Texas Medical Center entities to pay $15m to settle concurrent surgery claims

Three Texas Medical Center Institutions have agreed to pay $15 million to resolve claims that they billed for concurrent heart surgeries in violation of Medicare teaching physician and informed consent regulations.

Baylor College of Medicine (‘BCM’) , Surgical Associates of Texas PA and Baylor St Luke’s Medical Center (‘BSLMC’) are the entities involved. BSLMC is a joint venture between CommonSpirit Health and BSM. It operates a teaching hospital, formerly known as St. Luke’s Episcopal Hospital, in Houston.

The investigation began in Aug 2019, following a whistleblower complaint. Three heart surgeons, who performed at St. Luke’s, were alleged to be running two operating rooms at once. They delegated key aspects of the surgery to unqualified medical residents. This included coronary artery bypass grafts, valve repairs and aortic repair procedures.

Medicare regulations dictate when teaching physicians can leave the operating room for any operation, no matter how complex.

The settlement resolves allegations that from June 2013 to Dec 2020, the three surgeons violated these rules in various respects. Surgeons often ran two operating rooms at once and failed to attend the surgical “timeout”. This is a critical moment where the entire team would pause and identify key risks to prevent surgical errors, according to the allegations.

Additionally, surgeons would allegedly enter a second or occasionally a third operation without designating a backup surgeon. At times, the surgeons allegedly hid these activities by falsely attesting on medical records they were physically present for the entire operation.

In addition, medical staff did not inform patients the surgeon would be leaving the room to perform another operation.

The whistleblower will receive $3,075,000 under the provisions of the False Claims Act.


Sign up for my newsletter

Leave a Reply

Your email address will not be published. Required fields are marked *