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Texasmedical center institutions agree to pay $15M record settlementinvolving concurrent billing claims for critical surgeriesMonday, June 24, 2024HOUSTON– Baylor St. Luke’s Medical Center (BSLMC), Baylor College of Medicine(BCM) and Surgical Associates of Texas P.A. (SAT) have jointly agreed topay $15 million to resolve claims they billed for concurrent heartsurgeries in violation of Medicare teaching physician and informedconsent regulations, announced U.S. Attorney Alamdar S. Hamdani. BSLMC is a joint venture between CommonSpirit Health, a nationalhospital chain, and BCM, a medical school in Houston.BSLMC operates ateaching hospital, formerly known as St. Luke’s Episcopal Hospital, inits Medical Center.BCM employs teaching physicians and residents whoperform services at BSLMC, including Dr. Joseph Coselli, 71, Houston,and Dr. Joseph Lamelas, 63, Miami, Florida.SAT is a medical practicegroup affiliated with various cardiothoracic surgeons, including Dr.David Ott, 77, Houston.The investigation began Aug. 7, 2019, upon the filing of a sealed quitam lawsuit aka whistleblower complaint.The whistleblower allegedCoselli, Lamelas and Ott - three heart surgeons who performed at St.Luke’s - engaged in a regular practice of running two operating rooms atonce and delegating key aspects of extremely complicated and riskyheart surgeries to unqualified medical residents.The heart surgeries atissue are some of the most complicated operations performed at anyhospital including coronary artery bypass grafts, valve repairs andaortic repair procedures.These surgeries typically involve opening apatients’ chest and placing the patient on the bypass machine for someportion of time. 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 3, 2013, to Dec.21, 2020, Ott, Coselli and Lamelas violated these rules in variousrespects. Surgeons often ran two operating rooms at once and failed toattend the surgical “timeout”— a critical moment where the entire teamwould pause and identify key risks to prevent surgical errors, accordingto the allegations.Additionally, surgeons would allegedly enter a second or occasionallya third operation without designating a backup surgeon. At times, thesurgeons allegedly hid these activities by falsely attesting on medicalrecords they were physically present for the “entire” operation. Inaddition, medical staff did not inform patients the surgeon would beleaving the room to perform another operation.“Patients entrusted these surgeons with their lives - submitting tooperations where one missed cut is the difference between life anddeath,” said Hamdani. “Allegedly, the patients were unaware their doctorwas leaving for another operating room. This settlement reaffirms theimportance of Medicare requirements governing surgeon presence andensuring that no physician - no matter how prominent or successful - canskirt around the rules.”“The complete disregard for patient safety exhibited by these threedoctors put patients at risk and violated Medicare regulations for theirown convenience and greed,” said Special Agent in Charge Jason E.Meadows of the Department of Health and Human Services Office ofInspector General (HHS-OIG). “This record settlement demonstrates oursteadfast commitment to protecting Medicare beneficiaries and workingwith our law enforcement partners to utilize all the tools in ourarsenal to hold accountable those who steal from Medicare and otherfederal health care programs.”“Any time any one of us goes under the knife as a vulnerable patient,we implicitly trust that the surgeons and medical professionals haveour best interest at heart, especially here in Houston’s world-renownedhospitals,” said Special Agent in Charge Douglas Williams of the FBI -Houston field office. “In this case, doctors gambled with theirpatients’ care, during complicated open-heart surgeries no less,compromising quality of care over quantity and then falsely billedMedicare for reimbursement of services they improperly delegated. Wehope today’s civil settlement announcement represents accountability fordoctors and hospitals everywhere.”The $15 million recovery is the largest settlement to date involving concurrent surgeries.The False Claims Act entitles the private whistleblower who commencesthe suit to a portion of the recovery.In this case, the whistleblowerwill receive $3,075,000.The U.S. Attorney’s Office, DHHS-OIG and FBI conducted theinvestigation.Assistant U.S. Attorneys Brad Gray and Andrew Bobb arehandling the case.The claims resolved by the settlement are allegations only and there has been no determination of liability.