The two largest not-for-profit health care organizations in Washington state — MultiCare and Providence — have both reached settlement agreements in two class-action lawsuits after a neurosurgeon purportedly conducted unnecessary or improper spine surgeries to increase profits over the course of several years.
In total, a sum of $155.5 million will be paid to more than 2,000 members of each class-action lawsuit. Previously, Providence and MultiCare paid a little more than $27.6 million combined for false claims made to Medicare, Medicaid, and other federal healthcare programs during Dr. Jason Dreyer's time as a neurosurgeon at each respective organization.
William Gilbert, the lawyer representing the patients, said not all of the 2,000 or so members of the class-action lawsuits were victims of unnecessary or excessive surgeries. The majority of them were "more likely than not, necessary and appropriate."
"If you look back at the history of this case, there's multiple cases," Gilbert said. "So they (the government) settled a false claims act case with MultiCare. They settled a false claims act case with Dreyer. They settled a false claims act case with Providence. We came in to protect the individual patients because the false claims act cases do not protect the patients. It's just the government getting their money back."
Gilbert said that if someone was treated by Dreyer, they would get $2,000 in the settlement. In order to receive more compensation, a person's surgery would have to be determined to be "unnecessary, excessive, or otherwise substandard."
While the settlements still have to be finalized, Gilbert is hopeful that will happen sometime after January 1.
"It is the first step in the last chapter of a very complex and very protracted litigation that was hard fought," Gilbert said. "We're happy and my clients appreciate that these medical providers, Providence and MultiCare, have taken it seriously at this point and responded the way they've responded."
But the first chapter of this story goes all the way back to July 2013 when Dreyer was hired to work at Providence's St. Mary Medical Center in Walla Walla.
While working there, Dreyer and another neurosurgeon, Dr. Daniel Elskens, were encouraged by Providence "to conduct spine surgeries at high-volume rates by applying a productivity bonus metric scheme that provided the surgeons financial incentive to perform a high volume of surgical procedures of greater complexity," according to the 175-page complaint filed on behalf of patients involved in the class-action lawsuit.
Because of the frequency and volume of Dreyer's surgeries, he became the highest paid neurosurgeon across all 51 of Providence's hospitals, earning between $2.5 million and $3.1 million a year, according to court records.
At one point, he was the second highest paid employee in all of Providence, behind only the CEO.
In May 2018, according to the U.S. Attorney's Office, Dreyer was placed on administrative leave because of concerns raised by medical staff.
He resigned from Providence months later in November 2018. Providence later disclosed that they "did not report Dr. Dreyer to the National Practitioner Data Bank (NPBD) or the Washington State Department of Health," according to court documents.
Elskens, meanwhile, was allowed to resign in 2017 without being reported to the National Practitioner Data Bank. He later found employment in Ohio .
"As a high-reliability organization, we recognize the importance of continuous improvement," a provided statement from Providence said. "Throughout this process, our protocols and safeguards have been reviewed to ensure we are delivering quality care to everyone we serve."
After resigning from Providence, Dreyer found a job at MultiCare where he provided neurology services at Deaconess Hospital and MultiCare Rockwood Clinic in Spokane.
When Dreyer applied to MultiCare, he had been board-certified by the American Board of Osteopathic Surgery since 2014 and he had a license to practice medicine in the state of Washington since 2013. He was hired by MultiCare in Spokane in early 2019 and worked there until he resigned in November 2021.
During MultiCare's hiring process, according to court documents, MultiCare's Regional Administrator Mark Donaldson reached out to a Globus Medical Sales representative because they were aware, to a degree, of Dreyer having issues surrounding his departure from Providence St. Mary's.
Donaldson emailed Dr. John Demakas, MultiCare's Medical Director for Surgical Services, about the meeting with the Globus sales representative. Donaldson told Demakas in that email that the sales representative "spoke very highly of Dr. Dreyer and said he has been exonerated of the issues in Walla Walla," according to court documents.
Donaldson testified that he knew the Globus sales representative wanted to keep Dreyer's business if he was hired by MultiCare and "therefore he took with a grain of salt what he was told, which included that the allegations were unfounded" and that Dreyer was "a high producer."
The hiring committee did not conduct any inquiry with Providence in regards to the "issues" that Dreyer had supposedly been exonerated of, according to court documents.
Dr. Antoine Tohmeh, another spine surgeon for MultiCare who was not a part of the hiring process, called Dr. David Yam, who was then the former Providence St. Mary Medical Director of Neurosurgery, to ask about his work with Dreyer. Yam told Tohmeh "nothing good" about Dreyer and informed Tohmeh that he "had questioned Dr. Dreyer's medical indications for surgery."
In November 2017, Yam reported concerns about Dreyer conducting medically unnecessary, overly complex, or otherwise improper procedures "with the intent of increasing his productivity" to the Providence administration. Months later, in April 2018, Yam reported him again.
Tohmeh also knew during the hiring process that Dreyer had been put on administrative leave while employed at Providence St. Mary and Dreyer hadn't performed a surgery in approximately a year "due to concerns that had arisen while he was employed."
Court documents state that Tohmeh told Demakas all of this before Dreyer was hired. In response, Demakas told Tohmeh that they would have to "reign him (Dreyer) in."
"Based on his conversations with Dr. Demkas, it was Dr. Tohmeh's understanding that Dr. Demakas, as one of three members of Defendant MultiCare's hiring and selection committee for the neurosurgeon position, understood there was a problem with Dr. Dreyer but that Dr. Demakas thought he could control it," according to court documents.
Donaldson, who was another member of the hiring and selection committee for the neurosurgeon position, became aware of Dreyer's "aggressiveness and surgical selection." He even noted in an email to Demakas and MultiCare's President of Deaconess Hospital Laureen Driscoll that there were "some red flags on (Dreyer's) practice style and relationships that we need to clarify when he comes for an interview."
Despite the concerns that were raised, Dreyer signed an employment agreement with MultiCare in May 2019 and began operating in July. Within months of Dreyer beginning to operate on patients at MultiCare, two different physician assistants raised patient safety concerns. The first walked out of the operating room while Dreyer was performing surgery and the other decided to resign from MultiCare rather than deal with Dreyer again.
Once Dreyer resigned, lawsuits followed.
In April 2022, Providence agreed to pay nearly $22.7 million to resolve allegations that it fraudulently billed Medicare, Medicaid and other federal health care programs for medically unnecessary neurosurgery procedures performed by Dreyer and Elskens.
A year later, in April 2023, Dreyer settled with the federal government and agreed to pay roughly $1.2 million.
In February 2026, MultiCare Deaconess Hospital and MultiCare Rockwood Clinic in Spokane agreed to pay about $3.7 million to resolve federal and state allegations that it knowingly endangered patient safety and "falsely and fraudulently billed Medicare, Medicaid, and other federal health care programs for spinal surgery procedures performed at Deaconess between 2019 and 2021," according to a press release from the Department of Justice.
"MultiCare would later defend its hiring of Dr. Dreyer in part by claiming it repeatedly checked the NPDB's records in May 2019 and found no adverse report on Dr. Dreyer from Providence," court records said.
According to a statement from a MultiCare spokesperson, they are confident that "MultiCare would have prevailed had this case gone to trial."
It's decision to settle was "a practical business decision that allows the company to avoid the cost, uncertainty, and distraction of prolonged litigation and to focus resources on its mission of providing high-quality care to its patients."
MultiCare is committed to maintaining professional standards and supporting a culture focused on patient safety, quality, and accountability, the statement read. Similarly, a statement from Providence said the settlement allows them to remain focused on the patients and communities they serve and "avoids the significant cost and ongoing disruption of prolonged litigation."
"This process has triggered change in both of these institutions," said Gilbert, the lawyer for the patients. "Both of these medical institutions, Providence and MultiCare, have made changes to make sure that in the future this kind of thing doesn't happen again."
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