Baylor St. Luke’s Medical Center, along with Baylor College of Medicine and Surgical Associates of Texas PA, has agreed to a $15 million settlement to resolve allegations of improper Medicare billing practices involving concurrent surgeries performed by three heart surgeons in Houston. This settlement marks the largest ever in the United States related to claims of concurrent surgeries, according to the U.S. Attorney’s Office for the Southern District of Texas.
The agreement comes as a result of a whistleblower lawsuit initiated in 2019 and includes a payment of $3,075,000 to the whistleblower. Federal authorities alleged that the three surgeons—who are not named—often operated two rooms simultaneously without the appropriate oversight, exposing patients to unnecessary risks and violating Medicare regulations.
Special Agent in Charge Jason E. Meadows of the Department of Health and Human Services Office of Inspector General criticized the actions of the surgeons, stating, “The complete disregard for patient safety exhibited by these three doctors put patients at risk.” In a similar condemnation, Douglas Williams of the FBI’s Houston field office remarked that the doctors’ decisions compromised the quality of patient care during intricate surgeries, while they falsely billed Medicare for services they improperly delegated.
Allegations from the whistleblower claimed that the surgeons frequently did not attend critical surgical “timeouts,” moments where the surgical team pauses to identify key risks and prevent errors. Procedures in question included coronary artery bypass grafts and various valve repairs.