Baylor, others paying $15M over DOJ allegations they ‘gambled’ with heart patient health
Multiple Texas healthcare providers have agreed to pay $15 million to resolve claims they ran two operating rooms at once, using “unqualified medical residents” to perform significant parts of “extremely complicated and risky heart surgeries.” These alleged actions were direction violations of Medicare policies.
According to a statement from the U.S. Department of Justice (DOJ), Baylor St. Luke’s Medical Center (BSLCM), Baylor College of Medicine (BCM) and Surgical Associates of Texas P.A. (SAT) allegedly violated these policies from 2013 to 2020. Three surgeons at the heart of the DOJ’s investigation were Joseph Coselli, MD, Joseph Lamelas, MD, and David Ott, MD.
Medicare regulations are clear about when teaching physicians can and cannot leave the operating room during operations. The individuals in question repeatedly went against these regulations, according to a whistleblower complaint.
One common violation involved heart surgeons operating multiple operating rooms at once, with teaching physicians moving from one to the other. As a result, surgeons would allegedly miss out on critical “timeout” gatherings designed to help trainees by highlighting potential risks. In addition, heart surgeons from these groups were accused of entering other procedures without being clear about who the backup surgeon would be if needed. According to the whistleblower complaint, the surgeons sometimes covered up these actions by providing false information on medical records. Also, patients were allegedly never told that their surgeon was going to be leaving the room to tend to other patients.
These are allegations only, the DOJ emphasized, and there has been "no determination of liability."
“The complete disregard for patient safety exhibited by these three doctors put patients at risk and violated Medicare regulations for their own convenience and greed,” Special Agent in Charge Jason E. Meadows of the Department of Health and Human Services Office of Inspector General said in a prepared statement. “This record settlement demonstrates our steadfast commitment to protecting Medicare beneficiaries and working with our law enforcement partners to utilize all the tools in our arsenal to hold accountable those who steal from Medicare and other federal healthcare programs.”
“Any time any one of us goes under the knife as a vulnerable patient, we implicitly trust that the surgeons and medical professionals have our best interest at heart, especially here in Houston’s world-renowned hospitals,” added Special Agent in Charge Douglas Williams of the FBI’s Houston field office. “In this case, doctors gambled with their patients’ care, during complicated open-heart surgeries no less, compromising quality of care over quantity and then falsely billed Medicare for reimbursement of services they improperly delegated. We hope today’s civil settlement announcement represents accountability for doctors and hospitals everywhere.”
The $15 million payment represents a record of sorts. It is largest amount to date recovered by the U.S. government in a case involving concurrent surgeries. The whistleblower who filed the original complaint will receive more than $3 million, per DOJ policies.
Michael has more than 16 years of experience as a professional writer and editor. He has written at length about cardiology, radiology, artificial intelligence and other key healthcare topics.