, Physician Associates, Orlando Health Physician Group and Orlando Health Imaging Centers in May of last year citing allegations of the False Claims Act and retaliatory actions that violated the Whistleblower’s Act. Douk’s complaint claimed that the health organization’s policy of self-referrals not only violated the Stark Law, but also impeded patient’s freedom of choice.

Orlando Health bought out Physician Associates in 2012 where Daouk had been employed since 2009. After the purchase, physicians were only encouraged to refer more patients to Orlando Health entities, but it wasn’t until 2014 did Orlando health make the internal referrals a mandate, according to the factual allegations in the lawsuit.

In 2014, fellow physician Lori Grant, MD a podiatrist at Physician Associates, and Daouk both received formal emails from the COO stating, “The Board has asked me to remind you that you are an employee of an Orlando Health owned company, and therefore should show some loyalty.” The email went on to question why both physicians had referred patients to non-affiliated Florida Hospital, as well as other imaging services.

In November of the same year, both physicians received notification from Physician Associates that their privileges with Florida Hospital had been terminated, and that if they wanted to pursue privileges at the facility, they would have to credential themselves and provide their own liability and malpractice coverage.

In 2017 and 2018, the lawsuit states, Daouk attempted to refer more patients to Orlando Health Imaging Centers to comply with the policy and accommodate the location of patients. However, according Daouk, the imaging centers had significant issues with scheduling, answering phone calls, patient wait times, as well as access issue on their imaging portal where providers pulled up scans.

In May 2018, Daouk was voted off of Physician Associates Board citing a requirement that at least one board member had to be a specialist. Several months later, Daouk was let go from Physician’s Associates but told he could continue to work for Orlando Health Physician Group, contingent on referring his surgeries to Dr. Phillips Hospital which had been purchased by Orlando Health. Shortly after, Daouk was terminated citing his continuation of performing surgeries at Florida Hospital.

According to the Orlando Sentinel report, the Justice Department declined to involve themselves in the case leaving Daouk to pursue the issue on his own. The attorney for Daouk did not issue a statement. Additionally, Orlando Health’s position is that they do not comment on pending litigation.


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    About The Author

    • F.J. Thomas

      F.J. Thomas has worked in healthcare business for more than fifteen years in Tennessee. Her experience as a contract appeals analyst has given her an intimate grasp of the inner workings of both the provider and insurance world. Knowing first hand that the industry is constantly changing, she strives to find resources and information you can use.

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