Baylor St. Luke’s Medical Center, Baylor College of Medicine (BCM), and Surgical Associates of Texas PA haveagreed to pay $15 million to resolve claims that three heart surgeons falsely billed Medicare for cardiac procedures in which they were only partially present because tghey had doublebooked surgeries. Double booking of surgeies is not an uncommon practice.
Other hospitals have faced federal investigations for double-booking practices in recent years, but none have paid as much as Baylor to settle the allegations.
In a case at The Massachusetts General Hospital in Boston in 2022, anesthesiologist Lisa Wollman, MD, alleged that five orthopedic surgeons there often kept patients under anesthesia longer than medically necessary because the doctors were working in two operating rooms. According to Wollman’s attorneys, said she repeatedly witnessed and complained about the practice from 2010 to 2015 to no avail. She ended up leaving MGH and filing the suit.This was the third time since 2019 that MGH had to settle allegations that it had double-booked. In theMGH case, the hospital paid $14.6 million.
In 2023, the University of Pittsburgh Medical Center (UPMC) and James Luketich, MD, agreed to pay $8.5 million to settle claims similar to those in the Baylor case. Jonathan D’Cunha, MD, former vice chair of cardiothoracic surgery at UPMC, alleged that Luketich, the longtime chair of UPMC’s Cardiothoracic Surgery Department, regularly performed as many as three complex procedures simultaneously, failed to participate in all the “key and critical” portions of his surgeries, and “forced his patients to endure hours of medically unnecessary anesthesia time as he moved between operating rooms.”
The settlement at Baylor is the culmination of a whistleblower suit that was brought in 2019. It is the largest ever for a complaint involving concurrent surgeries, according to the US Attorney’s Office for the Southern District of Texas. The whistleblower will receive $3,075,000.
According to the whistleblower’s allegations, the surgeons often entered a second or third operation without designating a backup surgeon. They also allegedly falsely attested on medical records that they were physically present for the “entire” operation, and medical staff did not inform patients that the surgeon would be leaving the room to perform another operation.
That violates Medicare’s teaching physician and informed consent regulations, US Attorney Alamdar S. Hamdani said in the statement.
Jeffrey Newman is a whistleblower lawyer, whose firm represents whistleblowers in healthcare fraud cases under the False Claims Act (FCA) and also under the Securities and Exchange, FINCEN and CFTC whistleblower programs. He can be reached at Jeff@JeffNewmanLaw.com or at 617-823-3217
