A significant medical settlement has emerged from Baylor St. Luke’s Medical Center in Houston, Texas, where three heart surgeons have agreed to pay $15 million to resolve allegations of misleading Medicare billing practices. The surgeons were accused of claiming reimbursement for cardiac procedures in which they were only partially present, effectively putting patient safety at risk. This settlement marks one of the largest resolutions concerning concurrent surgeries, as reported by the U.S. Attorney’s Office for the Southern District of Texas.
The allegations stemmed from a whistleblower lawsuit filed in 2019, which has now culminated in this record settlement. As part of the resolution, the whistleblower will receive a payment of $3,075,000 for their role in bringing the misconduct to light.
Statements from federal officials highlight the severity of the violations, with Jason E. Meadows, Special Agent in Charge of the Department of Health and Human Services Office of Inspector General, asserting that the actions of the surgeons demonstrated a blatant disregard for patient safety. The investigation revealed that the doctors, during complex operations such as coronary artery bypass grafts and aortic valve repairs, often managed multiple surgeries at the same time. This practice not only contravenes Medicare regulations but also compromises the quality of care provided to patients.
Investigators found that the surgeons frequently entered additional operations without properly designating a backup surgeon. They are accused of falsely documenting in medical records that they were present for the entirety of the procedures.