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Baylor St. Luke’s Medical Center, Baylor College of Medicine and medical practice group Surgical Associates of Texas P.A. have agreed to pay a record $15 million settlement.
A federal investigation determined three Houston surgeons are responsible for leaving multiple complicated heart surgery procedures to unqualified medical residents in order to perform simultaneous operations, according to the U.S. Attorney’s Office.
Surgeons Joseph Coselli, Joseph Lamelas and David Ott are accused of violating Medicare regulations by running multiple operating rooms at once and delegating critical moments in advanced heart surgeries to unqualified residents.
The renowned surgeons failed to designate backup surgeons during the concurrent operations and lied on medical records by falsely stating they were present for the entirety of the procedures, according to the attorney’s office. An investigation was launched after a whistleblower complaint in 2019.
From 2013 to 2020, Coselli, Lamelas and Ott allegedly submitted false claims to Medicare for reimbursement for heart surgeries. On some occasions, they were overseeing three operations at once without the knowledge of the patients, according to court documents.
Baylor St. Luke’s Medical Center, Baylor College of Medicine and medical practice group Surgical Associates of Texas P.A. have agreed to pay a record $15 million settlement. The whistleblower is set to receive more than $3 million. The settlement is the largest involving concurrent surgeries to date, according to the attorney’s office.
“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,” Special Agent Douglas Williams of the Federal Bureau of Investigation Houston field office said in a press release.
“In this case, doctors gambled with their patients’ care, during complicated open-heart surgeries no less, comprising quality of care over quantity and then falsely billed Medicare for reimbursement of services they improperly delegated,” he said.
In a statement, Robert Corrigan, general counsel for Baylor College of Medicine claimed no patients were harmed and no federal laws or regulations were violated by the surgeons’ actions.
“The settlement agreement acknowledged that BCM disputed that any violations of federal law occurred and that the college being a party to the agreement is not an admission of liability by Baylor,” according to the statement. “The college decided to amicably resolve the dispute prior to a trial on the merits after considering the cost and expense incurred by Baylor to date, and anticipated future costs and expenses, including attorneys’ fees.”
The claims resolved by the settlement are allegations and there has been no determination of liability, according to the attorney’s office.
Baylor St. Luke’s Medical Center described the settlement as an agreement with the Department of Justice “to resolve documentation and billing matter involving compliance and billing requirements set forth by the Centers for Medicare and Medicaid Services.”
“The DOJ claims are strictly allegations and the settlement by Baylor St. Luke’s is not an admission of liability,” according to the medical center. “Baylor St. Luke’s remains committed to complying with all CMS regulations.”
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