SIOUX FALLS, S.D. — Uncle Sam is back on the trail of Dr. Wilson Asfora.

The U.S. Justice Department is suing the former Sanford Health neurosurgeon and two companies he owns in South Dakota, claiming he performed medically unnecessary surgeries and funneled kickbacks to himself for implanting his companies' medical devices in his patients.

Sanford Health, which was previously named alongside Asfora in the matter, fired Asfora in late September and reached a $20.25 million settlement with prosecutors late last month that removed it from the suit and included its promise to cooperate with prosecutors with information about Asfora and his companies.

In its complaint filed Wednesday, Nov. 13, the Justice Department claims Asfora and two companies he owned and operated, Medical Designs LLC and Sicage LLC, set up multiple kickback schemes created to net Asfora hundreds of thousands of dollars in exchange for Asfora using devices from the two companies in spine surgeries he conducted.

Kickbacks, 'consulting fees' and a $800 bounty

Asfora received multiple warnings he was performing medically unnecessary surgeries implanting the devices in which he had a financial interest, but he continued to perform the procedure anyway, the complaint states.

Asfora not only got illegal kickbacks, he specifically created Sicage LLC to process kickbacks for surgeries he conducted at Sioux Falls Specialty Hospital, prosecutors claim.

Asfora also encouraged other surgeons to use products provided through his companies, and in one case offered a surgeon $800 cash for each device he used, an offer the surgeon declined and said didn't sound legal or proper, according to the complaint.

In the complaint, prosecutors allege Asfora disguised kickbacks as consulting fees, paid out to fellow surgeons who used his devices in their surgeries.

Asfora marked as high-risk doctor

The suit also documented numerous complaints by patients against Asfora of unnecessary and sometimes sloppy surgeries. In one case, Asfora's procedures paralyzed a patient, while others harmed patients through unnecessary spinal fusions, according to the suit.

While Asfora regularly misled Sanford Health about his relationship with the companies providing the devices he was using, the surgeon was for years marked as one of the highest-risk physicians in Sanford and nationwide, the complaint states.

"As Asfora expanded his use of products in which he had a financial interest, patient complaints about him soared, putting him in the riskiest category measured by" national patient risk assessment data, the complaint stated.

Prosecutors filed the suit in federal court in South Dakota under the whistleblower provisions of the False Claims Act. Two fellow Sanford surgeons initially brought the case against Asfora before the government stepped in to litigate the case, as allowed under the law.

“The Department of Justice will seek to hold accountable physicians and medical device companies that receive or pay illegal kickbacks in any form,” said Assistant Attorney General Jody Hunt of the Department of Justice’s Civil Division, in a news release. “Improper inducements have no place in our federal healthcare system where medical decisions should be based on the healthcare needs of patients and not on a physician’s personal financial interest.”